Discussion
underactive, urinary urgency, urinary incontinence, hematuria, infection
DISEASE, URINARY INCONTINENCE, HEMATURIA, ADVERSE EFFECTS, INFECTION, COMPLICATIONS
DU is a disease that does not yet have an effective treatment. We demonstrated that CT with ADSCs could be used to treat this disease efficiently, as they were able to increase the maximum flow, the mean flow and volume urinated as well as reduce the residual volume in uroflowmetry exams. Furthermore, treatment with ADSCs improved the efficiency of voiding. CT was still able to increase maximal flow, maximal detrusor pressure, voided volume and BCI in the pressure flow study. This is the first report that demonstrates that ADSCs transplantation can bring these benefits to patients diagnosed with DU.Only one previous case report and one study examined the use of stem cells to treat underactive bladder. These data were produced by the same research group [The present research used adipose tissue as a source for the extraction of mesenchymal stem cells, which is an easily accessible source that has a larger pool of stem cells [Another factor in the comparison of our study with that of Gilleran [We also emphasize that our patients were followed up for 12 months and had no adverse effects or the occurrence of hematuria, urinary urgency and/or infection. Thus, we consider the therapy safe, which is consistent with Levanovich [We also suggest that the parameters obtained in the study of flow pressure, maximum flow, urinary volume, maximum detrusor pressure and BCI are important in evaluating the effects of CT. In our patients, all of these values increased in 100, 100, 88.89 and 100% of the patients, respectively, which confirms the therapeutic effect. These data are unprecedented in the literature for this type of study, and Levanovich [These quantitative results are supported by the 67.54% reduction in the ICIQ-SF score 6 months after treatment and 78.60% 12 months after treatment. This is an important, condition-specific quality of life questionnaire related to urinary incontinence [All patients maintained voiding diaries and underwent clinical follow-up with laboratory tests. No complications were reported at any time. Moreover, after 12 months of CT, 77.78% of patients no longer used intermittent clean catheterization, and 22.22% reported a reduction from five daily catheterizations to two. Biochemical tests did not indicate any change in renal function (data not shown).