PT  - JOURNAL ARTICLE
AU  - A Frudinger
AU  - D Kölle
AU  - W Schwaiger
AU  - J Pfeifer
AU  - J Paede
AU  - S Halligan
TI  - Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up
AID  - 10.1136/gut.2009.181347
DP  - 2010 Jan 01
TA  - Gut
PG  - 55--61
VI  - 59
IP  - 01
4099  - http://gut.bmj.com/content/59/01/55.short
4100  - http://gut.bmj.com/content/59/01/55.full
SO  - Gut2010 Jan 01; 59
AB  - Objective: To treat anal incontinence due to obstetric external anal sphincter disruption via injection of autologous myoblast cells.Design: Observational pilot study.Setting: University hospital and district hospitalPatients: 10 women suffering from anal incontinence due to obstetric anal sphincter injury, refractory to conventional non-surgical therapy.Interventions: Autologous myoblasts were cultured from a pectoralis muscle biopsy, harvested, and injected into the external anal sphincter defect using direct ultrasound guidance.Main outcome measures: Wexner incontinence score, anal squeeze pressures, and quality of life 12 months after injection. Safety and technical feasibility.Results: The procedure was well tolerated and no adverse events were observed. At 12 months the Wexner incontince score had decreased by a mean of 13.7 units (95% CI, −16.3 to −11.2), anal squeeze pressures were unchanged, and overall quality of life scores improved by a median of 30 points (95% CI, 25 to 42). Anal squeeze pressures did rise significantly at 1 month and 6 months post-injection (p = 0.03).Conclusions: Injection of autologous myoblasts is safe, well tolerated, and significantly improves symptoms of anal incontinence due to obstetric anal sphincter trauma.