Weve all heard of the ostrich that hid its head in the sand when ever a natural enemy approached. I am not certain that the analogy necessarily applies completely, but its close to what I just read in my March 2007 issue of The American Journal of Medicine, normally clearly up on the latest regarding the state of the art in the world of medicine and affectionately known to internists as The Green Journal. However in this case they have totally ignored the most exciting research in that alleged state of the art commentary.
The article of note in that most recent issue is entitled Office Management of Geriatric Urinary Incontinence. In simple terms geriatric incontinence relates to persons past 65 who have lost their ability to control their urinary bladders; they spill urine into their underwear or beds with the slightest of provocations. A truly distressing, embarrassing and quality of life altering problem.
The clinical piece points out several pertinent statistics. Women are affected 2 to 3 times as often as men, basically due to anatomical differences in the urethra. 15% to 30% of those persons 65 years of age and older are affected; a formidable number. The cost of treating the condition in the US in the year 2000 approached a staggering $20 billion.
The treatise discussed various treatment options, citing behavioral changes, drug treatment, permanent catheter placement, reconstructive surgery, artificial sphincters and injections with bulk agents (mostly collagen). What was conspicuous by its absence was the newly reported research coming out of Austria and reported in the December 13, 2006 Issue of Internal Medicine News (Also reported in this blog on 1-7-07) that has to have all informed physicians reeling with excitement. Those researchers were profoundly successful in their treatment of this most troubling condition of urinary incontinence.
They first harvested stem cells (autologous) from the forearm muscles of 63 incontinent patients. They then cultured those stem cells and produced 50 million myoblasts (muscle cell precursors) and 50 million fibroblasts (connective tissue cell precursors). The Austrian physicians then injected the former into the region of the inefficient bladder sphincter muscles and the latter into the sub mucosal regions of the urethra. After 6 to 30 months of follow up 79% of those person so treated were entirely continent. They could pitch their Depends@ into the trash. Of those 28 patients treated in the good old American way, that is with collagen injections, only 2 (7%) were relieved of their incontinence. Because the stem cells were derived from their own bodies, rejection of the grafts was never an issue.
When are the researchers in these United States ever going to stop chasing after the money and legislation to support Embryonic Stem Cell (ESC) research when autologous stem cell transplantations have proven to be so successful? It appears that the ESC ostrich is afraid of losing his money because the big bad wolf, the autologous stem cell out of Austria, is sneaking up behind.