Muscle-derived cell injection to treat anal incontinence due to obstetric trauma: pilot study with 1 year follow-up.

Abstract

To treat anal incontinence due to obstetric external anal sphincter disruption via injection of autologous myoblast cells. Observational pilot study. University hospital and district hospital 10 women suffering from anal incontinence due to obstetric anal sphincter injury, refractory to conventional non-surgical therapy. Autologous myoblasts were cultured from a pectoralis muscle biopsy, harvested, and injected into the external anal sphincter defect using direct ultrasound guidance. Wexner incontinence score, anal squeeze pressures, and quality of life 12 months after injection. Safety and technical feasibility. 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). Injection of autologous myoblasts is safe, well tolerated, and significantly improves symptoms of anal incontinence due to obstetric anal sphincter trauma.