Cellular technologies in the treatment of urologic diseases

The use of multipotent stem cells opens new possibilities in various fields of medicine, including urology. This article provides a detailed overview of experimental and clinical studies demonstrating the efficacy of multipotent stem cells in the treatment of urologic diseases. Multipotent stem cells have been shown to reduce the severity of renal failure, improve urinary incontinence, and alleviate both organic and functional bladder disorders, ischemia–reperfusion injuries of the testes, erectile dysfunction, and penile enlargement. Moreover, they have proven effective in Peyronie disease and ischemic priapism. New tissue-engineering approaches for cystoplasty and urethral stricture repair are described, in which multipotent stem cells are adsorbed onto various graft materials before surgery. The high therapeutic efficacy of cell therapy is most likely associated with its ability to stimulate regeneration and angiogenesis, restore microcirculation and innervation, inhibit inflammation and apoptosis, and reduce tissue injury and fibrosis. Only a small fraction of implanted multipotent stem cells remain viable and differentiate into smooth muscle and endothelial cells. The primary effect of multipotent stem cells is most likely mediated by paracrine mechanisms. No severe adverse effects have been reported following the clinical application of multipotent stem cells.