Stem cell therapy for pelvic organ prolapse

Pelvic organ prolapse (POP) is a hidden disease – while the injury happens during childbirth, the patient will not know about the damage until many years later, often during late menopause.

The potential new stem cell treatment, which is being developed in the laboratory but is not yet ready for human clinical trials, could potentially be given to women immediately after a traumatic childbirth. It means that invasive surgery could be avoided later in life.

This treatment is based on new research led by Dr Shayanti Mukherjee and PhD student Kallyanashis Paul. It follows on from earlier research by Hudson Institute researchers led by Professor Caroline Gargett that showed endometrial stem cells had tissue healing properties.

“What is really fascinating about this work is that we can potentially use a woman’s own stem cells from her endometrium, delivered in a natural plant-based product – an aloe vera-based hydrogel – to heal the woman’s own tissue injury,” Dr Mukherjee said.

What does the latest pelvic organ prolapse research show?

The study, published in Applied Materials Today, suggests that local delivery of endometrial stem cells in an aloe vera hydrogel could reduce or eventually replace the need for pelvic floor reconstructive surgeries through early tissue repair and regeneration.

The research found that vaginal childbirth can damage tissue biomechanics, detectable at the nanoscopic level, and that this can be restored following the treatment. The study explored the hidden nature of this birth injury in preclinical models, and also validated the protective treatment delivering cells vaginally in the aloe vera-based hydrogel.

“Although birth trauma injuries occur during childbirth, its impact is often seen much later in life when women start developing symptoms such as vaginal bulge or a dragging sensation, and bladder, bowel, and sexual dysfunction,” Dr Mukherjee said.

The study’s first author Kallyanashis Paul added: “POP is a hidden pandemic for women. It significantly disrupts their quality of life. This study, which contributes to a body of research aiming to create a tissue engineering treatment for childbirth injury to avoid women developing POP, could really make a big difference to the lives of women with the condition.”

Key points

  • Pelvic organ prolapse develops when tissues, pelvic floor muscles and ligaments that support the pelvic organs (bladder, uterus and bowel), become damaged, usually in vaginal childbirth, causing organs to shift or ‘drop’ into or outside the vagina.
  • The new treatment would reverse the decline of pelvic floor function by delivering therapeutic endometrial stem cells (eMSCs) via an aloe vera hydrogel soon after childbirth to repair an injury.
  • One in four women experience pelvic floor disorders, of which one is POP.
  • Hudson Institute researchers are developing a world-first new treatment using stem cells from the endometrium to heal childbirth injury.

What is the significance of the research?

There is no reliable cure for POP. Transvaginal mesh implants have been used to treat it. However, complications and side effects have resulted in an Australian Senate inquiry into its use, resulting in a recommendation that these only be used as a last resort for POP. A number of class actions have been brought against manufacturers of the mesh implants by women who suffered debilitating complications from their use.

Collaborators | Monash University, Melbourne Centre for Nanofabrication (MCN)

Funders | International Postgraduate Research Training and Monash Graduate Scholarships, The CASS Foundation Medicine/Science Grants, CSIRO, NHMRC, Victorian Government Operational Infrastructure Support Program

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