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Women’s Incontinence

Regenerative Urology has been used to help some women with urinary leakage.
Today, new technology affords us an opportunity to use surgical stem cell technology to
heal and improve our tissues naturally which is especially important for patients who
suffer from loss of bladder control.
Early work done on female incontinence in the 1980’s and 1990’s demonstrated that
injections of a person’s own fat around the urethra may help leakage by bulking the
tissues and increasing outlet resistance for the bladder. The procedure worked well in
the short term but often the results would disappear but the end of 6-12 months
because some of the injected fat would not take and get absorbed by the body. Fat
derived stem cells can be used to enhance the transferred fat and keep most of it alive
indefinitely. Also known as “cell assisted lipo-transfer” (CAL) stem cell enhanced fat
transfer is one of the most exciting areas of cosmetic surgery today since fat is used for
many cosmetic defects around the body. When fat transfer around the urethra is applied
to urinary leakage in women with weak urethral sphincters problems, the stem cells
keep the fat alive and healthy so that the leakage can be controlled in a natural and
sustainable fashion.

The stem cell enhanced fat transfer technique seems to work best for mild stress
incontinence and women with weak urethral tissues, (also known as intrinsic sphincter
deficiency ISD) which is associated with hormonal changes and aging.
The procedure involves a mini liposuction followed by enhancement of the removed fat
with stem cells from one’s own body (also obtained from a fat sample). These are
injected together under local anesthesia (or rarely light sedation) to provide bulking
around the urethra. The process takes 1 hour and is a minor outpatient procedure.
Results can be immediate and there have been no complications on any of these
procedures we have performed.
Dr. Lander is the Co-Medical Director of California Stem Cell Treatment Center® and
the Cell Surgical Network™ which is an international research collaboration dedicated
to the investigational use of adult mesenchymal stem cells found in fat tissue.

Male Incontinence after treatment of Prostate Cancer

After radical prostatectomy surgery, most patients experience some degree of erectile
dysfunction. Even if the surgery is robotic or “nerve sparing,” there is some damage to
the cavernous nerves responsible for erection since they must be carefully “peeled” off
the prostate capsule during surgery. Most doctors tell patients that it may take 6 to 18
months to get their erections back. Many therapies exist to accelerate this including
penile “rehabilitation” (cycling with a vacuum pump) or daily Cialis. Other than that, most
patients just have to wait until the nerves “recover” on their own. It is actually your native
stem cells that are responsible for all of the healing that takes place.
The same goes for healing the bladder neck where the prostate gland was removed.
Adequate stem cells circulating in the area allows healthy and rapid healing without with
scarring, allowing successful post-surgery urinary control. Healing of the bladder neck
and the nerves responsible for erection may theoretically be accelerated by adding
large quantities of stem cells (from your own fat) immediately after surgery and early
anecdotal evidence from a small series of patients treated by Dr. Lander seems to
support this. There appears to be good reason to use stem cell therapy in the post-
operative healing period in an attempt to achieve faster healing and more rapid return to
erections and urinary control.

We focus on using adipose derived stem cells because they are younger and more
plentiful than bone marrow derived cells. A recent technological breakthrough enables
us to now use Adipose (fat) derived stem cells obtained in surgery for same day use.
These cells have the potential to repair and regenerate human tissue such as cartilage,
bone, fat, muscle, nerves and blood vessels. They also work on the immune system
and have anti-inflammatory effects.

Lichen Sclerosis

Lichen sclerosis LS is a skin condition that occurs in women, men and even children but
most frequently seen in post-menopausal women. The skin around the genitals and
anus can become thin and turn shiny and smooth. Affected skin can tear easily and
become scarred. Severe itching, changes in skin color, pain, bleeding, and blisters can
also occur. Causes of Lichen Sclerosis may be autoimmune or hormonal but the exact
cause is poorly understood. Other areas of the body can be affected but those usually
resolve without treatment. Lichen Sclerosis is not contagious. Diagnosis can be
confirmed on a skin biopsy.

Without treatment, patches on the genitals can lead to scarring and pain or become
cancerous. Lichen Sclerosis can cause scars that narrow the vagina interfering with
sexual intercourse. Treatment has traditionally involved surgical excision (not always
possible especially in women) and powerful topical steroids which can help mitigate
itching and scarring but weaken the skin. Optimization of estrogen levels is also helpful.
More advanced treatment includes retinoids (vitamin A like compounds), UV light
therapy, or Tacrolimus (immune suppressant).

Your own stem cells from fat have been used for a variety of medical of medical
treatments to repair and regenerate acute and chronically damaged tissues. A recent
technological breakthrough enables us to now use Adipose (fat) derived stem cells
(ASC’s) for the mitigation of LS. WE use them systemically and also inject them into the
involved lesions and results have been excellent. The investigational protocol for LS
also involves the addition of topical growth factors in the form of AQ Skin Serum (pure
growth factors and FDA approved for topical application). These growth factors
available in doctor’s offices can work together with the stem cell therapy and may be
helpful in healing the Lichen Sclerosis lesions. AQ Products are available through Dr.
Lander’s office.

Vulvodynia

Female genital pain also known as vulvodynia is chronic pelvic floor and vaginal pain
often of unknown cause. It is also often associated with Interstitial Cystitis. Cell therapy
may be effective in some cases.

Dr. Lander has successfully treated several cases of vulvodynia using fat derived stem
cells injected into the pudendal nerves and vaginal tissue targets.

Fat derived stem cells (aka SVF) has immuno-modulatory, pain modulating, and anti-
inflammatory effects and therefore may be effective in healing chronically inflamed
nerves.

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