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Table 1 Selected preclinical studies of MSCs transplantation for PFDs

From: MSC-based therapy in female pelvic floor disorders



MSC sources

Method of injection/number of cells

Tracking of MSCs

Functional assessments

Main outcomes


Lin et al. 2010 [38]


Human ADSCs

Urethral or intravenous/1 × 106

Labeled with BrdU and EdU

Conscious cystometry

Urinary voiding function improved, elastin and smooth muscle content increased and MSCs survival for at least 4 weeks.

Transplantation of ADSCs via urethral or intravenous injection was effective in the treatment and/or prevention of SUI in a preclinical setting

Cruz et al. 2012 [57]



Intravenous/2 × 106

Labelled with GFP


GFP + MSCs in the pelvic region both 4 and 10 days after VD; the total flux decreased from 4 to 10 days after VD and sham VD

Intravenous administration of MSCs could provide an effective route for cell-based therapy

Sadeghi et al. 2015 [80]


Human BM-MSCs

Periurethral or intravenous/1 × 106

In situ hybridization; bioluminescence imaging

LPP test

LPP, connective tissue content and vascular density increased in periurethral or intravenous groups; no labeled cells were observed in urethras at 4, 10, and 14 days

Human MSCs restored urinary continence with an immediate and sustained effect in the VD model; MSCs remained at the site of periurethral injection for < 7 days

Menachem- Zidon et al. 2019 [58]

Rats/posterior midline vaginal incision


Intravenous or vaginal subepithelial/2 × 106

Labeled with PKH-26 or GFP


The epithelial layer healed; systemically transplanted MSCs differentiate into endothelial cells; systemically transplanted MSCs form blood vessel structures

These findings pave the way to further studies of the potential role of MSCs transplantation in improving surgical outcome in women with PFD

Salcedo et al. 2013 [81]

Rats/SP or PNC


Intravenous (IV) or intramuscular (IM) into the anal sphincter/2 × 106

Labelled with GFP

Anal pressure test; anal sphincter EMG

Anal sphincter pressure increased in IV and IM groups after SP, but not after PNC; sphincter EMG amplitude also increased in both groups, but frequency only increased in IV group

MSC treatment resulted in significant improvement in anal pressures after SP, suggesting that MSCs could be utilized to facilitate recovery after anal sphincter injury

Salcedo et al. 2014 [82]



IM/5 × 105 or serial IV/5 × 105 daily for 6 consecutive days

Labelled with GFP

Anal pressure test

Both IM and IV MSC treatment after injury caused an increase in anal pressure sustained at 5 weeks

MSCs delivered intravenously and intramuscularly resulted in functional recovery

Kuismanen et al. 2018 [83]


Human ADSCs

Intramuscular into the external sphincter/3 × 105

Labelled with PMP-50


ARM pressure was significantly higher in ADSCs treatment groups; No difference in the sphincter muscle continuation between the groups

The ADSCs injection with both saline and Bulkamid is a promising nonsurgical treatment for acute anal sphincter injury

Gautam et al. 2014 [102]

Rabbits/cryoinjured urethral model

Autologous ADSCs

Urethral/2 × 106

Labeled with PKH26

LPP test

LPP of the cell-implanted group was higher compared with control group; implanted PKH26-labeled ADSCs were immunohistochemically positive for myoglobin, SMA, and Pax7 antibodies

Implantation of ADSCs into cryoinjured rabbit urethras promoted the recovery of urethral function

  1. VD vaginal dilation, SP sphincterotomy, LLP leak-point pressure, PNC pudendal nerve crush, ADSCs adipose-derived stem cells, BM-MSCs bone marrow-derived MSCs, BrdU 5-bromo-2-deoxyuridine, EdU 5-ethynyl-2-deoxyuridine, GFP green fluorescent protein, PMP-50 magnetizable nanoparticles, EMG electromyography, ARM anorectal manometry, SAM smooth muscle actin, Pax7 a satellite cell marker