Single cells, single cells

› andrea@altsexcolumn.com

Dear Andrea:

I read your recent article about postpregnancy changes [12/19/07]; you didn’t mention one promising new treatment for stress incontinence, stem cells. Maybe you’re not interested because it’s not a standard treatment yet, but in case you simply didn’t know, here are some links: www.medscape.com/viewarticle/494967 (requires log-in), www.medpagetoday.com/Surgery/Urology/tb/6055.

Love,

Helpful Reader

Dear Helpful:

I’m interested! My interest in urinary stress incontinence goes way back to when I was first looking into the female ejaculation thing and telling people over and over that "this is not urinary stress incontinence! Nothing to do with that! Forget you ever heard the words urinary stress incontinence." Which I promptly did. And now I’m writing and teaching about what happens to sex after you have babies and barely have time to think about female ejaculation, but guess what’s back as an issue, big-time? Of course. People talk about baby weight and boobs and tiredness and getting "touched out" by having a baby stuck to you at all hours, but how often does anyone mention the fact that peeing when you laugh, sneeze, or do anything more interesting in the way of convulsive expulsions is (a) very common postpartum (in which postpartum can mean, say, 40 years postpartum) and (b) just mortifying and deeply antierotic? (Right, yes, except to that subset — you know who you are — who do find random uncontrollable peeing erotic; you can just sit down, since we’re not talking to you.)

From the Medscape article Helpful linked:

Preliminary research suggests that stem cell therapy is a viable and efficacious treatment for stress urinary incontinence, according to results presented … at the 90th scientific assembly and annual meeting of the Radiological Society of North America.

"We believe we have developed a long-lasting and effective treatment that is especially promising because it is generated from the patient’s own body," said Ferdinand Frauscher, MD, associate professor of radiology at the Medical University of Innsbruck, Austria. In the study, women who had autologous adult stem cells implanted into the rhabdosphincter were free of incontinence for a year or longer, he said.

You caught the part where these were the women’s own stem cells, right? These are not the stem cells of controversy, drawn from the blasto-Americans whose lives are supposed to be every bit as valuable as that of an adult with a life and a family and a case of Parkinson’s or MS and no good therapies, nope. They were pulled out of the patients’ arms and injected back into the women’s urethras, where they proceeded to thicken the walls and make the sphincter more elastic and contractile. Plus, they’re smart:

"These are very intelligent cells," Dr. Frauscher said. "When they connect with other cells they stop growing." He said it takes about two weeks for the cells to complete the process. However, some women in the study reported a benefit within 24 hours of treatment. Dr. Frauscher said that was probably due to a "bulking" effect of the cells, creating pressure on the urethra.

In another, similar study, the women were still continent a year later. This is really good news, if a little early and a little techy and not likely to be appearing at a doc-in-the-box clinic near you any time soon. We can keep our fingers (and, unfortunately, our legs) crossed, though.

While we’re crossing, here’s more good news for women who, like me, did their dancing to ’80s music while the ’80s were still happening and might be wondering where their smooth skin, bouncing curls, and vaginal lubrication went: gone with the estrogen, of course. You could get whiplash keeping up with the latest on hormone-replacement therapy for menopause — it’ll give you cancer; no, it’ll protect you from heart attacks; no, it’ll give you heart attacks but protect you from cancer — but (also from Medscape, at www.medscape.com/viewarticle/568354):

The American Association of Clinical Endocrinologists (AACE) has released a statement on hormone replacement therapy (HRT) and cardiovascular risk, emphasizing that HRT does not appear harmful in younger women in early menopause and may indeed be beneficial in this group.

Younger for these purposes means under 60 (phew!) or less than 10 years after menopause. HRT isn’t going to be for everyone, and these are the same numbers (the Nurses’ Health Study) that have been crunched and crunched again while women get the above-mentioned sore necks (and sometimes much, much worse) in attempting to keep up with the latest, but right now this seems good. I’ve tried to look forward to my cronehood as a time of wisdom and serenity, but … bleah. Just whisper the words vaginal atrophy to any woman past 35 and you’ll see how eager most of us are to give up our estrogen. Given the choice, I’d rather pee my pants.

Love,

Andrea

Andrea is home with the kids and going stir-crazy. Write her a letter! Ask her a question! Send her your tedious e-mail forwards! On second thought, don’t do that. Just ask her a question.