A Dual-Target Approach: Combining Intra-Sphincteric and Intravesical Platelet-Rich Plasma as a Novel Regenerative Strategy for Mixed Urinary Incontinence | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 28 October 2025 | ||
| Document Type: Review Articles | ||
| DOI: 10.21608/zumj.2025.426961.4217 | ||
| Authors | ||
| Haneen Ibrahim Omar* 1; safwat Elsaid Abouhashim2; Emad A. Salem3; Kareem M. Taha4 | ||
| 1Zagazig University urology department | ||
| 2zagazig university urology department | ||
| 3urology department zagazig unniversity | ||
| 4Department of urology, Zagazig University | ||
| Abstract | ||
| Background: The presence of the stress (SUI) and urgency (UUI) components together, mixed urinary incontinence (MUI), is a multi-factorial therapeutic issue due to its multi-factorial pathophysiology. Platelet-rich plasma (PRP), an autologous growth factor concentration, has recently become a novel regenerative therapy for certain types of incontinence but has not been sufficiently studied for use in MUI. Objective: The review aims to integrate the current evidence for PRP in urinary incontinence with particular emphasis on evaluating the new concept of a two-target intra-sphincteric and intravesical treatment of MUI. Methods: Narrative synthesis of the literature was performed, including mechanisms of action, SUI and UUI clinical trials with PRP, and a strong evaluation of a new milestone clinical trial using the two-target approach for MUI. Results: Existing literature supports PRP injections for SUI efficacy and safety, and intravesical instillations for bladder conditions like interstitial cystitis. The new Omar et al. (2025) trial establishes that with this protocol, there is great and long-lasting subjective (ICIQ-SF, OAB scores) and objective (cough stress test, urodynamics) improvement in MUI patients at six months, with a benign safety profile underpinned by short-lived dysuria (29%). Conclusion: Double-target PRP represents a paradigm in the treatment of MUI that addresses both the SUI anatomical pathology and the UUI urothelial pathology at the same time. It is safe, effective, and minimally invasive regenerative therapy. These preliminary favorable findings are an open invitation for confirmation by large-scale randomized controlled trials to determine their role in the modern-day urological armamentarium. | ||
| Keywords | ||
| Mixed Urinary Incontinence; Platelet-Rich Plasma; Dual-Target Injection; Stress Urinary Incontinence; Urgency Urinary Incontinence | ||
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