(1) Background: Limited data showed changes in glomerulation in the bladder mucosa of patients with interstitial cystitis (IC) after intravesical hyaluronic acid (HA) bladder infusion. We aimed to investigate the above changes. (2) Methods: Medical records of IC patients were reviewed retrospectively, from January 2010 to October 2019. Patients who had received repeated cystoscopy after intravesical HA treatment were enrolled. The associations of multiple parameters, including the ages, symptoms, initial glomerulation stage, HA doses, and the interval period of repeated cystoscopy between the glomerulation change in the repeated cystoscopy were analyzed. (3) Results: Among the 35 patients, 9 cases (25.7%) showed better glomerulation grades in the repeated cystoscope (Group 1), 20 cases (57.1%) showed the same grades (Group 2), and 6 cases showed worse grades (Group 3). No difference was seen in the initial grades or treatment course among the three groups. The interval periods from the initial to the repeated cystoscopy of Group 1 were longer than Group 2 and Group 3 (p = 0.031). Group 3 presents an elder age trend than the other two groups. (4) Conclusion: Intravesical HA repaired bladder glomerulation in a small group of patients with IC. Prolonged treatment has potential benefits, while older age is possibly a negative factor. However, no strong correlation was found between the initial glomerulation grades or changes in glomerulation grades with clinical symptoms.

Voiding dysfunction (VD) after sling operation is not uncommon. Sling revisions by incision/excision are usually effective; however, they may result in recurrent stress urinary incontinence (SUI). We aimed to evaluate continence status after an innovative sling revision procedure that preserves the integrity of the sling. Patients who underwent either a single-incision (AJUST) or a trans-obturator (TVT-O) mid-urethral sling were studied. Transvaginal tape elongation (i.e., sling midline incision and mesh interposition) was performed on patients with post-sling VD. Factors that may affect recurrent SUI were investigated by statistical analyses. Of 119 patients, 90 (75.6%) (45 AJUST and 45 TVT-O) were available for long-term (median 9; 8–10 years) follow-up. A significantly higher rate (17.2% vs. 3.3%, p = 0.014) of VD was noted after AJUST (N = 10) than after TVT-O (N = 2). After sling revision, four (33%) of the 12 cases reported recurrent SUI, which was not significantly different (p = 1.000) from the rate (37%, 29/78) of patients who did not undergo sling revision. Further statistical analyses revealed no significant predisposing factors affecting the recurrence of SUI. Surgical continence did not seem to be affected by having had sling revision with transvaginal tape elongation for post-sling VD.

(1) Background: Treating female pelvic organ prolapse (POP) is challenging. Surgical meshes have been used in transvaginal surgeries since the 1990s, but complications such as mesh exposure and infection have been reported. Polyvinylidene fluoride (PVDF) mesh, known for its stability and non-reactive properties, has shown promise in urogynecological surgeries. (2) Methods: A retrospective analysis was conducted on 27 patients who underwent a modified PVDF vaginal mesh repair procedure using DynaMesh^®-PR4 and combined trans-obturator and sacrospinous fixation techniques. Additional surgeries were performed as needed. (3) Results: The mean operation time was 56.7 min, and the mean blood loss was 66.7 mL. The average hospitalization period was 4.2 days with Foley catheter removal after 2 days. Patients experienced lower pain scores from the day of the operation to the following day. Postoperative follow-up revealed that 85.2% of patients achieved anatomic success, with 14.8% experiencing recurrent stage II cystocele. No recurrence of apical prolapse was observed. Complications were rare, with one case (3.7%) of asymptomatic mesh protrusion. (4) Conclusions: The modified vaginal mesh procedure using DynaMesh^®-PR4 showed favorable outcomes with a short operation time, low recurrence rate, rare complications, and improved functional outcomes. This surgical option could be considered for anterior and apical pelvic organ prolapse in women.

Interstitial cystitis (IC) is a complex syndrome characterized by symptoms such as bladder pain, urgency, frequency, and nocturia, without the presence of urinary tract infection or any other identifiable pathology. Traditional treatments, including medication and bladder instillation, are often ineffective in about 30% of patients. Currently, efforts are focused on developing therapies based on the possible pathogenesis of IC. This study is a phase one clinical trial which aimed to investigate the safety and efficacy of autologous peripheral blood mononuclear cell (PBMC) intravesical injections, which have the potential to promote tissue regeneration, as a novel treatment for IC. The study involved isolating PBMCs using the Sepax Cell Separation System and injecting these cells beneath the bladder mucosa layer of patients with IC. Clinical efficacy was evaluated using voiding diaries, questionnaires, and cystoscopic examinations before and 3 months after treatment. Twelve patients with refractory IC participated in this study. Observed side effects, such as pain or urinary tract infection, were mild and transient which demonstrated the safety of this treatment modality. Although the treatment response varied among patients, a third of the patients experienced moderate to significant progress according to the GRA score. Four patients exhibited improvement in bladder glomerulations during postoperative follow-up cystoscopy. In conclusion, the overall safety profile of PBMCs injections appears to be favorable. Further research is needed to optimize treatment protocols and understand the factors influencing individual responses to this therapy.

Genitourinary syndrome of menopause (GSM) is a common hypoestrogenic condition marked by vulvovaginal atrophy and lower urinary tract symptoms that significantly impair quality of life in peri- and postmenopausal women. Although local estrogen therapy remains the standard of care, its use is constrained by contraindications, adherence challenges, and concerns regarding long-term safety, particularly in women with estrogen-sensitive conditions. As a result, interest has grown in regenerative, non-hormonal alternatives. Stem cell-based therapy, particularly using mesenchymal stem cells (MSCs), has emerged as a potential therapeutic strategy for restoring urogenital tissue structure and function. The current body of evidence largely consists of preclinical studies, small clinical case series, and investigations in related but distinct conditions, which provide potential mechanistic insights. Preclinical studies suggest that MSCs from adipose tissue, bone marrow, and umbilical cord promote vaginal epithelial regeneration through paracrine mechanisms, including angiogenesis, immunomodulation, extracellular matrix remodeling, and restoration of local estrogen signaling and vaginal microbiota. To date, current clinical studies have not provided direct evidence on the efficacy of characterized MSC-based therapies specifically in GSM populations. Early clinical evidence, primarily involving adipose-derived tissue products such as micro-fragmented adipose tissue, reports improvements in symptoms overlapping with GSM, including vaginal dryness, dyspareunia, urinary symptoms, and sexual function, with benefits lasting up to two to three years after a single treatment and no serious adverse events reported. However, available data are limited by small cohorts, the absence of randomized trials, and regulatory variability. This review summarizes current evidence and outlines key scientific, ethical, and regulatory challenges that must be addressed to guide future research and clarify the therapeutic potential of MSC-based approaches in GSM, ultimately enabling translation.