Elmi et al (2011) evaluated the effectiveness of endourethral autologous myoblast transplantation in the treatment of UI in children with bladder exstrophy-epispadias complex. Subjects were evaluated at 4 years of follow-up regarding the safety, efficacy and durability of the procedure, and health related quality of life. A total of 7 boys underwent autologous myoblast transplantation between May and December 2006. All patients had persistent UI after bladder neck reconstruction and bulking agent injection. Patients were followed for 4 years after autologous myoblast transplantation regarding clinical outcomes and cystometric, urodynamic, uroflowmetric and urethrocystoscopic evaluations. Health related quality of life was also measured before treatment and at final follow-up. No evidence of urinary obstruction was observed. Five children (71 %) were completely continent and 2 (29 %) were socially dry with complete daytime dryness at final follow-up. Health related quality of life was improved significantly. Urodynamic studies revealed a progressive increase in bladder capacity (p < 0.001). Mean detrusor leak point pressure showed a 27 cm H(2)O (158 %) increase during 4-year follow-up. Uroflowmetry parameters of voided volume and average maximum flow rate were improved significantly (p < 0.001). The authors concluded that the 4-year outcomes demonstrate that autologous myoblast transplantation for UI in children with bladder exstrophy-epispadias complex is relatively reliable, reproducible, safe and effective with minimal morbidity. This novel treatment represents a promising therapeutic approach in patients with UI. They stated that further randomized trials with larger numbers of patients and longer follow-up are needed.