Cell-based therapies for anal incontinence have been investigated for over a decade with preclinical and clinical studies reporting encouraging results (1-7). We read with great interest the new report of de la Portilla et al. (8). In this well-conducted triple blinded randomized controlled trial, the authors did not demonstrate any statistically significant differences in functional scores (Jorge-Wexner score being the primary outcome), manometric, or ultrasonographic parameters between patients injected (under ultrasound control) with autologous adipose-derived mesenchymal stem cells or a placebo for an anal sphincter defect.