Erectile dysfunction (ED) is a common major sexual disorder among men and can significantly impact quality of life for both patients and their partners. Its prevalence has increased in recent decades. This increase may result from a concurrent increase in the number of patients with one or more ED risk factors. Some of these are:
- Heart disease.
- Lower education
- Spinal Injury.
The American Urological Association guidelines suggest patients with ED should see a mental health professional as adjunctive therapy, which has been shown to improve adherence to treatment plans and enhance the effects of other treatment approaches, resulting in improved erectile function. Most clinical guidelines suggest the use of oral phosphodiesterase type 5 inhibitors (PDE5-Is), such as sildenafil (viagra)’ as the first line of therapy. However, PDE5-Is only provides temporary symptom relief and rarely addresses the underlying etiology of a patient’s ED.
Current management options include the use of medication (PDE5-Is), prostaglandin (alprostadil) urethral suppositories. vasoactive intracavernosal injections, vacuum erection devices and penile implants.
Vacuum erection devices can be considered and involve negative pressure to engorge the penis, coupled with a constriction band to effectively trap blood for a period of minutes so as to allow rigidity perhaps sufficient for penetration. Penile implants have traditionally been reserved for failure of medical therapy. A 3-piece inflatable penile prosthesis is the most widely used design within the United States.
These therapeutic interventions exhibit significant impact in providing relief to patients; however, due to their associated adverse effects and lack of long-term efficacy, newer modalities such as regenerative therapeutics have gained attention due to their safe and prolonged efficacy. Stem cell therapy is one of them.
Stem cells are unique, undifferentiated cells with 3 important features: unlimited proliferation, multi-differentiation potency and perpetual self renewal. They have unique proangiogenic, antifibrotic, and antiapoptotic characteristics.
The regenerative effects of stem cells are attained by the secretion of numerous growth factors (paracrine action) and/or their migration to the injury site along with cell contact and cellular differentiation. In these sites they could regenerate the damaged tissues according to the stimuli or the received signals.
Bochinski et al. first reported in 2004 the injection of ESC into rat ED models with cavernous nerve injury (CNI). Subsequent studies investigated the effects of Stem cell treatment of ED caused by aging, diabetes, hyperlipidemia, CNI, and other etiologies.
Several studies have shown sustained effects at 1 year of follow up with Stem cells. The studies reported improved penile hemodynamics, sexual desire, intercourse satisfaction and improved erectile function scores. Another important point is that no major adverse effects were described and Stem cell therapy has shown efficacy in ED of different etiologies.
At Zignagenix we offer a combined therapy for ED, that includes an intravenous infusion of mesenchymal stem cells with exosomes, which also contains antiinflammatory substances called cytokines, and localized injections (P-Shot) directly into the cavernous bodies of the penis and the glans.
We also include Platelet-Rich Plasma (PRP) to the localized injections to increase the quantity of growth factors, chemokines and angiogenic factors that play a crucial role in regenerating damaged cells in the nerve cells and in the corporal tissues of the penis. P-Shot is a quick procedure and you don’t need any type of preparation previous to your treatment.
These current regenerative therapies including both stem cells and PRP have shown incredible results in terms of restoring erectile functions, sexual life of males and therefore play a crucial role in restoring confidence and relationships. At our clinic we have extensive experience in managing this condition with a high degree of satisfaction among our patients.
He, M., von Schwarz, E.R. Stem-cell therapy for erectile dysfunction: a review of clinical outcomes. Int J Impot Res 33, 271–277 (2021).
Ethan L. Matz, Ryan Terlecki, Yuanyuan Zhang, John Jackson, Anthony Atala. Stem Cell Therapy for Erectile Dysfunction. Sexual Medicine Reviews, Volume 7, Issue 2, 2019, Pages 321-328.
Protogerou V, Chrysikos D, Karampelias V, Spanidis Y, Sara EB, Troupis T. Erectile Dysfunction Treatment Using Stem Cells: A Review. Medicines (Basel). 2021;8(1):2. Published 2021 Jan 6. doi:10.3390/medicines8010002