Stem Cell Treatment for Men with Erectile Dysfunction
Treatment of Erectile Dysfunction with Stem Cell Therapy
What are Stem Cells? Can Stem Cells Treat Erectile Dysfunction?
Stem cells are progenitor cells from which other cells in the body originate. They are undifferentiated cells that are capable of becoming different types of cells in the body, including heart, muscle, and blood vessel cells. This property of stem cells is believed to give them the ability to renew and repair damaged tissue.
In the context of erectile dysfunction, stem cells are thought to stimulate the function of endothelial cells in the penis as well as cavernous smooth muscle cells, which are key components of erections. Endothelial cells line the inner surface of blood vessels in the penis. The relaxation of cavernous smooth muscle cells allows a massive inflow of blood into the penis that produces a rigid erection. Stem cells are believed to increase blood flow to the penis through the nitric oxide pathway, which stimulates the nerves that lead to erections.
The introduction of stem cells into a poorly functional penis is thought to improve the function of existing endothelial cells (ECs) and cavernous smooth muscle cells (CSMCs) through paracrine effect, by release ‘growth factors’ that stimulate endothelial cells and smooth muscle cells to work better. Stem cells are also thought to improve erectile function by replenishing the penis with new and better functioning ECs and CSMCs through differentiation of stem cells. It is thought that stem cells may be able to reverse the damage to penile blood vessels caused by fibrosis from nerve injury as a result of radical prostatectomy. Stem cell therapy is unlikely to help with severe fibrosis that occurs after priapism, calcinosis, or with severe Peyronie’s disease. Stem cells are also believed to repair endothelial cells affected by hyperlipidemia injury. Finally, stem cells may reverse long-term damage caused by diabetes in the endothelial cells, smooth muscle cells, and nerves which are essential for healthy, strong erections.
Sources of Stem Cells for Treatment of ED in Men
There are different types of stem cells in the body that can be used for the treatment of various medical conditions including erectile dysfunction:
- ADSCs: Adipose-derived stem cells (or adipose-derived stromal cells)
- ADRCs: Adipose-derived regenerative cells
- MSCs: Mesenchymal stem cells (or marrow stromal cells)
There are a number of potential sources of stem cells for the treatment of erectile dysfunction, including:
- Fat-derived or adipose-tissue-derived stem cells: This is the most commonly used source of stem cells for the treatment of ED in men. Fat cells are obtained by liposuction typically from adipose tissue in the buttocks. Fat tissue contains mesenchymal stem cells (MSCs) which are progenitor stem cells that can be used for the treatment of erectile dysfunction. One benefit of using fat-derived MSCs is that a large number of stem cells can be obtained in a short period of time directly from the patient. Using a patient’s own tissue to harvest stem cells takes care of concerns about the risk of infectious diseases and immune problems that may arise if donor stem cells are used. Stem cells are present in the stromal vascular fraction (SVF) of the adipose tissue, which can be separated from fat cells and other cells using various techniques.
- Umbilical cord or placental stem cells: The umbilical cord and placenta are rich sources of stem cells and are a possible source of stem cells that can be easily obtained during the delivery of babies. There are some concerns about the risk of infection and immune problems that may arise if the cells are not derived from reliable sources. In general, umbilical cord and placental stem cells are thought to not be
- Bone-marrow-derived stem cells (BMSCs): The bone marrow is another source of stem cells that can be obtained from the patient. However, the number of bone marrow stem cells is small and typically these stem cells need to be multiplied in the laboratory before they are reintroduced into the patient for treatment.
- Platelet Rich Plasma: This is not a source of stem cells. Platelet-rich plasma does not contain stem cells in useful numbers. PRP (platelet rich plasma) but it is thought to contain certain growth factors such as platelet-derived growth factor that stimulate and improve the function of penile endothelial cells.
How Do Stem Cells Treat ED in Men?
Stem cells are thought to stimulate existing endothelial cells (ECs) and cavernous smooth muscle cells (CSMCs) and to upregulate their activity and function through paracrine effects and production of growth factors. Stem cells are also thought to differentiate locally into healthier ECs and CSMCs that improve penile function. Early scientific studies show that this does occur to some extent.
FDA and Stem Cell Therapy for ED
Stem cell therapy for erectile dysfunction is not FDA approved. In fact, the FDA has issued warnings about the risks of unregulated, unproven stem cell treatments which are known to cause serious medical problems. There are reports of blindness in patients who were treated with stem cells for visual problems. Stem cells have not been studied sufficiently for the treatment of erectile dysfunction. The studies that have been performed involved the administration of stem cells to men with severe erectile dysfunction. Therefore, the risks of stem cell treatments are unknown in men with mild to moderate erectile dysfunction. In addition, theoretically, just as stem cell therapy can improve erection function, it can also potentially cause proliferation and formation of scar tissue in men with pre-existing scar tissue, leading to worsening penile function.
Is Stem Cell Therapy for ED the Right Option for You?
Currently, studies examining the efficacy of stem cell therapy for the treatment of erectile dysfunction look promising. It appears that stem cells cause a small improvement in endothelial function in the penis, which can lead to improved blood flow based on penile Doppler studies. However, stem cell therapy has not been able to restore adequate erections in men with ED to the point that there is no need for medications, penile injections with TriMix, or penile implants. Stem cell therapy is still in an experimental stage. In addition, it is fairly expensive and is not covered by any insurance. The benefit from stem cells and the role of this treatment for erectile dysfunction are unclear at the present time.
In contrast to stem cell therapy, treatment with low-intensity extracorporeal shockwave therapy (Li-ESWT) for ED has been studied in hundreds of patients. Studies that support the use of shockwave therapy for erectile dysfunction are well-designed randomized controlled trials. These studies demonstrate that many men with erectile dysfunction can obtain erections sufficient for intercourse with shockwave therapy without the use of medications. This therapy is effective in men for whom medications do not work. It may allow such men to avoid penile implants. It may be possible to use medications after treatment with shockwave therapy for ED.
For the reasons mentioned above, at this time New York Urology Specialists do not recommend stem cell therapy for erectile dysfunction. For men who are interested in exploring options other than medications or penile injections, shockwave therapy for erectile dysfunction is a reasonable option with a better cost-effectiveness ratio, good safety record, and scientifically supported effectiveness. For men with severe ED, a penile implant is an effective and reliable treatment option.
We have extensive experience with shockwave therapy for ED at New York Urology Specialists. As one of the first practices to offer shockwave for ED in NYC and the US, we have performed hundreds of treatments with shockwave therapy. For good candidates, shockwave therapy is effective in 80% of men. Shockwave for ED has a good safety profile.
We offer affordable, highest-quality urology care with or without insurance. Find out our office hours or directions to our office. We offer weekday, weekend and evening office hours.
Dr. Alex Shteynshlyuger is a board-certified urologist, who specializes in all aspects of care for sexual problems in men including ED, premature ejaculation and other sexual concerns. He has successfully treated hundreds of men with sexual problems including ED and poor libido.
ED is Treatable in Nearly Every Man
At New York Urology Specialists, our urologists are specially trained in the evaluation and treatment of erectile dysfunction. We understand the challenges that ED creates for our patients, their relationships and their self-esteem. We help you find a treatment for erectile dysfunction that fits your needs, your lifestyle and your preferences.
Urologists are doctors specializing in the treatment of men with erectile dysfunction. By the virtue of our experience and skill, we are able to offer an effective treatment option for nearly every man who desires an effective treatment for ED. We offer medical and surgical treatment for erectile dysfunction.
We treat some of the most complex ED problems including:
- erectile dysfunction in men with prostate cancer after radical prostatectomy
- ED in men with multiple sclerosis
- impotence in men with diabetes.
- Priapism in men and other emergency penis problems.
- Erectile dysfunction in men with Peyronie’s disease
- Erectile dysfunction in men for whom Viagra and Cialis do not work.
- Erection problems in men with low testosterone.
Schedule an Appointment with Dr. Shteynshlyuger:
Dr. Alex Shteynshlyuger is a fellowship trained board-certified urologist with expertise in evaluation and treatment of urological problems in men and women using modern effective and proven treatment methods. He is highly recommended by top primary care physicians in the New York area. If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to contact us with any questions.