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We offer stem cell therapies for the following urological conditions and diseases:
Stem Cell Treatment for Erectile Dysfunction:
Erectile Dysfunction (ED) is defined as the inability to achieve or sustain an erection suitable for sexual intercourse. ED affects up to one third of men of men throughout their lives and has a substantial negative impact on intimate relationships, quality of life and self-esteem. Causes are multifactorial but can be related to loss of testosterone, surgical damage to the penile nerves, medications, or other medical illnesses. The most common cause of ED is “vasculopathy”, which is damage to the delicate blood vessels in the penis. This vasculopathy is often associated with age but strongly related to atherosclerosis, diabetes, hypertension, high cholesterol and cerebrovascular and peripheral vascular disease. Vasculopathy is also very prominent in patients with Peyronies disease and penile scarring. Men with ED are also at significantly increased risk of coronary artery disease. Therefore, when men have ED, screening for cardiovascular risk factors should be considered because symptoms of ED present as much as three years earlier than other symptoms of coronary artery disease such as chest pain. The current treatment of ED centers around the use of Phosphodiesterase type 5 inhibitors such as Viagra, Cialis, or Levitra. Intraurethral pellets and intracavernosal (penile injectable agents) are also available if oral medications fail. Various mechanical external vacuum pump devices are helpful also in patients who are comfortable with assisted devices. Penile revascularization surgery has mostly fallen out of favor due to poor outcomes in most patients.
Using state of the art equipment, this device is used to pre-treat the targeted tissue to stimulate blood vessel formation to increase the survival rate and regeneration of stem cells.
At this time, the only treatment available to patients who have not succeeded with any of the above are surgically implanted hydraulic penile prostheses. These surgeries are somewhat invasive but often effective. Adipose derived stem cells have shown extraordinary promise in revascularizing cardiac tissue, ischemic limbs and other organs suffering damage from poor blood flow by regenerating small blood vessels as well as smooth muscle and nerves. We have evidence that adipose derived stem cells stimulate endothelial (small blood vessel lining) growth and improve penile blood flow in animal models. Early attempts have been made in human patients to improve erectile function using adult mesenchymal stem cells however results have been inconsistent. There is some evidence that results will be optimized if the transplanted stem cells are “activated.” The process of stem cell activation is usually a natural phenomenon induced by inflammatory and ischemic events. However, chronic micro-vasculopathy may require tissue micro-trauma to induce cellular healing and angiogenesis. Controlled tissue micro-trauma can be induced using low intensity shock wave treatment of the penis, which has been used successfully for years for penile pain associated with Peyronies disease. In 2012, a publication in the Journal of Urology (See Citation) provided evidence that shock wave technology alone can significantly improve erectile function in comparison to placebo treatment.
The Journal of Urology Volume 187, Issue 4, Supplement, Page e606, April 2012
Stem Cell Treatment for Polycystic Kidney Disease
Polycystic kidney disease (PKD), is one of the most common life threatening, inherited diseases in humans, affecting more than 1 in 500 individuals. Patients with the disease experience an abnormal proliferation of kidney cells that ultimately results in cysts and a decline in organ function leading to kidney failure.
PKD comes in two forms. Autosomal dominant polycystic kidney disease (ADPKD) develops in adulthood and is quite common, while autosomal recessive polycystic kidney disease (ARPKD) is rare but frequently fatal. ADPKD is caused by mutations in either of two proteins, polycystin-1 and polycystin-2, while ARPKD is caused by mutations in a protein called fibrocystin. There is no cure or widely adopted clinical therapy for either form of the disease.
The mechanisms that cause cysts to form have long been poorly understood. Recently, a team of scientists from the HSCI Kidney Disease Program at Brigham and Women’s Hospital were able to reprogram the skin cells from five PKD patients—three with ADPKD and two with ARPKD—into induced pluripotent stem cells, which can give rise to many different cell types, and then differentiate them into other cell types.
Adipose-derived stem cell therapy is now being studied as a potential therapy to repair kidney cells and/or delay further deterioration in kidney function.
Stem Cell Treatment for Interstitial Cystitis:
Millions of patients suffer from Interstitial Cystitis /painful bladder syndrome. This severe and debilitating condition has historically been confused with other bladder pathology which must be ruled out, making IC difficult to diagnose. Currently, Interstitial Cystitis/PBS is defined as “an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes.” (2009 new American IC/BPS Guidelines). Although there are several theories to explain IC, the exact cause remains unclear. Many patients with IC have the biomarker APF (antiproliferative factor) in their urine which inhibits bladder cell proliferation, making healing of the bladder lining much more difficult (1). Recent research indicates IC may be related to systemic neurosensitization and neuroinflammation that occurs within the bladder and also some other organ systems (2). Regardless of the cause, the end result of IC is damage to urothelium and bladder muscle that can run the spectrum from mild mucosal irritation to deep Hunner’s ulcers.
Peyronies Disease “PD” has been described by experts as a physically and psychologically devastating problem manifested by a fibrous inelastic scar of the fibrous chambers of the penis known as the tunica albuginea. The scarring (known as “peyronies plaques”) can cause pain, bending, narrowing, hinging and shortening of the penis in the erect state. Recent demographic studies have shown that up to 9% of men have this problem and it seems to be even more prevalent after radical prostatectomy surgery. More than half of the cases worsen over time and only 13% resolve spontaneously. Peyronies is also closely associated with erectile dysfunction.
There is no known non-surgical cure for PD and surgery or needling techniques can often result in more scarring, shortening or loss of sensation and adequate erectile function. Non-surgical therapies such as Vitamin E, colchicine, tamoxifen, carnitine, and Omega-3 fatty acids, show no benefit over placebo. Verapamil cream is used by clinicians but there are no controlled trials proving that the verapamil penetrates into the tunica albuginea. There have been numerous studies on intralesional injection of verapamil showing some positive effects in decreasing curvature and deformity improved in 30% to 60% of patients. The usual treatment is 10 mg injected every two weeks a total of twelve times. Injection of interferon alpha 2b has shown very mixed results. There are FDA studies of a drug called Xiaflex, which is made from bacterial collagenase. Early results may be promising, with curvature reduction 20% higher than with placebo.
There is evidence that stem cells will actively seek out and attempt to repair a Dupytren’s contracture, which is nearly identical to PD but occurs in the hand. Stem cells may be highly effective in inflammatory scarring conditions occurring in other parts of the body. We have developed a protocol for injection of SVF (rich in mesenchymal stem cells and growth factors) directly into Peyronies plaques. Some patients are also eligible to receive low intensity shock wave therapy in conjunction with SVF to maintain activation of the stem cells to induce revascularization and healing.
Post Prostatectomy Incontinence Protocol
In America alone, more than three million men are affected by loss of bladder control, a medical condition known as urinary incontinence. This problem has a great impact on health and quality of life for those who suffer with it. Male urinary incontinence is usually caused by a damaged sphincter, the circular muscle that controls the flow of urine out of the bladder. It often happens as the unavoidable result of prostate cancer surgery. When the sphincter is damaged, the man cannot squeeze or close off the urethra and leakage occurs especially with straining or exercise.
Lichen Sclerosus is a skin condition that occurs in women, men and even children but most frequently seen in post-menopausal women. The skin around the genitals and anus can turn shiny and smooth and spots grow into patches. Skin over the spots turns thin and crinkled and can tear easily and become scarred. Itching, changes in skin color, pain, bleeding and blisters can also occur. Causes of LS may be auto-immune or hormonal but overall the exact cause is poorly understood. Other areas of the body can be affected but those usually resolve without treatment. LS is not contagious. Diagnosis can be confirmed on skin biopsy. Without treatment, patches on the genitals can lead to scarring and pain or become cancerous. LS can cause scars that narrow the vagina interfering with sexual intercourse. Treatment has traditionally involved surgical excision (not always possible especially in women) and powerful topical steroids which can help mitigate itching and scarring. Optimization of estrogen levels is also helpful. More advanced treatment includes retinoids (vitamin A like compounds), UV light therapy, or Tacrolimus (immune suppressant). At SFSCTC, Dr. Herskowitz can perform a mini liposuction to obtain stromal vascular fraction (SVF) which is rich in adult stem cells and growth factors. SVF has immuno-modulatory and anti-inflammatory effects and therefore may be effective in healing the abnormal patches of skin associated with LS. Our protocol also addresses the systemic component of LS by administration of intra-venous SVF in addition to local injections. Additional growth factors in the form AQ Skin Solutions (pure growth factors FDA approved as a cosmetic for topical application) can work with the cell therapy and may be helpful in healing the LS skin lesions.
“Thanks to the SFSCTC, my ED is 80% better and my self-esteem has increased. I feel like a normal, healthy guy again and I couldn’t be happier.”
Read more patient testimonials
ED, Patient 1 Month Follow-up:
“I saw a big improvement from what I was experiencing and I am grateful I spent the money to get the procedure done. I would like to thank Dr. Herskowitz for his help and for being brave enough to be part of the future of medicine.”
Lichen Sclerosus Patient
“I highly recommend Anatara and the SFSCTC for those seeking help for autoimmune disorders. Dr Herskowitz, the cardiologist and immunologist who founded Anatara Medicine and the San Francisco Stem Cell Treatment Center is caring and compassionate, highly skilled, and informs his patients with details about their treatment and what to expect. Sarah, his medical assistant, is also caring and compassionate and skilled at her job. The Naturopathic doctor spent time with me to develop a highly effective naturopathic course of treatment for my autoimmune condition while Dr Herskowitz performed stem cell therapy as treatment. I feel that the improvement in my condition is due to their skill and caring.”
– Sally W.
“I had Lichen Sclerosus for about 6 years before it was correctly diagnosed. It was treated with the standard cortisone and estrogen creams for another two years, during which time the condition worsened alarmingly. In desperation, I turned to stem cell therapy. Within hours of my first stem cell treatment the tissue was pink and plyable within a week it appeared about 40% improved. Over the next 6 months progress was slower, but continued to about 70% of what was normal for me. I had a second stem cell treatment one month ago and am overjoyed by the transformation of the tissue; most of the area is 100% improved, and the area worst affected by LS is continuing to progress and is now at about 90%. I took advantage of the complementary and alternative approaches offered by the San Francisco Stem Cell Treatment Center in conjunction with the stem cell injections. Their holistic and whole-body approach helped to lay the groundwork for the stem cell treatments both enhancing and prolonging the effects. When a person has suffered with this condition for as long I have, the results and the relief are nothing short of miraculous. I utterly and absolutely recommend both the treatment and the SF Stem Cell Center!”
New Study on Stromal Vascular Fraction Combined with Shock Wave for the Treatment of Peyronie’s Disease
This pilot study was used to evaluate safety and subjective outcomes in a small series of Peyronie’s disease patients using a combination of autologous stromal vascular fraction (SVF) and penile shock wave treatments.