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With the new advances of stem cell therapy, we offer procedures that can rejuvenate and revitalize sexual function.
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.
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. 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 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.
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.
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.
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.
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.
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Any and all statements and opinions are provided for educational information and are not intended for medical diagnosis. As with all medical treatments and procedures, results may vary on an individual basis.
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Anatara Medicine & San Francisco Stem Cell Treatment Center | 1700 California Street, Suite 520 | San Francisco, CA 94109 | P: 1 (888) 453-6825 | F: (415) 345-0059