Adult Stem Cells for Erectile Dysfunction
The definition of erectile dysfunction (ED), also known as impotence, is the recurring or consistent inability to acquire or sustain a penile erection of sufficient rigidity and duration for sexual intercourse. Surveys show ED to be present in 16% of the male population with an increasing incidence with age. Approximately 8% of men age 20-30 experience ED while 37% of men age 70-75 suffers from ED.
The purpose of this paper is to help readers gain a greater understanding of the use of adult stem cells for ED. We also want to offer a framework for evaluating if stem cell treatment should be considered an option for you or your loved one. The paper covers the following:
- What are the common causes of ED?
- What are the current medical treatment options for ED?
- How are adult stem cells deployed for ED?
- How is Extracorporeal Shock Wave Therapy (ESWT) used in ED?
- What results can I expect after deployment of adult stem cells for ED?
Feel free to skip to sections that provide information that is helpful to you. For more information including definitions and descriptions of ED visit:
Frequently Asked Questions
A: Erectile dysfunction can result from a number of underlying causes. Normal erectile function requires intact vascular and neurologic function and proper psychogenic stimulus. Interruption of any of these areas can result in erectile dysfunction. Common causes are vascular, neurological, hormonal or endocrinologic, and medications (pharmacologic).
There is strong association with cardiovascular disease. Many view erectile dysfunction as an early warning sign for heart attack or stroke disease. Men over age 45 or with significant risk factors (family history, smoking, high cholesterol) should discuss their erectile dysfunction with their primary physician. A cardiovascular evaluation may be appropriate. Other evaluations such as a complete history, medication review, hormonal testing and genital examination may also be considered. Proper evaluation can lead to effective treatment in most men. For many men who do not find effective treatments, adult stem cell therapy may be a good option. For more complete information on the causes of erectile dysfunction see:
A: Typically, the first step in treating erectile dysfunction is determining the underlying cause. This may involve different types of testing such as: a medical history, lab work, cardiac stress testing and others. Following the evaluation, the commonly used treatment options are:
1. Medications such as Viagra (sildenafil) and Cialis (tadalafil). These are known as phosphodiesterase inhibitors. These work well in many men. Unfortunately, some men have side effects with these medications and others do not respond. Men taking nitroglycerin type drugs cannot use phosphodiesterase inhibitors.
2. Drugs injected into the penis such as Caverject (alprostadil) are the second choice. These drugs work for many men, but others dislike the need for a shot. These drugs are also available as a penile suppository (insertion up the urethra).
3. Vacuum assisted erection devices. These devices use a vacuum pump to assist erection. They are frequently coupled with a ring that fits at the base of the penis to help maintain the erection. Typically, no more than half of men are satisfied with the long term use of these devices.
4. Penile prosthesis is an option for men who do not respond to or are not satisfied with the above options. Several types are available.
5. Testosterone replacement therapy has been shown to be effective in the presence of low testosterone levels. The effectiveness of testosterone alone may decrease over time for men with low testosterone levels. For men with normal testosterone levels, adding to the levels is rarely helpful for erectile dysfunction.
6. Other treatments are used from time to time that range from pills to vascular surgery.
To learn more about treating erectile dysfunction please see:
Using the above options is effective for the majority of men. If you are a person doing well using these options, this might not be the right time to consider adult stem cell treatment. For those who have not responded or who do not like the options available for them, adult stem cell therapy is an option for them.
A: When we use the adult stem cells/SVF (see above for a description of Stromal Vascular Fraction –SVF) to treat a disorder we refer to it as deployment. The typical deployment for erectile dysfunction is into the shaft of the penis using a small needle. We add local anesthetic to help with the discomfort.
We do some special treatments to the penis using a device called Extracorporeal Shock Wave Therapy (ESWT) before and after deployment. The ESWT appears to enhance the response to adult stem cell/SVF deployment.
A: Very large versions of Extracorporeal Shock Wave Therapy (ESWT) devices are used widely for the treatment of kidney stones. These devices deliver a shock wave to the body that breaks apart the kidney stone. Much smaller versions of ESWT have been used for orthopedic injuries, scar improvement and even treatment of cellulite on women’s legs. The small device has been used by itself for ED and a related disorder called Peyronie’s Disease (click here to read about adult stem cells and ESWT for Peyronie’s Disease). The treatment is most similar to a deep massage.
We give three ESWT treatments about every other day for about a week. Following the second treatment we deploy the adult stem cells/SVF as described This combination of adult stem cell/SVF deployment and ESWT treatment is the most advanced protocol for erectile dysfunction.
A: Currently the treatment group is not large enough to give a conclusive answer to this question. It is important to note that the Food and Drug Administration (FDA) has NOT approved the use of adult stem cells for any disorder. This includes the use of stem cells for erectile dysfunction. Fortunately, we have enough early experience to talk about trends in therapy. Over 78% of patients are seeing a positive response. Remember that many of these patients have failed to respond to multiple other forms of treatment.
With some disorders for which stem cells are used require repeat deployments over time. It is too early to tell if repeat deployments will be recommended for erectile dysfunction. However, we are encouraged by the results to date.