a-) STEM CELL ERECTILE DYSFUNCTION TREATMENT BY SVF ((STROMAL VASCULAR FRACTION)
Erectile dysfunction is defined as the inability of a man to achieve or maintain a satisfactory erection for sexual intercourse. About 50% of men aged 40-70 have some degree of erectile dysfunction.
In our time, there are effective methods (drugs, needles, vacuum devices, prostheses) for the treatment of erectile dysfunction. The success of usage of these treatments alone or in combination is up to 80% but not 100%. Because these
treatments are only symptomatic, not curative. Scientists have been working on curative permanent therapy for a long time thus first shock wave therapy to the penis and then PRP treatments were developed. Although it has obtained certain success with these treatments, has not been for patients with severe erectile dysfunction.
Recently we have started to use stem cell therapy for erectile dysfunction treatment and we observed very successful results.
Stem cells can regenerate and repair tissue due to their capacity for division and differentiation. Stem cells can replace damaged cells in the area where they are applied or they can stimulate the regeneration of these cells. This is the basic logic in stem cell therapy.
In preclinical (experimental-animal) studies, it has been found that injecting stem cells obtained from adipose tissue into the penis improves erection functions. In almost all of the studies, stem cell applications have improved penile nerve damage, vascular insufficiency, diabetes mellitus, hyperlipidemia, and erectile dysfunction due to aging.
When animal experiments were successful in this way, clinical (human) studies gained momentum. About 10 years later in experimental studies, the first clinical reports began to appear. In 4 human clinical studies published to date, stem cells have been used in patients with erectile dysfunction.
The first study was published in 2010 by Bahk et al. from Korea. Stem cells obtained from the umbilical cord were injected into the penis of 7 patients aged between 57 and 87 years, who had erectile dysfunction due to diabetes, did not respond to any treatment, and were decided to have a prosthesis. The patients were followed for a total of 11 months. In 3 of 7 patients who received stem cell therapy, erection was achieved without medication, and in 2 with medication. No serious adverse effects were reported during treatment and follow-up.
In 2015, Levy et al from the United States injected umbilical cord-derived stem cells into the penis of 8 patients aged 40-70 years with vascular erectile dysfunction. At the end of the 6th month, it was stated that 3 of 8 patients had sexual intercourse without needing any medication, 4 of them taking a low-dose oral medication, and 1 patient had sexual intercourse with penile injection treatment. No side effects were reported during the treatment.
In 2016, Yiou et al from France injected bone marrow stem cells into the penis of 12 patients, aged between 45-70 years, who had prostatectomy for prostate cancer, had erectile dysfunction due to vascular insufficiency, and did not respond to any treatment. they followed. It was reported that 9 of 12 patients had sexual intercourse using drugs after 6 months. This situation continued in the 1st year of follow-up. No serious side effects were noted.
In 2016, Martha Kirstine Haahr from Denmark and colleagues injected adipose tissue-derived stem cells into the penis of 17 patients aged 46-69 years, who had undergone prostatectomy for prostate cancer and had erectile dysfunction that did not respond to any treatment. It was stated that at 6 months, 8 of 17 patients regained their ability to have sexual intercourse. No serious side effects were reported.
Stem cell therapy is rapidly developing as a viable treatment option, especially for patients with erectile dysfunction who do not respond to other treatments. With a wealth of preclinical data, 4 published clinical trials, and many ongoing clinical trials, both physicians and patients have begun to embrace this cutting-edge treatment.
The Process
For stem cell therapy we use SVF FLUID, which contains a large number of alive, reparative, and regenerative stem cells. to obtain stem cells, approximately 50 ccs of adipose tissue is taken from the abdomen or sides of the patient with the liposuction method. This procedure is performed under local anesthesia and takes an average of half an hour. Afterward, the fat tissues taken from the patient are subjected to some enzymatic reactions and a concentrated liquid consisting of alive cells.
In this liquid, there are stem cells that have the ability regenarate where it touches. The SVF liquid is injected into the areas where the erection occurs in the penis, namely the tube structures in the penis, and the system is repaired. Injected stem cells regenerate tissues and create a suitable environment for the formation of new vessels. This allows more blood flow to the penis and therefore improves the erection problem. The duration of the treatment is only 30 minutes.
Clinical studies show that with SVF stem cell therapy, a performance of erectile disfunction improvement is min 50% up to a maximum of 300% has been recorded from the patients. It is also possible to continue this treatment until the desired performance is achieved.
b-) ESWT(Extracorporeal Shock Wave Therapy) Application in Erectile Treatment
It has been proven that the shock waves application by LISWT repairs the vascular structure through the cell, creates new vessels, and by increases the blood supply in the penis, it treats the main cause of the erection problem.
The European Association of Urology has been recommending it as a first-line treatment since 2013.
•Permanant effect, no side effects no need for anesthesia
• No interaction with drug usage.
• No expensive
• It is painless. The session takes around 10 minutes.
• It is applied as 1 - 2 sessions per week for 4-6 weeks.
Effect Mechanism And Success Rate
It stimulates cell regeneration, cell formation, and new vessel formation by mechanical stimulation in tissues.
The treatment success rate has been reported as 80% in multicenter placebo-controlled studies.