Urology is one of the fields at the forefront of stem cell therapy research.

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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.

Peyronies Disease and Stromal Vascular Fraction (SVF)

There is no known non-surgical cure for PD and surgery can often result in more scarring, shortening or loss of sensation and adequate erectile function. Cases that involve calcification seem to do the worst with non-surgical treatment. Non-surgical therapies include: Vitamin E, Potaba, colchicine, tamoxifen, carnitine, and Omega-3 fatty acids. Unfortunately, formal studies have shown no benefit of any of these over placebo. Verapamil cream is often used by clinicians but there are no controlled trials proving that the verapamil penetrates into the tunica albuginea. There have been eight 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 is an ongoing FDA study of a drug (phase 3) called Xiaflex which is made from bacterial collagenase. Early results may be promising with curvature reduction 20% higher than with placebo. There are some ongoing European studies of a penile traction device that stretches the penis and early results seem to indicate a benefit but it involves a rigorous daily application of a device to the penis.

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 intralesional injection of autologous adipose derived stromal vascular fraction (rich in mesenchymal stem cells and growth factors) directly into Peyronies plaques as a non-surgical option for patients who have not responded to other conservative measures but wish to avoid surgery. Some patients will also be eligible to receive low intensity shock wave therapy in conjunction with SVF deployment in an effort to activate the stem cells to induce revascularization and healing.

Cell Surgical Network and Peyronies Disease

We care about our Peyronies Disease patients at the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out the Confidential Candidate Application, we will answer the questions and concerns you may have about Cell Surgical Network protocols for Peyronies Disease.

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 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 also helpful 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.

 

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 and 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

DOES LOW-INTENSITY EXTRACORPOREAL SHOCK WAVE THERAPY HAVE A PHYSIOLOGIC EFFECT ON ERECTILE FUNCTION? SHORT-TERM RESULTS OF A RANDOMIZED, DOUBLE-BLIND, SHAM-CONTROLLED STUDY Vardi, Appel, Kilchevsky, Gruenwald

At Cell Surgical Network, we have designed a protocol to deploy extremely high numbers of adipose derived stromal vascular fraction (rich in stem cells and growth factors) into the penile corpora cavernosa in conjunction with low intensity shock wave therapy in an effort to stimulate vascular endothelial repair and angiogenesis. This represents an attempt to achieve improvement erectile dysfunction in patients with vasculopathy and Peyronies disease.

Erectile Dysfunction Call to Action

We care about our Erectile Dysfunction patients at the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out our Confidential Candidate Application, we will answer the questions and concerns you may have about Cell Surgical Network protocols for Erectile Dysfunction. Our Cell Surgical Network has Treatment Centers in several states. Locate the closest Treatment Center using Our Physician Network Map.

Incontinance
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.

Male Incontinence and Cell Surgical Network

Cell Surgical Network is using Stromal Vascular Fraction with adipose derived adult mesenchymal stem cells to treat post prostatectomy incontinence. The SVF and a small amount of condensed fat matrix is injected with a telescope directly into a deficient sphincter under local anesthetic.  Based on experience from Nagoya University, Japan where Stromal Vascular Fraction has been used successfully for male incontinence, we believe that the external sphincter may be regenerated to some extent to provide bladder control.  We can provide access to the same technology through our investigatory protocol.

Male Incontinence Call to Action

We care about our Male Incontinence patients at the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out our Confidential Candidate Application, we will answer the questions and concerns you may have about Cell Surgical Network protocols for Male Incontinence. Our Cell Surgical Network has Treatment Centers in several states. Locate the closest Treatment Center using Our Physician Network Map.

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