Various treatments are available that deal with male erectile dysfunction but most of them are on-demand, meaning that these treatments help induce erections when taken just before sexual activity.
For the majority of patients this is absolutely fine and indeed PDE-5 inhibitors and intracavernosal injections have revolutionised male sexual health as they present a very safe and effective treatment for over 90% of patients suffering from erectile dysfunction, irrespective of age or other comorbidities.
For patients not responding to these medical therapies, the penile prosthesis implant is always an alternative, but it is an invasive and irreversible operation.
As with any field of medicine, the holy grail of impotence treatment would be restoring a natural healthy erectile function, very much like the one experienced by men in their early 20s – this the promise that stem cell treatments hold!
Unfortunately, from theory to practice there is a long way and in order to establish the therapeutic effects of stem cell treatments on erectile function, extensive clinical assessment is required, not only to establish the safety of stem-cell treatments but mainly their efficacy.
As such we welcome the publication of a new study from Odense University in Denmark, which evaluates the effects of a single injection of stem cells in the erection mechanism of impotent patients that had undergone radical prostatectomy. We are particularly excited about this study as we have been closely following the work of the director of the study, Prof. Soren Sheikh and the basic stem cell research that he is involved is state-of-the-art. As Prof. Sheikh communicated to us in the past, he firmly believes that erectile dysfunction therapy will be the first widely adopted stem cell treatment.
Overview of the Study
The study enrolled seventeen men suffering from post-radical prostatectomy (RP) erectile dysfunction, with no recovery using conventional therapy. All subjects had RP performed 5–18 months before enrolment, and were followed for 6 months after the single stem cell injections.
Intracavernous injection of stem cell was well-tolerated and only minor events related to the liposuction and cell injections were reported at the one-month evaluation, but none at later time points. Interestingly, the study participants were further categorized based on whether they were also suffering from incontinence – a very common side effect of RP. Accordingly, for continent men, 8 out of 11 men recovered erectile function. In contrast, incontinent men did not regain erectile function.
Interpretation of the Results
As explained earlier, from theory to practice is a long way and this study is a very first basic step. In our view, the main scientific value of this study is the fact that the injection of stem cells in the erection mechanism does not lead to any immediate adverse effects and does not seem to compromise the tissue where it is injected. Beyond that, another interesting point is the difference in outcomes between continent and incontinent men but this is only a hint for future research direction and patient selection for further trials.
In summary, a much more elaborate study (double-blind, placebo-controlled) would need to be carried out to evaluate the efficacy of the stem cell treatment for erectile dysfunction. Nonetheless, proving that stem cell intra-cavernosal injection is safe will hopefully allow regulators and research groups to approve further studies so as to move forward such an important research field.