Stem Cell Therapy for Erectile Dysfunction: What the Research Shows

How well is stem cell therapy for erectile dysfunction understood, and what do clinical findings show? In this article, we share research insights on stem cells and their secretome in the context of erectile dysfunction, and explain the scientific rationale behind these approaches.

There are several possible causes for ED. In general, there are organic and psychogenic causes of ED.

Organic ED can occur due to physical damage during surgery (e.g. prostate surgery), or when the patient suffers high blood pressure, diabetes or cardiovascular disease. Thus, organic ED can be divided into the following groups:

• Vascular or vasculogenic causes – damage to vessels or worsening of their state due to age-related changes can cause ED
• Neurogenic causes – peripheral nerve injury (often detected in diabetes mellitus and in men after surgical removal of the prostate) can cause ED
• Endocrine causes – some diseases can lead to a decrease in testosterone production, which causes ED
• Penile causes – penile diseases such as Peyronie's disease cause ED

Psychological problems can also cause impairment in erectile function, these are categorized into the psychogenic group. When the occurring impotence is generalized, the person is not capable of sexual arousal. The cause of that may be depression, anxiety or other mental disorders. There is also situational psychogenic ED, which can be associated with the partner or a situation.

As mentioned previously, there are many different causes of ED, which all require a different type of treatment.

In case of hormonal imbalance or mental causes, medication is a common option. In these cases, the underlying imbalance is targeted during treatment, hoping that the ED will disappear once the cause is eliminated.

Current treatments for vascular ED include medications such as PDE5 inhibitors (commonly known as the “blue pill” you can take before intercourse). Other treatment possibilities are injections or even penile implants.

When physical injury is the cause of impotence, the only way to fully restore sexual function is to treat the underlying physical problem. This is, however, dependent on the injury and is oftentimes not very successful.

Many of these established options act mainly on the symptoms rather than on the underlying cause, and some are invasive or can involve side effects. This has contributed to growing interest in regenerative approaches that aim to address the underlying tissue rather than the symptoms alone.

Research has identified regenerative and immunomodulatory properties of stem cells. Since these findings, scientists and physicians across many disciplines have investigated how the cells might be applied to a range of conditions.

In urology, and specifically erectile dysfunction, research suggests these effects may be mediated largely by the secretion of growth factors and cytokines into the blood stream, possibly alongside the migration of these factors to the major pelvic ganglia and a degree of cellular differentiation¹.

Research suggests that stem cells may support the regeneration of penile tissue, blood vessels and nerves in the treated area. Unlike medication taken to induce an erection on a given occasion, this approach is directed at the underlying tissue rather than at the symptom, and its aim is a longer-term rather than a purely symptomatic effect.

Mesenchymal stem cells (MSCs) are the cell type most frequently used in urological applications, and the most common method of delivery is direct injection¹.

Treatment protocols typically involve several applications over a few months, and may be repeated periodically depending on the individual case.

Because direct injections can be uncomfortable and carry some potential for side effects, there is also growing interest in the intravenous application of stem cells or their secretome. The stem cell secretome is the sum of the components stem cells release, including exosomes, growth factors and cytokines.

This cell-free approach is designed to deliver selected stem-cell-derived factors in a more controlled form, while avoiding some of the risks associated with administering living cells. Research suggests that a substantial part of the activity associated with stem cells may be mediated by these secreted factors.

Read more about exosomes and what they are here.

The price for stem cell treatments can vary considerably, because it depends on the individual situation of the patient and on the type of treatment involved.

The source of the stem cells, for instance, greatly impacts the price. If the stem cells come from bone marrow concentrate, the price is generally lower than when they come from mesenchymal stem cells.

Another factor is the treatment schema. Many clinics offer single injections, which are lower in price than schemes involving several applications.

Finally, the price is often influenced by the regulatory requirements and quality standards that apply to a given clinic. In strictly regulated countries, prices tend to be higher, because clinics must meet defined manufacturing and quality standards for the product. Because these requirements differ between countries, prices also differ internationally.

In the US, a typical price for a single stem cell injection can vary between 2.000 to 12.000 USD

ANOVA is a German Stem Cell Clinic that focuses on each patient’s individual situation. We offer a range of stem-cell-based approaches and tailor treatment following an individual medical assessment. Stem-cell-based and secretome therapies remain developing medical approaches, and individual outcomes cannot be predicted. If you would like more information or a cost estimate, please get in touch with us. Our patient care managers can provide you with information and can arrange a consultation with our doctors.