Erectile dysfunction treated with intracavernous stem cells: A promising new therapy?

In the past decades, great interest has been shown in the development of new therapies for erectile dysfunction. Stem cell therapy has generated promising results in numerous preclinical trials in animal models, which is why has led to the development of the first clinical trials in humans. The main cause involved in the pathophysiology of erectile dysfunction is vascular damage related to endothelial and neuronal injury. The interest in stem cell therapy is justified by their capability to differentiate into specific damaged tissues, including endothelium and nervous tissue, and induction of the host own cell proliferation. Despite the great effort of the many studies carried out to date, knowledge about biological effects, therapeutic efficacy and safety of stem cells therapy for erectile dysfunction is still very limited.

Erectile dysfunction treated with intracavernous stem cells: A promising new therapy? / Células madre vía intracavernosa para el tratamiento de la disfunción eréctil: ¿una nueva modalidad terapéutica?

In the past decades, great interest has been shown in the development of new therapies for erectile dysfunction. Stem cell therapy has generated promising results in numerous preclinical trials in animal models, which is why has led to the development of the first clinical trials in humans. The main cause involved in the pathophysiology of erectile dysfunction is vascular damage related to endothelial and neuronal injury. The interest in stem cell therapy is justified by their capability to differentiate into specific damaged tissues, including endothelium and nervous tissue, and induction of the host own cell proliferation. Despite the great effort of the many studies carried out to date, knowledge about biological effects, therapeutic efficacy and safety of stem cells therapy for erectile dysfunction is still very limited

En las últimas décadas, ha habido gran interés en el desarrollo de nuevos tratamientos para tratar la disfunción eréctil. El tratamiento con células madre ha arrojado prometedores resultados en numerosos estudios preclínicos en modelos animales, lo cual ha generado el desarrollo de los primeros ensayos clínicos en seres humanos. Puesto que la principal causa implicada en la fisiopatología de la disfunción eréctil es una lesión vascular asociada con lesión endotelial y neuronal, el interés por el tratamiento con células madre se justifica por la capacidad que tienen para diferenciarse en los distintos tejidos dañados, incluyendo endotelio y tejido neuronal, y en la inducción de la reparación de las propias células del huésped. A pesar del gran esfuerzo de los distintos estudios realizados hasta el momento actual, el conocimiento sobre los efectos biológicos, la eficacia terapéutica y la seguridad del tratamiento con células madre aún se encuentra muy limitado

[Use of tadalafil in the rehabilitation of patients with a history of posterior urethral injury in the context of pelvic fracture]. / Uso de tadalafilo en la rehabilitación de pacientes con antecedente de lesión de uretra posterior en el contexto de fractura pélvica.

OBJECTIVE: To evaluate the tadalafil effect in the treatment of erectile dysfunction as a consequence of posterior urethral injury. MATERIAL AND METHODS: This is a retrospective study that included patients with posterior urethral injury caused by previous pelvic fracture; our patients received emergency urethral alignment and urethroplasty between 8 to 10weeks after trauma. To assess the degree of erectile dysfunction pre- and post-treatment, we applied the questionnaire of International Index of Erectile Function (IIEF-5). Statistics Wilcoxon test and descriptive statistics were performed. RESULTS: Eight patients were included in this study, with an average age of 32.5years; the IIEF scale prior to treatment was on average 8.5 points and increased to 12.36 points with a value of P=.011. DISCUSSION: These eight patients showed erectile dysfunction at the time of IIEF assessment, this due to emergency urethral realignment arising from the trauma caused by pelvic fracture. Treatment with inhibitors of 5-phosphodiesterase (iPDE5) is the first-line treatment in patients with erectile dysfunction because it is efficient, non-invasive and well tolerated. In this study we found results indicating good response to this treatment in 7 out of the 8 patients (87.5%). Only one patient showed no improvement after treatment, due to the presence of risk factors such as age (65years), tobacco use, and high blood pressure. CONCLUSION: The 87.5% of patients with urethral injury medicated with tadalafil were rehabilitated.

Uso de tadalafilo en la rehabilitación de pacientes con antecedente de lesión de uretra posterior en el contexto de fractura pélvica / Use of tadalafil in the rehabilitation of patients with a history of posterior urethral injury in the context of pelvic fracture

Objetivo. Evaluar la utilidad del tadalafilo en el tratamiento de la disfunción eréctil a consecuencia de una lesión uretral posterior. Material y métodos. Estudio retrospectivo que incluyó pacientes con lesión uretral posterior a consecuencia de fractura de pelvis, tratados en primera instancia mediante realineamiento uretral de urgencia y posteriormente uretroplastia término-terminal entre las 8-10 semanas posteriores al trauma. Para evaluar el grado de disfunción eréctil previa y postratamiento con tadalafilo se aplicó el cuestionario Índice Internacional de Función Eréctil (IIEF-5). Se realizó la prueba estadística de rangos de Willcoxon y estadística descriptiva. Resultados. Se incluyeron 8 pacientes en este estudio, los cuales tuvieron una media de edad de los 32,5 años. La escala IIEF previa al tratamiento con tadalafilo estuvo en promedio de 8,5puntos y tuvo un aumento postratamiento de 12,36 puntos, con una valor de p=0,011. Discusión Los 8 pacientes incluidos mostraron disfunción eréctil al momento de la evaluación IIEF, esto debido al realineamiento uretral de urgencia y derivada del trauma ocasionado por la fractura de pelvis. El tratamiento con inhibidores de la 5-fosfodiesterasa (iPDE5) es el de primera línea en pacientes con disfunción eréctil debido a que es eficiente, no invasivo y bien tolerado. En este estudio encontramos resultados que indican buena respuesta a este tratamiento en 7 de los 8 pacientes (87,5%). Solo un paciente no mostró mejoría con el tratamiento, sobresaliendo la presencia de factores de riesgo, como la edad (65 años), el tabaquismo y la hipertensión arterial. Conclusión. Se rehabilitó el 87,5% de los pacientes con lesión uretral medicados con tadalafilo (AU)

Objective. To evaluate the tadalafil effect in the treatment of erectile dysfunction as a consequence of posterior urethral injury. Material and methods. This is a retrospective study that included patients with posterior urethral injury caused by previous pelvic fracture; our patients received emergency urethral alignment and urethroplasty between 8 to 10 weeks after trauma. To assess the degree of erectile dysfunction pre- and post-treatment, we applied the questionnaire of International Index of Erectile Function (IIEF-5). Statistics Wilcoxon test and descriptive statistics were performed. Results. Eight patients were included in this study, with an average age of 32.5 years; the IIEF scale prior to treatment was on average 8.5 points and increased to 12.36 points with a value of P=.011. Discussion. These eight patients showed erectile dysfunction at the time of IIEF assessment, this due to emergency urethral realignment arising from the trauma caused by pelvic fracture. Treatment with inhibitors of 5-phosphodiesterase (iPDE5) is the first-line treatment in patients with erectile dysfunction because it is efficient, non-invasive and well tolerated. In this study we found results indicating good response to this treatment in 7 out of the 8 patients (87.5%). Only one patient showed no improvement after treatment, due to the presence of risk factors such as age (65 years), tobacco use, and high blood pressure. Conclusion. The 87.5% of patients with urethral injury medicated with tadalafil were rehabilitated (AU)