Introduction

Erectile dysfunction (ED) is a predominant male sexual disorder with prevalence in individuals of the higher age group (> 40 years). It is a multifaceted disorder arising from a plethora of factors. It profoundly impacts an individual’s mental well-being. The effects extend to relationship issues with the partner. The unreasonable societal standards further aggravate the situation, resulting in depression and anxiety.

The limitations of present treatment modalities and the psychological consequences of the disorder have driven the application of stem cell therapy in ED. The potential of stem cells can successfully address the components of the disorder to provide relief from symptoms.

Vascular Erectile Dysfunction Symptoms

ED describes the inability to achieve or maintain an erection, leading to unsatisfactory sexual intercourse. Several factors can contribute to the disorder, classified as psychogenic and organic. Blood flow disruption is the most common among the organic factors of ED. It is referred to as vascular or Vasculogenic Erectile Dysfunction. It is characterized by the following symptoms:

• Failure to get an erection

• It is difficult to maintain a firm erection during sexual activity.

• The person may have less sexual drive.

Vascular Erectile Dysfunction Causes

Vascular ED is marked by reduced blood flow in the penis to achieve or sustain an erection. The process of erection depends on smooth muscle relaxation of the penis. It widens the blood vessel diameter, increasing the blood supply into the corpora cavernosa, the spongy region of the penis required for erection. The blood filling in this region compresses the veins, which decreases the efflux of blood. Nitric oxide and cyclic guanosine monophosphate (cGMP) orchestrates the entire process. The degradation of cGMP by phosphodiesterase contracts the smooth muscle and reverses the process. Impairment of any step can lead to vascular ED. It is broadly categorized as follows based on the  

Arterial ED: Blockage or narrowing of arteries supplying blood to the penis

Venous ED: Faster blood drainage from the penis veins

The myriad of comorbidities can lead to vascular ED that adds to the complexity of the disorder and its treatment. The following causes result in blood vessel narrowing, which also leads to ED:

Peripheral artery disease: Blockage of arteries in the lower limbs

Coronary artery disease: Obstruction in arteries of the heart

Hypertension: High blood pressure can weaken the vessels and affect blood flow

High cholesterol: It can accumulate in vessels and block them

Diabetes: High glucose deposits in vessels, which can deteriorate them

Obesity: It dysregulates the vascular homeostasis.

Aging: Apart from increasing comorbidities with age, the blood vessels also weaken due to rising oxidative stress.

Vascular Erectile Dysfunction Treatment

The treatment modalities for Vascular Erectile Dysfunction (ED) can be grouped based on the underlying pathways they target:

Preventing degradation of cGMP: It is usually the first line of treatment and employs phosphodiesterase type 5 inhibitors (PDE-5)

Increasing vessel diameter: It uses several vasodilators such as prostaglandin E2, atropine, papaverine, etc. These categories also include balloon angioplasty with or without stent to widen the arteries.

Revascularization: It is a surgical procedure that involves bypassing the blocked artery by forming another route for blood flow by the existing arteries.

However, these treatments demonstrate temporary effects, and prolonged use of medications shows adverse complications. Several people respond poorly to this treatment, thus prompting the development of an innovative solution.

Stem Cell Treatment for Vasculogenic ED

Stem Cell Treatment has been the emerging solution for several disorders, including vascular ED. It treats multiple cellular pathways and regenerates tissue, resulting in functional restoration. Mesenchymal stem cells (MSCs) have been researched extensively for their impact on ED. Scientists have revealed the following actions of stem cell therapy on vascular ED:

• Stem cells transform into blood vessel cells, including smooth muscle cells and endothelial cells. It replenishes the lost or damaged cells of vessels to repair them.

• These cells also increase the quantity of blood vessels by secreting vascular endothelial growth factor (VEGF), angiopoietin, bFGF, etc., thus restoring blood supply.

• They create a favourable microenvironment for vessel repair by combating inflammation and oxidative stress. These two processes cause cell damage and deteriorate blood vessels.

• They also prolong vascular cell survival and mitigate hypoxia in endothelial cells.

All these pathways restore the blood flow and improve erectile function. A clinical trial in 2021 reported significant improvements in vascular flow, erectile functions and rigidity of erection after administering umbilical cord MSCs. The prosecution also documented that the treatment did not result in any complications.

In Conclusion

The setbacks in the Current Treatment Options for vascular ED have prompted the development of alternatives. Regenerative medicine has been gaining momentum due to its tissue repair capacity, which subsequently improves tissue functions. Stem cells, the vital components of regenerative medicine, have been thoroughly researched. Instead of targeting a single pathway in conventional therapies, these cells act on multiple pathways to treat ED in a holistic manner. Stem cell treatment is a minimally invasive, non-surgical alternative which offers lasting results. Clinical trials have demonstrated that the treatment is effective and safe, deeming it a potential cure for ED in future. Long-term clinical trials with a high sample size will lead to the translation of this therapy into hospitals. Advancells is reshaping the future of stem cell therapy for ED with its premium-quality stem cells.