Combination Therapy Using Human Adipose-derived Stem Cells on the Cavernous Nerve and Low-energy Shockwaves on the Corpus Cavernosum in a Rat Model of Post-prostatectomy Erectile Dysfunction.

Abstract

OBJECTIVE:

To investigate combined therapeutic efficacy of human adipose-derived stem cells (h-ADSCs) application on injured cavernous nerve and low-energy shockwave therapy (SWT) on the corpus cavernosum in a rat model of post-prostatectomy erectile dysfunction.

MATERIALS AND METHODS:

Rats were randomly divided into 5 groups: control, bilateral cavernous nerve injury (BCNI), adipose-derived stem cell (ADSC) (BCNI group with h-ADSCs on the cavernous nerve), SWT (BCNI group with low-energy SWT on the corpus cavernosum), and ADSC/SWT (BCNI group with a combination of h-ADSCs and low-energy SWT). After 4 weeks, erectile function was assessed using intracavernosal pressure. The cavernous nerves and penile tissue were evaluated through immunostaining, Western blotting, and a cyclic guanosine monophosphate assay.

RESULTS:

ADSC/SWT significantly improved intracavernosal pressure compared to the other experimental group. ADSC had significantly increased β-III tubulin expression of the cavernous nerve, and SWT had a markedly enhanced vascular endothelial growth factor expression in corpus cavernosum. The ADSC/SWT group had a significantly increased in alpha smooth muscle actin content (P < .05), neural nitric oxide synthase (nNOS) of the dorsal penile nerve (P < .05), endothelial nitric oxide synthase (eNOS) protein expression (P < .05), and cyclic guanosine monophosphate level (P < .05) compared to the ADSC or SWT alone group. In addition, ADSC/SWT reduces the apoptotic index in the corpus cavernosum.

CONCLUSION:

In this study, h-ADSCs showed an effect on the recovery of injured cavernous nerve and low-energy SWT improved angiogenesis in the corpus cavernosum. The h-ADSCs combined with low-energy SWT showed beneficial effect on the recovery of erectile function in a rat model of postprostatectomy erectile dysfunction.

• Authors: Seung Hwan Jeon, Kshitiz Raj Shrestha, Richard Y Kim, Ae Ryang Jung, Yong Hyun Park, Ohseong Kwon, Ga Eun Kim, So Hyun Kim, Ki Hean Kim, Ji Youl Lee
• Journal: Urology (Urology) Vol. 88 Pg. 226.e1-9 (Feb 2016) ISSN: 1527-9995 [Electronic] United States
• PMID: 26522972 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Topics

• Adipocytes (transplantation)
• Animals
• Combined Modality Therapy
• Disease Models, Animal
• Erectile Dysfunction (etiology, therapy)
• Humans
• Male
• Penis (innervation)
• Prostatectomy (adverse effects)
• Random Allocation
• Rats
• Rats, Sprague-Dawley
• Stem Cell Transplantation
• Ultrasonic Therapy