Urology

Interstitial Cystitis | Peyronies Disease | Erectile Dysfunction | Male Incontinence


Interstitial Cystitis

STEM CELLS FOR INTERSTITIAL CYSTITIS /PBS

Millions of patients suffer from Interstitial Cystitis /painful bladder syndrome. This severe and debilitating condition has historically been confused with other bladder pathology which must be ruled out, making IC difficult to diagnose. Currently, Interstitial Cystitis/PBS is defined as "an unpleasant sensation (pain, pressure, discomfort) perceived to be related to the urinary bladder, associated with lower urinary tract symptoms of more than 6 weeks duration, in the absence of infection or other identifiable causes." (2009 new American IC/BPS Guidelines). Although there are several theories to explain IC, the exact cause remains unclear. Many patients with IC have the biomarker APF (antiproliferative factor) in their urine which inhibits bladder cell proliferation, making healing of the bladder lining much more difficult (1). Recent research indicates IC may be related to systemic neurosensitization and neuroinflammation that occurs within the bladder and also some other organ systems (2). Regardless of the cause, the end result of IC is damage to urothelium and bladder muscle that can run the spectrum from mild mucosal irritation to deep Hunner's ulcers.

INTERSTITIAL CYSTITIS AND ADIPOSE DERIVED MESENCHYMAL STEM CELLS

Adipose derived adult (non-embryonic) mesenchymal stem cells are currently being investigated for use in degenerative conditions that result in damage to various organs and systems. These cells have the ability to seek out areas of injury and regeneration and assist in the repair of nerves, blood vessels, muscle, fat, cartilage, bone, and many other structures. These cells are naturally recruited by cytokines (SDF-1 stromal derived factor one, HGF hepatocyte growth factor, and platelets), to sites of inflammation, ischemia, hypoxia, or injury and they assist in the healing process either by directly forming needed cells or secreting chemical messengers that promote healing. Stem cells are mobilized naturally from bone marrow when the body is healing but they are also found dormant but available in human adipose tissue. These stem cells from fat are abundant in levels up to 2500 times greater than those found in bone marrow and research indicates that the fat derived stem cells have equivalent regeneration potential to the bone marrow cells (3). Also, stem cell treatment success appears to relate to the number of cells used and this gives adipose cells a significant potential advantage to regenerate human tissues. Mesenchymal stem cells have been used extensively around the world in the successful treatment of orthopedic, cardiac, pulmonary, and neurologic disease in both humans and veterinary models. We have evidence that adipose derived stem cells can differentiate into functional smooth muscle cells (4,5) and we think therefore, that bladder repair by stem cells may be possible in IC patients. A recent study in mice with bladder outlet obstruction demonstrated that florescent protein labeled MSC's (mesenchymal stem cells) injected intravenously into test subjects incorporated into bladder muscle resulting in decreased hypoxia, hypertrophy, and fibrosis and increased blood flow. Nine out of ten mice who received MSC's had improved bladder compliance (6).

We know that patients with IC demonstrate abnormal cell signaling and cytokine release (7). For this reason, we believe that stem cell treatment may be helpful for interstitial cystitis patients who exhibit mucosal and smooth muscular damage. We have developed a protocol to treat patients with IC of various stages with adipose derived stem cells. Our protocol uses high doses of stem cells injected intravenously and also intra-vesically (directly into the bladder lumen) and in some cases directly into trigger points in the pelvic floor. We have evidence that intravesical instillation of adipose derived stem cells into mice effectively shows morphological and phenotypic evidence of smooth muscle incorporation into the bladder wall three months after instillation (8).

Silicon Valley Stem Cell Treatment Center is using high dose autologous adipose derived stem cells for the investigational treatment of various degenerative diseases. The use of autologous cells ensures that the patients receive cells from only their own bodies. The technology to isolate the adipose derived stem cells has been obtained from Korea and is state of the art. All CSCTC studies are patient funded and not approved by the FDA. We have initiated a pilot study to investigate the effectiveness of high dose adipose derived stem cells on interstitial cystitis. Only adult adipose derived stem cells are used at the Silicon Valley Stem Cell Treatment Center since embryonic stem cells have the potential to form rare tumors and have ethical considerations. At Silicon Valley Stem Cell Treatment Center, the stem cells are obtained from a "mini" liposuction-like procedure performed under local anesthetic. Stem cells are isolated on site from the patient's own fat and then deployed in our facility within 90 minutes. Regenerative healing naturally takes time and we do not expect immediate improvement in symptoms. Patients will be followed closely through our research registry and data collected carefully to help establish effectiveness of our treatment protocols.


Peyronies Disease "PD"

Peyronies Disease "PD" has been described by experts as a physically and psychologically devastating problem manifested by a fibrous inelastic scar of the fibrous chambers of the penis known as the tunica albuginea. The scarring (known as "peyronies plaques") can cause pain, bending, narrowing, hinging and shortening of the penis in the erect state. Recent demographic studies have shown that up to 9% of men have this problem and it seems to be even more prevalent after radical prostatectomy surgery. More than half of the cases worsen over time and only 13% resolve spontaneously. Peyronies is also closely associated with erectile dysfunction.

Peyronies Disease and Stromal Vascular Fraction (SVF)

There is no known non-surgical cure for PD and surgery can often result in more scarring, shortening or loss of sensation and adequate erectile function. Cases that involve calcification seem to do the worst with non-surgical treatment. Non-surgical therapies include: Vitamin E, Potaba, colchicine, tamoxifen, carnitine, and Omega-3 fatty acids. Unfortunately, formal studies have shown no benefit of any of these over placebo. Verapamil cream is often used by clinicians but there are no controlled trials proving that the verapamil penetrates into the tunica albuginea. There have been eight studies on intralesional injection of verapamil showing some positive effects in decreasing curvature and deformity improved in 30% to 60% of patients. The usual treatment is 10 mg injected every two weeks a total of twelve times. Injection of interferon alpha 2b has shown very mixed results. There is an ongoing FDA study of a drug (phase 3) called Xiaflex which is made from bacterial collagenase. Early results may be promising with curvature reduction 20% higher than with placebo. There are some ongoing European studies of a penile traction device that stretches the penis and early results seem to indicate a benefit but it involves a rigorous daily application of a device to the penis.

There is evidence that stem cells will actively seek out and attempt to repair a Dupytren's contracture which is nearly identical to PD but occurs in the hand. Stem cells may be highly effective in inflammatory scarring conditions occurring in other parts of the body. We have developed a protocol for intralesional injection of autologous stem cells into peyronies plaques as a non-surgical option for patients who have not responded to other conservative measures but wish to avoid surgery.

Silicon Valley Stem Cell Treatment Center and Peyronies Disease

We care about our Peyronies Disease patients at Silicon Valley Stem Cell Treatment Center and the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out CSCTC Confidential Candidate Application, we will answer the questions and concerns you may have about Silicon Valley Stem Cell Treatment Center and Cell Surgical Network protocols for Peyronies Disease. Our Cell Surgical Network has Treatment Centers in several states, checkout our Physician Network to find the closest Treatment Center. Our Physician Network Map.


Erectile Dysfunction "ED"

Erectile Dysfunction is defined as the inability to achieve or sustain an erection suitable for sexual intercourse. ED affects up to one third of men of men throughout their lives and has a substantial negative impact on intimate relationships, quality of life and self-esteem. Causes are multifactorial but can be related to loss of testosterone, surgical damage to the penile nerves, medications, or other medical illnesses. The most common cause of ED is "vasculopathy", which is damage to the delicate blood vessels in the penis. This vasculopathy is often associated with age but strongly related to atherosclerosis, diabetes, hypertension, high cholesterol and cerebrovascular and peripheral vascular disease. Men with ED are also at significantly increased risk of coronary artery disease. Therefore, when men have ED, screening for cardiovascular risk factors should be considered because symptoms of ED present as much as three years earlier than other symptoms of coronary artery disease such as chest pain. The current treatment of ED centers around the use of Phosphodiesterase type 5 inhibitors such as Viagra, Cialis, or Levitra. Intraurethral pellets and intracavernosal (penile injectable agents) are also available if oral medications fail. Various mechanical external vacuum pump devices are helpful also in patients who are comfortable with assisted devices. Penile revascularization surgery has mostly fallen out of favor due to poor outcomes in most patients. At this time, the only treatment available to patients who have not succeeded with any of the above are surgically implanted hydraulic penile prostheses. These surgeries are somewhat invasive but mostly effective. Adipose derived stem cells have shown extraordinary promise in revascularizing cardiac tissue, ischemic limbs and other organs suffering damage from poor blood flow by regenerating small blood vessels as well as smooth muscle and nerves. We have evidence that adipose derived stem cells stimulate endothelial (small blood vessel lining) growth and improve penile blood flow in animal models. Early attempts have been made in human patients to re-vascularize their penile arteries using stem cells from umbilical cord blood and results showed great promise as discussed at a 2008 meeting of the American Urological Association in Orlando Florida. At Silicon Valley Stem Cell Treatment Center, we have a protocol to deploy extremely high numbers of adipose derived stem cells into the penile corpora cavernosa to naturally revascularize the penis allowing recovery of normal erections.

Erectile Disfunction Call to Action

We care about our Erectile Disfunction patients at Silicon Valley Stem Cell Treatment Center and the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out CSCTC Confidential Candidate Application, we will answer the questions and concerns you may have about Silicon Valley Stem Cell Treatment Center and Cell Surgical Network protocols for Erectile Disfunction. Our Cell Surgical Network has Treatment Centers in several states, checkout our Physician Network to find the closest Treatment Center. Our Physician Network Map.


Male Incontinence

Post prostatectomy incontinence Protocol

In America alone, more than three million men are affected by loss of bladder control, a medical condition known as urinary incontinence. This problem has a great impact on health and quality of life for those who suffer with it. Male urinary incontinence is usually caused by a damaged sphincter, the circular muscle that controls the flow of urine out of the bladder. It often happens as the unavoidable result of prostate cancer surgery. When the sphincter is damaged, the man cannot squeeze or close off the urethra and leakage occurs especially with straining or exercise.

Male Incontinence and Silicon Valley Stem Cell Treatment Center

CSCTC is using Stromal Vascular Fraction with adipose derived adult mesenchymal stem cells to treat post prostatectomy incontinence. The SVF and a small amount of condensed fat matrix is injected with a telescope directly into a deficient sphincter under local anesthetic. Based on experience from Nagoya University, Japan where Stromal Vascular Fraction has been used successfully for male incontinence, we believe that the external sphincter may be regenerated to some extent to provide bladder control. CSCTC can provide access to the same technology here in Silicon Valley through our investigational protocol.

Male Incontinence Call to Action

We care about our Male Incontinence patients at Silicon Valley Stem Cell Treatment Center and the Cell Surgical Network and take pride in the time we provide to our patients to deploy the best protocols to help our patients achieve their goals. By filling out CSCTC Confidential Candidate Application, we will answer the questions and concerns you may have about Silicon Valley Stem Cell Treatment Center and Cell Surgical Network protocols for Male Incontinence. Our Cell Surgical Network has Treatment Centers in several states, checkout our Physician Network to find the closest Treatment Center. Our Physician Network Map.