Erectlie Dysfunction

Erectlie dysfunction (ED) is defined as the consistent or recurrent inability to attain or maintain an erection sufficient for satisfactory sexual performance.

ED risk factors include widespread diseases such as hypertension and obesity, but also medications such as β-blockers and anti-depressants, as well as major life-style factors like smoking and alcohol use cause ED.

Moreover, age is a risk factor; approximately one third of men in their forties report ED symptoms, 50% of the male population aged between 40 and 70 years will suffer from ED at some stage, with 10% of these affected severely

At the cellular level, ED is thought to be caused by neuro-vascular or hormonal dysfunction resulting in impaired vasodilatation of penile arteries When the natural nocturnal erection is lost, the penis tissue enters a chronic hypoxic state leading to vascular dysfunction

Many physical causes of ED exist, with only 10–20% of sufferers believed to have a solely psychological cause .There are many organic causes for ED, with the majority of these based upon vascular insufficiency.


1. Atherosclerosis //Hyperlipidaemia //Hypertension//Diabetes mellitus//Smoking
1. Traumatic brain injury//Parkinson’s disease//stroke//Multiple sclerosis
2. Brain tumours//Spinal cord injury// disc disease
3. Peripheral neuropathy (e.g. diabetic)//Uraemia//Alcoholism
1. Hypogonadism//Thyroid disease//Cushing’s disease//Hyperprolactinaemia
1. Beta blockers//LHRH analogues//Antidepressants //H2-receptor antagonists// Recreational drugs

International Index of Erectile Function-5 (IIEF-5) and Erection Hardness Score (EHS) are used to assess erectile function inclusion before and after stem cell administration.

Penile ultrasound Done after agents such as sildenafil. These drugs cause smooth muscle relaxation, vasodilatation and increased inflow of blood into the corpora cavernosa, leading to tumescence. An adequate response to a trial of these agents confirms adequate arterial supply and veno-occlusive mechanism, and precludes the need for further investigation.

Penile Doppler Sonogrphy : reserved for those patients with little or no response to these first-line medications, and in whom arterial or venous insufficiency is suspected.

Angiography: catheter angiography is reserved for those patients with a suspected stenotic or occlusive lesion causing arterial insufficiency. It is considered a second-line technique utilised as an adjunct to ultrasound. Catheterisation of the internal pudendal artery allows formal documentation of arterial supply to the penis, and will demonstrate the extent andlocation of any arterial lesion as preparation for bypasssurgery/revascularisation.

Cavernosography : is a technique utilising injection ofcontrast medium into the cavernosa as a means of primarily detecting defects in the veno-occlusive mechanism causing leaks.

MRI: is utilised almost exclusively as a second-line ‘‘problemsolving’’ modality in those cases where structural abnormality has been demonstrated but requires further characterisation. To demonstrate tunical dehiscence and cavernosal fibrosis Plaques and haematoma resulting from penile trauma/fracture etc

Objective measurement for the recovery of erectile function, includes measurement of penile hemodynamics or nerve impulse speed.
Adipose-derived regenerative cells (ADRCs, also referred to as stromal vascular fraction, SVF) are able to differentiate into vascular cells and neurons in vitro, and a large body of preclinical work shows a surprisingly good effect of ADRC injection into the corpora cavernosa.

The safety of applying freshly isolated autologous ADRCs along with BAC for non-homologous use in intracavernous injections has previously been fully explored in many studies .

Therapy of ED includes administration of Laser activated adipose derived stem cells with of Dose 0.5 million to 1 million per kg body weight along with PRP
It is a Day care procedure .very Minor adverse events related to the liposuction and injection like redness and swelling at the injection sites. scrotal and penile hematoma etc are observed in less than 20 % cases

70 % patients recover erectile function after ADRC injection with the ability to complete intercourse , Recover erectile function within 3 months, and that this effect persisted for 12 months.