Regenerative therapy for erectile dysfonction and CVD overlap syndrome

Objectives: Describe the procedure of obtaining optimal and injectable Nanofat Injecting a biocellular combination of HDPRP with or without Botox locally into c orpora cavernosa (CC) For the first time demonstrate direct injection into S3 foramen by using a combination of Nanofat and alpha 2 macroglobulin (a2M). Explain the combination of Nanofat, HD-PRP, a3M, with and without botox as the new and effective E D therapy.. Reporting increase in International Index of Erectile Function (IIEF). This study can be applied to vascular, neurological, metabolic diseases and degenerative conditions Introduction: ED is socioeconomic problem of the old and young population. Sexual and urology clinics focusing more on being well and less on treating the vascular and the neurological roots of ED. Current medical options, including oral phosphodiesterase type 5 (PDE5) inhibitors, implant, pump, intracavernosal (IC) injection and lifestyle medications, are suboptimal and never achieve the desire outcome. Cellular therapy with (Li-ESWT), PRP, and stem cell therapy, exert some curative effects, but they are still in their infancy. Stem cells therapy regardless of the source are at the research level. Materials / method: Lipoaspiration using a modified Tonnard and Alexander protocol was followed. Standard surgical sterile techniques during Tumescent infiltration, pretunneling, and AD-SVF harvesting , maintained during the whole procedure. The closed-syringe system with smooth cannulas and super luer-lock connection used to provide even vacuum force and low pressure lipoaspiration. Decanting, to remove the infranatant, centrifuge at 1000g for 3-4 minute. The products treated either mechanically or emulsified to produce the Nanofat. The Nanofat combine with HDPRP injected at S 3 level, location to be demonstrat Results: The great advantage of this technique resulted in use of small needle injection ability from a clinical standpoint. There were no complications from the closed-syringe microcannula system for autologous harvest with each patient followed up for 6 months to one year. Very minimal subdermal bruising was noticed at the donor sites. There was no need for antibiotics treatment. Drugs reaction, cellulitis, hemorrhage/hematoma, scaring, prolonged pain were not noticed. Clinical observation and PTs satisfaction of using this method have significant advantages over conventional over ED therapy. Conclusion: Most surgeons who are experienced with Autologous fat grafting can easily adopt this procedure of low pressure and minimally traumatic procedure. This is a safe, economical way and effective protocol to harvest AD-SVF, isolate the Nanofat and mixed it with 20% HD-PRP to enhance the reliability and clinical success of ED therapy. Further research is needed to provide methods to successfully and uniformly quantify survival and biochemical/molecular of the injectable biocellular materials at S level . This method is very attractive for the clinical providers and easily tolerated by the PTs.