摘要

Objectives: 1:Diagnose the problem with current ED medical options 2:Formulate a novel combined Biocellular approach for ED therapy 3: Focus on treating the vascular and neurological roots of ED. 4: Zero on treating the neurological causes of ED. 5: Obtain an injectable size nanofat with the same regenerative properties of AD-SVF 6:Describe the procedure to inject the biocellular combination locally in to IC and systemically into S3 foramen. 7: Demonstrate the S3 injection procedure. 8: Explain the combination of Nanofat, HD-PRP, a3M, with and without botulinum toxin. 9: Reporting increase IIEF Introduction: Erection requires healthy vascular, neurological, and tissue responses. A network of afferents fibers, spinal interneurons, sympathetic, parasympathetic, somatic nuclei, and the spinal cord trigger erections.Neurotransmitter, NE and NO released from the sympathetic nitrergic nerves, and endothelium activate the SM.Erection is a neurovascular event, with more complex neurological phase which has been neglected in therapy.This abstract is focusing on repairing the neurological damages. Lipoaspiration yield a heterogeneous population of cells, AD-SVF to produce Nanofat with similar therapy value Materials / method: Lipoaspiration using Tonnard and Alexander protocol. Routine surgical asepsis maintained during Tumescent infiltration, pretunnaling, and AD-SVF harvesting.Closed-syringe system with smooth cannulas and super luer-lock connection were used to provide low pressure lipoaspiration. Decanting to remove the infranatant fluid, centrifuge the harvest at 1000g for 3-4 minute. Mechanically disaggregated nanofat by sequential passes through different Luer-lock sizes and mixed with 20% HDPRP. A 2 cc was injected IC in 3 places and bilaterally and 10 cc mix with a2M injected in the S3, followed by PRPF. Results: The great advantage of this technique is the use of small needle injection.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 and with no need for antibiotics. 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. A significant improve in performance with increase in IIEF. Conclusion: Surgeons who are experienced with fat transfer can easily adopt the closed syringes technique for minimally traumatic procedures.The present study described a safe, economic and effective protocol to harvest AD-SVF, isolate the Nanofat, mixed with HD-PRP to enhance the reliability and clinical success of ED therapy. This study aimed to evaluate the nanofat preparations in treating ED as a way to apply to other vascular, neuropathy, and metabolic diseases.The method is attractive and easily tolerated by the PT.The presence of pericytes in the Nanofat may become a breakthrough in ED therapeutic.