Is there a role for stem cell therapy in erectile dysfunction secondary to cavernous nerve injury? Network meta-analysis from animal studies and human trials

Journal article

Wani, M.M., Rai, B.P., Webb, W.R. and Madaan, S. 2022. Is there a role for stem cell therapy in erectile dysfunction secondary to cavernous nerve injury? Network meta-analysis from animal studies and human trials. Therapeutic Advances in Urology. 14 (1-21). https://doi.org/10.1177/17562872221086999
AuthorsWani, M.M., Rai, B.P., Webb, W.R. and Madaan, S.
Abstract

Introduction: We carried out systematic review and network meta-analysis to investigate the role of stem cell therapy (SCT) in the management of erectile dysfunction (ED) secondary to cavernous nerve injury in rats and post-radical prostatectomy (RP) in humans.

Patients and Methods: The protocol was registered with PROSPERO database. We searched studies analyzing the efficacy of SCT for ED due to bilateral cavernous nerve injury (BCNI) in rats using Healthcare Databases Advanced Search (HDAS) Export software (MEDLINE,EMBASE, Scopus) from inception to September 2020. The outcome measurements, for 29 animal studies, were intracavernosal pressure (ICP), ICP/MAP (mean arterial pressure) ratio, and histological/molecular changes. All three available human trials evaluating SCT in post-RP ED were assessed for International Index for Erectile Function (IIEF) Score and Erection Hardness Score (EHS).

Results: For ICP measurement, animal studies were divided into adipose-derived stem cells
(ADSCs) subgroup and bone marrow–derived stem cells (BMSCs) subgroup. Pooled analysis of these studies showed a beneficial effect of SCT in improving erectile function in rats with BCNI using network meta-analysis (95% confidence interval, CI; p < 0.001). There was an increase in ICP/MAP ratio in stem cell groups (including co-intervention) compared with control BCNI group. Histological and molecular evaluation of penile tissue revealed an increase in neuronal nitric oxide synthase (nNOS), smooth muscle content, and anti-apoptotic activity. Human trials revealed improved IIEF (70–150% from baseline at 6 months) and EHS (80–200% from baseline).

Conclusion: Our results confirm that SCT does improve the erectile function in rats having cavernous nerve injury. Similarly, early human results have shown promising results.

KeywordsStem cells; Erectile dysfunction
Year2022
JournalTherapeutic Advances in Urology
Journal citation14 (1-21)
PublisherSAGE
ISSN1756-2872
1756-2880
Digital Object Identifier (DOI)https://doi.org/10.1177/17562872221086999
Official URLhttps://journals.sagepub.com/doi/10.1177/17562872221086999
Publication dates
Print29 Mar 2022
Publication process dates
Accepted07 Mar 2022
Deposited06 Apr 2022
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Open
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Bipolar transurethral resection of prostate: Current status in the management of bladder outflow obstruction
M. Bolgeri, S. Naji, A. Sahai, F. Anjum, S. Madaan, S. Sriprasad and I. Dickinson 2012. Bipolar transurethral resection of prostate: Current status in the management of bladder outflow obstruction. Journal of Clinical Urology. 5 (3), pp. 105-110. https://doi.org/10.1016/j.bjmsu.2011.06.004
Benign schwannoma of seminal vesicle presenting as haematospermia
Faqar Anjum, Senthy Sellaturay, Phauda Thebe, Ian Dickinson, Seshadri Sriprasad and Sanjeev Madaan 2012. Benign schwannoma of seminal vesicle presenting as haematospermia. Journal of Clinical Urology. 5 (3), pp. 137-139. https://doi.org/10.1016/j.bjmsu.2011.06.003
Submucosal ureteric calculus mimicking transitional cell carcinoma
Madaan, S., Bardapure, M., Nagarajan, M. and Biyani, C. S. 2010. Submucosal ureteric calculus mimicking transitional cell carcinoma. International Journal of Clinical Practice. 64 (1), pp. 131-133. https://doi.org/10.1111/j.1742-1241.2006.01070.x
A giant bladder calculus with a synchronous giant secondary vaginal stone: a case report
Miah, S., Madaan, S., Khan, M., Urwin, G. and Stower, M. 2009. A giant bladder calculus with a synchronous giant secondary vaginal stone: a case report. Current Urology. 2 (4), pp. 206-207. https://doi.org/10.1159/000209835
Segmental testicular infarction: conservative management is feasible and safe
Sanjeev Madaan, Steven Joniau, Katrien Klockaerts, Liesbeth DeWever, Evelyne Lerut, Raymond Oyen and Hendrik Van Poppel 2008. Segmental testicular infarction: conservative management is feasible and safe. European Urology. 52 (2), pp. 441-445. https://doi.org/10.1016/j.eururo.2007.03.061
Segmental testicular infarction. Conservative management is feasible and safe: part 2
Sanjeev Madaan, Steven Joniau, Katrien Klockaerts, Liesbeth DeWever, Evelyne Lerut, Raymond Oyen and Hendrik Van Poppel Segmental testicular infarction. Conservative management is feasible and safe: part 2. European Urology. 53 (3), pp. 656-658. https://doi.org/10.1016/j.eururo.2007.03.062
Key clinical issues in renal cancer: a challenge for proteomics
Rosamonde E. Bank, Rachel A. Craven, Patricia Harnden, Sanjeev Madaan, Adrian Joyce and Peter J. Selby 2007. Key clinical issues in renal cancer: a challenge for proteomics. World Journal of Urology. 25, pp. 537-556. https://doi.org/10.1007/s00345-007-0199-y
Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report
Sanjeev Kotwal, Sanjeev Madaan, Stephen Prescott, Sameer Chilka and Peter Whelan 2007. Unusual squamous cell carcinoma of the scrotum arising from a well healed, innocuous scar of an infertility procedure: a case report. Annals of the Royal College of Surgeons of England. 89 (5), pp. W17-W-19. https://doi.org/10.1308/147870807X188498
Limitations of extracorporeal shock wave lithotripsy
Madaan, S. and Joyce, A. 2007. Limitations of extracorporeal shock wave lithotripsy. Current Opinion in Urology. 17 (2), pp. 109-113. https://doi.org/10.1097/MOU.0b013e32802b70bc
Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma
Sanjeev Madaan, Victor Palit, Patricia Gudgeon and Chandra Shekhar Biyani 2007. Omental metastasis with malignant ascites: an unusual manifestation of prostatic adenocarcinoma. Canadian Urological Association Journal. 1 (3). https://doi.org/10.5489/cuaj.86
Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy
S. Guleria, R .Chahal, S. Madaan, H. C. Irving, C. G. Newstead, S. G. Pollard and J. P .A. Lodge 2005. Ureteric complications of renal transplantation: the impact of the double J stent and the anterior extravesical ureteroneocystostomy. Transplantation Proceedings. 37 (2), pp. 1054-1056. https://doi.org/10.1016/j.transproceed.2004.12.123
A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management
Rohit Chahal, Sanjeev Madaan, Sandeep Guleria, J Peter A Lodge and John A Spencer 2004. A complex caliceal-cutaneous and caliceal-peritoneal fistula in a renal transplant patient: a case for conservative management. International Urology and Nephrology. 36, pp. 245-247. https://doi.org/10.1023/b:urol.0000034654.26422.f7
Transplant renal artery kinking: a rare cause of early graft dysfunction
Mohiuddin Miah, Sanjeev Madaan, David J Kessel, Charles G Newstead and Sandeep Guleria 2004. Transplant renal artery kinking: a rare cause of early graft dysfunction. Nephrology Dialysis Transplantation. 19 (7). https://doi.org/10.1093/ndt/gfh152
5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP)
Mohamed Y. Hammadeh, Sanjeev Madaan, John Hines and Timothy Philp 2003. 5-years outcome of a prospective randomised trial to compare Transurethral Electrovaporization of the Prostate (TUVP) to Standard Transurethral Resection (TURP). Urology. 61 (6), pp. 1166-1171. https://doi.org/10.1016/S0090-4295(03)00109-2
Androgen-dependent regulation of human MUC1 mucin expression
Stephen Mitchell, Paul Abel, Sanjeev Madaan, James Jeffs, Khurram Chaudhary, Gordon Stamp and El-Nasir Lalani 2002. Androgen-dependent regulation of human MUC1 mucin expression. Neoplasia. 4 (1), pp. 9-18. https://doi.org/10.1038/sj.neo.7900194
Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer
S.S. El-Sheikh, S. Madaan, A. Alhasso, P. Abel, G. Stamp and E.-N. Lalani 2002. Cyclooxygenase-2: a possible target in schistosoma-associated bladder cancer. BJU International. 88 (9), pp. 921-927. https://doi.org/10.1046/j.1464-4096.2001.01649.x
Genitourinary neurofibromatosis with prostatic involvement
Madaan, S., Hammadeh, S., Thomas, K., Philp, T. and Singh, M. 2001. Genitourinary neurofibromatosis with prostatic involvement. BJU International. 87 (903).
Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment
S. Madaan, P.D. Abel, K.S. Chaudhary, R. Hewitt, M.A. Stott, G.W.H. Stamp and E.-N. Lalani 2001. Cytoplasmic induction and over-expression of cyclooxygenase-2 in human prostate cancer: implications for prevention and treatment. BJU International. 86 (6), pp. 736-741. https://doi.org/1046/j.1464-410x.2000.00867.x
A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy
Hammadeh, M. Y., Madaan, S., Singh, M. and Philp. T. 2001. A 3-year follow-up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy. BJU International. 86 (6), pp. 648-651. https://doi.org/10.1046/j.1464-410x.2000.00879.x
Cyclooxygenase-2 in prostate cancer
Madaan, S., Lalani, E-N. and Abel, P. D. 2000. Cyclooxygenase-2 in prostate cancer. Relias Media.
Urethral metastasis from a rectal adenocarcinoma
Madaan, S., Vohra, A. K., Riaz, A. A., Thomas, K. and Philp, T. 2000. Urethral metastasis from a rectal adenocarcinoma. BJU International. 86 (403).
Restorative proctocolectomy for collagenous colitis
Riaz, A. A,, Stirling, R. W., Madaan, S. and Dawson, P. M. 2000. Restorative proctocolectomy for collagenous colitis. Journal of the Royal Society of Medicine. 93 (5), pp. 261-261. https://doi.org/10.1177/014107680009300513