PMID- 35371295
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220405
IS  - 1756-2872 (Print)
IS  - 1756-2880 (Electronic)
IS  - 1756-2872 (Linking)
VI  - 14
DP  - 2022 Jan-Dec
TI  - 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.
PG  - 17562872221086999
LID - 10.1177/17562872221086999 [doi]
LID - 17562872221086999
AB  - 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. PROSPERO REGISTRATION ID: CRD42020201343.
CI  - (c) The Author(s), 2022.
FAU - Wani, Mudassir M
AU  - Wani MM
AD  - Royal Glamorgan Hospital, Cardiff, UK.
FAU - Rai, Bhavan P
AU  - Rai BP
AD  - Freeman Hospital, Newcastle, UK.
FAU - Webb, William Richard
AU  - Webb WR
AUID- ORCID: 0000-0002-2701-626X
AD  - SCRABEL, Institute of Medical Sciences, Faculty of Medicine, Health and Social 
      Sciences, Canterbury Christ Church University, Kent, UK.
FAU - Madaan, Sanjeev
AU  - Madaan S
AUID- ORCID: 0000-0003-4220-5613
AD  - Darent Valley Hospital, Darenth Wood Road, Dartford DA2 8DA, UK. Canterbury 
      Christ Church University, Kent, UK.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20220329
PL  - England
TA  - Ther Adv Urol
JT  - Therapeutic advances in urology
JID - 101487328
PMC - PMC8972940
OTO - NOTNLM
OT  - Erectile dysfunction
OT  - Radical Prostatectomy
OT  - Stem cells
COIS- Conflict of interest statement: The authors declared no potential conflicts of 
      interest with respect to the research, authorship, and/or publication of this 
      article. Authors recieved no financial support for this research.
EDAT- 2022/04/05 06:00
MHDA- 2022/04/05 06:01
PMCR- 2022/03/29
CRDT- 2022/04/04 05:29
PHST- 2021/07/22 00:00 [received]
PHST- 2022/02/24 00:00 [accepted]
PHST- 2022/04/04 05:29 [entrez]
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/05 06:01 [medline]
PHST- 2022/03/29 00:00 [pmc-release]
AID - 10.1177_17562872221086999 [pii]
AID - 10.1177/17562872221086999 [doi]
PST - epublish
SO  - Ther Adv Urol. 2022 Mar 29;14:17562872221086999. doi: 10.1177/17562872221086999. 
      eCollection 2022 Jan-Dec.