title: Combination Therapy Using Human Adipose-derived Stem Cells on the Cavernous Nerve and Low-energy Shockwaves on the Corpus Cavernosum in a Rat Model of Post-prostatectomy Erectile Dysfunction.
abstract: OBJECTIVE
  To investigate combined therapeutic efficacy of human adipose-derived stem cells (h-ADSCs) application on injured cavernous nerve and low-energy shockwave therapy (SWT) on the corpus cavernosum in a rat model of post-prostatectomy erectile dysfunction.
  
  
  METHODS
  Rats were randomly divided into 5 groups: control, bilateral cavernous nerve injury (BCNI), adipose-derived stem cell (ADSC) (BCNI group with h-ADSCs on the cavernous nerve), SWT (BCNI group with low-energy SWT on the corpus cavernosum), and ADSC/SWT (BCNI group with a combination of h-ADSCs and low-energy SWT). After 4 weeks, erectile function was assessed using intracavernosal pressure. The cavernous nerves and penile tissue were evaluated through immunostaining, Western blotting, and a cyclic guanosine monophosphate assay.
  
  
  RESULTS
  ADSC/SWT significantly improved intracavernosal pressure compared to the other experimental group. ADSC had significantly increased β-III tubulin expression of the cavernous nerve, and SWT had a markedly enhanced vascular endothelial growth factor expression in corpus cavernosum. The ADSC/SWT group had a significantly increased in alpha smooth muscle actin content (P < .05), neural nitric oxide synthase (nNOS) of the dorsal penile nerve (P < .05), endothelial nitric oxide synthase (eNOS) protein expression (P < .05), and cyclic guanosine monophosphate level (P < .05) compared to the ADSC or SWT alone group. In addition, ADSC/SWT reduces the apoptotic index in the corpus cavernosum.
  
  
  CONCLUSIONS
  In this study, h-ADSCs showed an effect on the recovery of injured cavernous nerve and low-energy SWT improved angiogenesis in the corpus cavernosum. The h-ADSCs combined with low-energy SWT showed beneficial effect on the recovery of erectile function in a rat model of postprostatectomy erectile dysfunction.
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Jeon
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kshitiz Raj
authors.initials: KR
authors.lastname: Shrestha
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Richard Y
authors.initials: RY
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ae Ryang
authors.initials: AR
authors.lastname: Jung
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ohseong
authors.initials: O
authors.lastname: Kwon
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ga Eun
authors.initials: GE
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: So Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Mechanical Engineering, Pohang University of Science and Technology (POSTECH), Pohang, Republic of Korea.
authors.forename: Ki Hean
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul St. Mary's Hospital The Catholic University of Korea, Seoul, Republic of Korea; Catholic Prostate Institute, The Catholic University of Korea, Seoul, Republic of Korea; Department of Bioinformatics, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: uroljy@catholic.ac.kr.
authors.forename: Ji Youl
authors.initials: JY
authors.lastname: Lee
mesh_terms: D017667:Adipocytes / Q000637:transplantation*; D000818:Animals; D003131:Combined Modality Therapy; D004195:Disease Models, Animal; D007172:Erectile Dysfunction / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D010413:Penis / Q000294:innervation; D011468:Prostatectomy / Q000009:adverse effects*; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D033581:Stem Cell Transplantation; D014464:Ultrasonic Therapy