Erectile Dysfunction (ED), is a debilitating issue for many men after age 40 which includes the inability to obtain and maintain an erection or simply a soft erection.

I have used a variety of procedures to treat erectile dysfunction, including extracorporeal shockwave therapy (ESWT) using staccato-like sound wave pulses along the shaft of the penis; platelet rich plasma (PRP) injected into the corpus cavernosum; or stem cells injected the same way. Some men have found benefit from these procedures, but many have not found a reversal of their loss of erectile ability.

Although I am a physician who follows the current medical scientific literature, for medical procedures that are on the edge of current development, I am highly interested in the experience and opinions of patients who have undergone these procedures. Because of what I am hearing from these patients, I am continuing to look for ED therapies that work better. 

Older men, usually past age 70, who cannot benefit from use of phosphodiesterase type 5 (PDE5) inhibitors, like Viagra or Cialis, end up injecting Trimix into the corpus cavernosum of the penis to produce a hard erection.  Trimix, as the name suggests, is a mixture of 3 drugs (papaverine, alprostadil, and phentolamine) that together dilate the blood vessels in the penis, causing inflow of blood into the penis and temporarily preventing it from escaping, thus producing an erect penis.   TriMix always works.  The problem is that having to interrupt one’s romantic interlude to inject one’s penis is not the best answer. 

A relatively young patient of mine with profound erectile dysfunction who could not obtain an erection without use of Trimix regained the ability to spontaneously produce an erection after getting his own stem cells injected into his penis.  This man had suffered trauma to his groin at a young age and suffered ED for over 20 years.  He tried ESWT multiple times and a variety of stem cell treatments, 6 of them, without success. But, after injection of his own fresh bone marrow, his ED problem was resolved.

Everyone has powerful stem cells sequestered in the bone marrow.  The largest cache by far of such stem cells is in the pelvic bone. When trauma occurs, the body is programmed to activate stem cells in the matrix of the pelvic bone and send them to the damaged tissue to promote repair.  

But the penis never gets the benefit of 20 million such stem cells via naturally occurring trauma.  However, if a high-tech trocar or needle-like device is inserted into the center part of the pelvic bone and marrow is extracted as the needle is retracted, 20 ml of quality bone marrow, replete with millions of stem cells, is obtained. Before any such procedure is done, local anesthetic is injected into the dorsum of the base of the penis to numb it and into the outer layer of bone where the trocar is to be injected, so the patient feels only pressure, not pain.  

Immediately after the bone marrow is obtained, the marrow is injected into the corpus cavernosa, the blood reservoirs in the penis. With 10 ml of marrow injected into each corpus cavernosum, every part of this anatomical structure is bathed in stem cells. The patient then dresses and goes home with a small gauze bandage on his penis and a little round bandage over the marrow extraction site.   He is told to refrain from sex for 4 days and to avoid a hot tub for 48 hours.

Is there any benefit of this type of procedure for women? Extraction of bone marrow and injection into areas of the vagina reverses post-menopausal vaginal atrophy, and this procedure also reverses painful lichen sclerosus.

David M. Odom, MD, is an integrative medicine physician with Longevity Therapeutics in La Quinta. (760) 698.8400.

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