ERECTILE DYSFUNCTION TREATMENT WITH COMBINATION OF MESENCHYMAL STEM CELL DERIVED EXOSOMES AND FOCUSED LOW-INTENSIVE SHOCK WAVE THERAPY

Relevance. Erectile dysfunction brings basic problem of urology, andrology and sexology. Erectile dysfunction have significant impact on quality of life, sexual and reproductive health and psychological condition in men. Novel experimental and clinical studies a several methods of regenerative medicine shoved simultaneous impact on main pathogenetic aims showing significant levels of clinical efficacy.Aim – to develop and analyze clinical effects of mesenchymal stem cell-derived exosomes intracavernous injections and low-intensity extracorporeal shock-wave therapy combination in patients with severe erectile dysfunction on background of metabolic syndrome and atherosclerosis.Materials and methods. A prospective clinical study was conducted on a contingent of 38 patients of “Men’s Health Clinic” (Kyiv, Ukraine) suffering from severe organic erectile dysfunction (ICD-10:N52.9; International index of erectile function score lower than 7) on the background of metabolic syndrome (ICD-10: E88.81) and generalized atherosclerosis (ICD-10: I70.9).Study results. Therapeutics model of combined application of mesenchymal stem cell-derived exosomes intracavernous injections and low-intensity extracorporeal shock-wave therapy showed significant positive impact of applied therapeutic model according to IIEF-5, EHS scores as well as due to pharmacodoppler-sonography data. Therapeutics model of application low-intensity extracorporeal shock-wave therapy also showed significant positive impact on same diagnostic categories.Conclusion. Comparison of post-therapeutic data between MG and CG showed absence of significant differences in all categories besides mean PSV, but values of statistical mistake probability are very close to significance threshold for IIEF-5 severe and moderate categories as well as EHS grades 4 and 2, what highlights perspective of further comparison studies on larger population scales, longer observation periods or less severe forms of ED.