Infiltrative Therapy of Adipose Vital Micrografts in a Metabolic and protective Solution in Peyronie's Disease: a Case Report in a Pilot Study

Lorenzo Svolacchia; Fabiano Svolacchia; Angela Maurisi

doi:10.5937/scriptamed57-66884

Lorenzo Svolacchia General Surgery Departments, “La Sapienza” University, Rome, Italy
Fabiano Svolacchia Department of Anatomical, Histological, Medical and Legal Sciences and the Locomotor Equipment, Section of Human Anatomy, Laboratory of Experimental Morphology at the University of Rome "La Sapienza", Italy, E-mail: fabiano.svolacchia@uniroma1.it 2 Medicine and Surgery (La Sapienza) ; email : lorenzo.svolacchia@hotmail.it
Angela Maurisi Private Practitioner, Rome, Italy

DOI: https://doi.org/10.5937/scriptamed57-66884

Keywords: Mesenchymal stem cells, adipose-derived, Stem cells, Adipose tissue, Penile induration, Exosomes

Abstract

Peyronie's disease (PD) or induratio penis plastica (IPP), is characterised by fibrotic plaque formation within the tunica albuginea, leading to penile curvature and pain. Current minimally invasive treatments provide limited outcomes. Aim of the research was to explore the preliminary feasibility and tolerability of intralesional injections of viable adipose-derived micrografts composed of mesenchymal stem cells (MSCs) and their exosomes, emulsified with a metabolic and protective solution of non-cross-linked hyaluronic acid, amino acid chains and sodium bicarbonate. A 52-year-old male presented with a 12-month history of penile curvature and painful erections. He underwent a single injection of adipose-derived micrografts (20-40 microns) composed of mesenchymal stem cells (MSCs) and their exosomes and emulsified with a metabolic and protective solution of non-cross-linked hyaluronic acid, amino acids branches and sodium bicarbonate for pH stabilisation directly into the plaque. Outcomes were assessed at baseline and 6 months post-treatment using goniometry, Visual Analogue Scale (VAS) for pain and International Index of Erectile Function-5 (IIEF-5). At 6 months, penile curvature decreased from 28° to 22°, a 21 % reduction. Pain resolved completely (VAS from 5 to 0) and erectile function improved (IIEF-5 from 17 to 21). No adverse events were reported. This single case report provides preliminary, hypothesis-generating observations suggesting that intralesional injection of adipose-derived micrografts combined with a metabolic and protective hyaluronic acid solution is feasible and apparently well tolerated in one patient with Peyronie’s disease. The observed numerical improvements in curvature, pain and erectile function cannot be attributed to the treatment with confidence in the absence of a control group and may reflect the natural history of the disease. This approach was investigational and not currently endorsed by EAU or AUA guidelines. Larger randomised controlled studies are required before any conclusion on efficacy can be drawn.

Author Biography

Fabiano Svolacchia, Department of Anatomical, Histological, Medical and Legal Sciences and the Locomotor Equipment, Section of Human Anatomy, Laboratory of Experimental Morphology at the University of Rome "La Sapienza", Italy, E-mail: fabiano.svolacchia@uniroma1.it 2 Medicine and Surgery (La Sapienza) ; email : lorenzo.svolacchia@hotmail.it

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