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MSCs and EPCs were identified by flow cytometry and in\u00a0vitro differentiation or immunofluorescence staining. 25 8-week-old male Sprague-Dawley rats were allocated to 1 of 5 groups: sham operation group, bilateral CNI group receiving periprostatic implantation of MSCs plus EPCs, MSCs, EPCs, or phosphate buffered saline (control group). 2 weeks after CNI and treatment, erectile function of rats was measured by electrically stimulating the CN. The penis and major pelvic ganglia were harvested for histologic examinations. RNA and protein levels of neurotrophin factors (vascular endothelial growth factor, nerve growth factor, and brain-derived neurotrophic factor) in mono- or coculture MSCs and EPCs were assessed by real-time polymerase chain reaction and enzyme-linked immunosorbent assay, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Intracavernous pressure and mean arterial pressure were measured to evaluate erectile function. Histologic examinations of the penis and major pelvic ganglia and RNA and protein levels of neurotrophin factors in MSCs and EPCs were performed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>MSCs and EPCs expressed the specified cell markers and exhibited the typical appearance and characteristics. Treatments using MSCs and\/or EPCs could increase endothelial and smooth muscle contents of the corpus cavernosum, decrease caspase-3 expression and increase penile neuronal nitric oxide synthase expression, and restore the neural component of the major pelvic ganglia in rats with CNI. Combined transplantation of MSCs and EPCs had a better effect on improving erectile function than single transplantation of MSCs or EPCs. Expression levels of vascular endothelial growth factor and nerve growth factor in coculture MSCs and EPCs were significantly higher than those of primary MSCs or EPCs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Translation<\/jats:title>\n                  <jats:p>Combined transplantation of MSCs and EPCs was more effective in restoring erectile function in CNI-related erectile dysfunction models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>The study, for the 1st time, proved that combined transplantation of MSCs and EPCs was more effective in restoring erectile function in rats with CNI. The rat model might not represent the human condition.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Combined periprostatic transplantation of MSCs and EPCs could restore erectile function in rats with CNI more effectively. MSCs might restore CN fibers by secreting neurotrophin factors such as vascular endothelial growth factor and nerve growth factor, and EPCs could enhance the paracrine activity of MSCs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2018.01.005","type":"journal-article","created":{"date-parts":[[2018,3,5]],"date-time":"2018-03-05T12:15:03Z","timestamp":1520252103000},"page":"284-295","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":21,"title":["Combined Transplantation of Mesenchymal Stem Cells and Endothelial Progenitor Cells Restores Cavernous Nerve Injury-Related Erectile Dysfunction"],"prefix":"10.1093","volume":"15","author":[{"given":"Jia-feng","family":"Fang","sequence":"first","affiliation":[{"name":"Department of Gastrointestinal Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu-na","family":"Huang","sequence":"additional","affiliation":[{"name":"Central Laboratory , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-yan","family":"Han","sequence":"additional","affiliation":[{"name":"Central Laboratory , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Ouyang","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Spine Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ze-hong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong-bo","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery , Guangzhou \u00a0 China"},{"name":"The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou \u00a0 China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"2023012309225264800_bib1","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1097\/01.sla.0000171299.43954.ce","article-title":"Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer","volume":"242","author":"Hendren","year":"2005","journal-title":"Ann Surg"},{"key":"2023012309225264800_bib2","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.eururo.2013.08.019","article-title":"Ten-year outcomes of sexual function after radical prostatectomy: results of a prospective longitudinal study","volume":"65","author":"Sivarajan","year":"2014","journal-title":"Eur Urol"},{"key":"2023012309225264800_bib3","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1097\/SLA.0b013e318269d03b","article-title":"Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer","volume":"257","author":"Luca","year":"2013","journal-title":"Ann Surg"},{"key":"2023012309225264800_bib4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.eururo.2012.04.046","article-title":"Prevention and management of postprostatectomy sexual dysfunctions. 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