ABSTRACT
PURPOSE: Although many clinical observations support the idea that denervation may cause erectile dysfunction, there has been suggested as an underlying cause, resulting in decreased penile tissue and consequently impotence. This study was initiated to investigate whether apoptosis follows denervation of the rat penis. MATERIALS AND METHODS: A total of 40 male Sprague-Dawley rats (10 weeks old) underwent abdominal exploration and unilateral or bilateral cavernous neurotomy. The penises were collected following sacrifice of animals at postoperation day 1, 2, 3, 6, or 10. Sham-operated animals served as controls. Tissues were embedded in paraffin and 3-?3 sections obtained. Deoxyribonucleic acid (DNA) fragmentation was analyzed by an in situ end-labeling method and by gel electrophoresis. Immunohistochemical study was carried out using monoclonal antibodies to p53. RESULTS: DNA fragmentation was evident in the tissues. In situ labeling revealed that the number of apoptotic bodies increased in tandem with the length of denervation. This finding was confirmed by electrophoretic analysis of DNA. However, there was no difference between the unilaterally and bilaterally treated groups. Immunohistochemical localization showed that p53 expression was increased in tissue sections of denervated animals, whereas little or no expression was shown in normal controls. CONCLUSIONS: Our results demonstrate that denervation causes apoptotic cell death in the rat penis. It is also suggested that unilateral nerve injury may be sufficient to affect normal erectile function. Further study will elucidate the molecular mechanisms of impotence caused by nerve-damaging operations such as prostatectomy.
Subject(s)
Animals , Humans , Male , Rats , Antibodies, Monoclonal , Apoptosis , Cell Death , Denervation , DNA , DNA Fragmentation , Electrophoresis , Erectile Dysfunction , Muscle, Smooth , Myocytes, Smooth Muscle , Paraffin , Penis , Prostatectomy , Rats, Sprague-DawleyABSTRACT
PURPOSE: Although many clinical observations support the idea that denervation may cause erectile dysfunction, there has been suggested as an underlying cause, resulting in decreased penile tissue and consequently impotence. This study was initiated to investigate whether apoptosis follows denervation of the rat penis. MATERIALS AND METHODS: A total of 40 male Sprague-Dawley rats (10 weeks old) underwent abdominal exploration and unilateral or bilateral cavernous neurotomy. The penises were collected following sacrifice of animals at postoperation day 1, 2, 3, 6, or 10. Sham-operated animals served as controls. Tissues were embedded in paraffin and 3-?3 sections obtained. Deoxyribonucleic acid (DNA) fragmentation was analyzed by an in situ end-labeling method and by gel electrophoresis. Immunohistochemical study was carried out using monoclonal antibodies to p53. RESULTS: DNA fragmentation was evident in the tissues. In situ labeling revealed that the number of apoptotic bodies increased in tandem with the length of denervation. This finding was confirmed by electrophoretic analysis of DNA. However, there was no difference between the unilaterally and bilaterally treated groups. Immunohistochemical localization showed that p53 expression was increased in tissue sections of denervated animals, whereas little or no expression was shown in normal controls. CONCLUSIONS: Our results demonstrate that denervation causes apoptotic cell death in the rat penis. It is also suggested that unilateral nerve injury may be sufficient to affect normal erectile function. Further study will elucidate the molecular mechanisms of impotence caused by nerve-damaging operations such as prostatectomy.
Subject(s)
Animals , Humans , Male , Rats , Antibodies, Monoclonal , Apoptosis , Cell Death , Denervation , DNA , DNA Fragmentation , Electrophoresis , Erectile Dysfunction , Muscle, Smooth , Myocytes, Smooth Muscle , Paraffin , Penis , Prostatectomy , Rats, Sprague-DawleyABSTRACT
PURPOSE: Lower urinary tract symptoms and erectile dysfunction both have a profound impact on the quality of life elderly men, but there are few reports that would enable us to clearly elucidate the relation between them. We investigated the prevalence of erectile dysfunction and its correlation with the severity of lower urinary tract symptoms as judged by the International Prostatic Symptom Score (I-PSS). MATERIALS AND METHODS: The total sample was 855 men aged 30 years and older (653 aged over 50) in 31 randomly selected areas of Jeong-Eup, Korea. Two questionnaires were sent. The first, on sexual activities, was based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) and was composed of several questions on the frequency of sexual intercourse, erectile ability, and the degree of any erectile dysfunction. The second, for men over 50 years of age, was the I-PSS. We analyzed the results with multivariate logistic analysis using an SAS program running on a personal computer. RESULTS: The response rate was 71.3% (466/653), and data sexual activities and I-PSS from 304 men were suitable for analysis. The prevalence of erectile dysfunction, defined as inability to achieve an erection sufficient for penetration, was 58.9% (179/304), and increased with age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, ans 100% in men over age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, and 100% in men over age 80 (p = 0.001). According to the intensity of lower urinary tract symptoms - mild (0-7), moderate (8-19), and severe (20-35) - the prevalence of erectile dysfunction was 46.6% (75/161), 68.8% (75.109), and 85.3% (29.34), respectively, and the prevalence of complete erectile dysfunction was 8.7% (14.161), 20.2% (22.109), and 47.1% (16.34), respectively. After adjustment for age, there was a statistically significant correlation between the severity of lower urinary tract symptoms and erectile dysfunction with the odds ratios being 2.395 and 4.125 in the moderately and severely symptomatic groups. CONCLUSIONS: There was a significant correlation between the presence of lower urinary tract symptoms and erectile dysfunction. We suggest that these two conditions are closed related by pathophysiologic mechanism, although clinical and basic research should be advanced to clarify the relation between them.
Subject(s)
Aged , Humans , Male , Aging , Coitus , Diagnostic and Statistical Manual of Mental Disorders , Epidemiologic Studies , Erectile Dysfunction , Korea , Lower Urinary Tract Symptoms , Mental Disorders , Microcomputers , Odds Ratio , Prevalence , Quality of Life , Surveys and Questionnaires , Running , Sexual BehaviorABSTRACT
PURPOSE: Lower urinary tract symptoms and erectile dysfunction both have a profound impact on the quality of life elderly men, but there are few reports that would enable us to clearly elucidate the relation between them. We investigated the prevalence of erectile dysfunction and its correlation with the severity of lower urinary tract symptoms as judged by the International Prostatic Symptom Score (I-PSS). MATERIALS AND METHODS: The total sample was 855 men aged 30 years and older (653 aged over 50) in 31 randomly selected areas of Jeong-Eup, Korea. Two questionnaires were sent. The first, on sexual activities, was based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) and was composed of several questions on the frequency of sexual intercourse, erectile ability, and the degree of any erectile dysfunction. The second, for men over 50 years of age, was the I-PSS. We analyzed the results with multivariate logistic analysis using an SAS program running on a personal computer. RESULTS: The response rate was 71.3% (466/653), and data sexual activities and I-PSS from 304 men were suitable for analysis. The prevalence of erectile dysfunction, defined as inability to achieve an erection sufficient for penetration, was 58.9% (179/304), and increased with age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, ans 100% in men over age: 37.2% in men in their 50s, 69.2% in men in their 60s, 83.3% in men in their 70s, and 100% in men over age 80 (p = 0.001). According to the intensity of lower urinary tract symptoms - mild (0-7), moderate (8-19), and severe (20-35) - the prevalence of erectile dysfunction was 46.6% (75/161), 68.8% (75.109), and 85.3% (29.34), respectively, and the prevalence of complete erectile dysfunction was 8.7% (14.161), 20.2% (22.109), and 47.1% (16.34), respectively. After adjustment for age, there was a statistically significant correlation between the severity of lower urinary tract symptoms and erectile dysfunction with the odds ratios being 2.395 and 4.125 in the moderately and severely symptomatic groups. CONCLUSIONS: There was a significant correlation between the presence of lower urinary tract symptoms and erectile dysfunction. We suggest that these two conditions are closed related by pathophysiologic mechanism, although clinical and basic research should be advanced to clarify the relation between them.
Subject(s)
Aged , Humans , Male , Aging , Coitus , Diagnostic and Statistical Manual of Mental Disorders , Epidemiologic Studies , Erectile Dysfunction , Korea , Lower Urinary Tract Symptoms , Mental Disorders , Microcomputers , Odds Ratio , Prevalence , Quality of Life , Surveys and Questionnaires , Running , Sexual BehaviorABSTRACT
A variety of technique of dynamic pharmacocavernosometry have been described to evaluate cavernous veno-occlusive function: however, there is no uniquely reliable and standard method so far After intracavernous (IC) injection of 45 mg papaverine and 2.5 mg phenblamine, we performed gravity cavernosometry(GC) and pump cavernosometry(PC), ie, measurement of saline infusion rate needed to obtain and to maintain an erection and measurement of pressure decay for 30 seconds and pressure drop time to 75 mmHg when pump was turned off at 150 mmHg IC pressure. Final diagnosis of venous leakage was made by cavernosoeraphy done at 90 mmHg IC pressure. The parametric values measured by each method to diagnose venous leakage and correlation among these methods were analyzed. The etiology of impotence in 45 patients studied was psychogenic in 8, venogenic in 21, combined arteriogenic and venogenic in 16. The measurement of induction flow rate was less reliable(p<0.05) for the diagnosis of venous leak than the other methods of PC and GC (p<0.01). The standard deviations of the induction and maintenance flow rate and pressure drop time were similar to or even higher than mean values. There was correlation among all these methods. Therefore, GC and PC, particularly measurement of the intracorporeal pressure decay are believed to be valuable methods for diagnosis of the corporal-venous leakage.
Subject(s)
Humans , Male , Diagnosis , Erectile Dysfunction , Gravitation , PapaverineABSTRACT
Intracorporeal synthetic penile implants, inflatable and noninflatable, have proved effective surgical adjuvants to the treatment of impotence during the last 20 years. Jonas noninflatable silicone prosthesis in which silver wires are embedded allows voluntary downward bending of the penis for urination in resting position and upward straightening for intercourse, thus, combining the simplicity of a noninflatable prosthesis with a more normal appearing detumescent phase. We experienced a case of Jonas silicone-silver penile prosthesis for erectile impotence in a 39 years old male.