ABSTRACT
This study aimed to explore whether and how anti-lysyl oxidase (anti-LOX) combined with a vacuum device (VD) could promote penile lengthening and to evaluate the effect on erectile function. This study was performed on four groups of adult rats: control, anti-LOX, VD (negative pressure value of -300 mmHg), and anti-LOX + VD. Penile length was measured by a modified VD method and verified on exposed length data. Intracavernous pressure (ICP) and maximum ICP/mean arterial pressure (MAP) ratio were recorded to assess erectile function. For corpus cavernosum, LOX activity and concentrations of pyridinoline, desmosine, hydroxyproline, and elastin were analyzed; transmission electron microscope and Hart's elastin staining were performed to monitor microstructural changes. Anti-LOX and VD significantly lengthened the penis by 10.8% (3.75 mm) and 8.2% (2.48 mm) compared with the control group, respectively, while anti-LOX + VD achieved the longest penile size (40.58 ± 0.40 mm) which was 17.4% longer than the control group (34.58 ± 0.54 mm). After 1-week washout, no penile retraction was observed. Meanwhile, exposed penile length data confirmed that the penis in the anti-LOX + VD group was also significantly longer. Anti-LOX inhibited LOX activity to reduce pyridinoline level, which led the penile tunica albuginea remodeling. However, it had no effect on hydroxyproline, desmosine, and elastin levels. Moreover, anti-LOX had no impact on erectile function, which was determined by ICP and ICP/MAP ratio. These results suggest that anti-LOX elongates the penis by reducing pyridinoline, which induces tunica albuginea remodeling. This lengthening effect was more obvious when combined with a VD. All procedures had no impact on erectile function.
ABSTRACT
The major role of treatment for impotence is played by vasoactive intracavernous pharmacotherapy or penile prosthesis during last decades. However, the former has a high risk of cavernosal fibrosis-and priapism, and the latter, also infection. We applied the Vacuum Constrictor Device to fifty of organic, 2 of old age, and 2 of unknown. Of 53 cases, 47 encountered the desirable erection were able to secure the vaginal penetration. Of 5 failed cases, 4 were because of maladjustment due to slim body and 1 was of pain on the pubic area due to previous old pelvic bone fracture. Of 17 cases with poor erection by vasoactive intracavernous pharmacotherapy 15 encountered good erection by means of Vacuum Constrictor Device and no significant complications were observed. Of 14 self-acquired Vacuum Constrictor Davicl which were used in which frequency of 10 to 17 times, 10 cases were shown to be satisfactory and the rest were not. Of 4 unsatisfactory cases, 2 were leakage of congested blood during intercourse, 1 was difficulty in intercourse due to pivot and the other one was of mild suprapubic pain due to previous pelvic bone fracture. Although Vacuum Temescence Enhancement Therapy is cumbersome in manipulation prior to sexual intercourse and has time limitation, it is easy to learn and has less complications than vasoactive intracavernous pharmacotherapy. Therefore Vacuum Tumescence Enhancement Therapy is thought to a preferable therapeutic alternative prior to vasoactive intracavernous pharmacotherapy and surgical treatment in impotence in spite of these disadvantages.