Zhongnan Hospital, Wuhan University, Department of Urology, Wuhan City, China.
J Sex Med. 2010 Oct;7(10):3365-72. doi: 10.1111/j.1743-6109.2010.01730.x.
Cavernous nerves (CNs) injury is the main cause of erectile dysfunction (ED) following radical prostatectomy. Its restoration remains challenging.
To investigate the feasibility of erectile function recovery by autologous vein graft after bilateral CNs being excised in a rat model.
A total of 36 adult male Sprague-Dawley rats were randomized into three groups. A 5mm segment of CN was excised bilaterally in group B and C. In group B, a 7-mm segment of autologous saphenous vein was interposed at the defect site bilaterally, with two nerve stumps inserted into the vein lumen. Group C underwent no repair. Group A was accepted a sham operation. 4 months later, apomorphine tests were performed on each rat, followed by injection of 4% fluorogold into bilateral corpus cavernous. 5 days later, after monitoring intracorporal pressure (ICP) changes induced by electrostimulation of CN, rats were sacrificed and their bilateral major pelvic ganglions were obtained for detection of fluorogold, and penile tissues of middle shaft were obtained for detecting nitric oxide synthase-containing nerve fibers in penile dorsal nerves.
Erectile function was assessed by apomorphine test and ICP monitoring. CN regeneration was judged by fluoroglod tracing and nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase staining.
Apomorphine tests resulted in 58% rats with erectile responses in group B, whereas no erection was observed in group C. ICP monitoring also demonstrated a significant recovery in erectile function in group B compared with group C. Much more and brighter fluorogold coloring cells were examined in major pelvic ganglions of group B than those of group C. NADPH-diaphorase staining also showed much more positive fibers were detected in penile dorsal nerves in group B than in group C.
Autologous vein graft could provide a guide channel to induce CN regeneration and successfully restore autonomic erectile function after CNs being excised in rats.
cavernous 神经（CNs）损伤是根治性前列腺切除术后勃起功能障碍（ED）的主要原因。其恢复仍然具有挑战性。
研究在大鼠模型中双侧 CN 切除后，自体静脉移植物恢复勃起功能的可行性。
将 36 只成年雄性 Sprague-Dawley 大鼠随机分为三组。B 组和 C 组双侧切除 5mm 段 CN。B 组双侧在缺损部位置入 7mm 段自体大隐静脉，将两个神经残端插入静脉管腔。C 组未修复。A 组接受假手术。4 个月后，对每只大鼠进行阿扑吗啡试验，然后将 4%荧光金注入双侧海绵体。5 天后，监测 CN 电刺激引起的阴茎体内压（ICP）变化后，处死大鼠，取双侧骨盆主要神经节检测荧光金，并取阴茎中轴部阴茎背神经检测含一氧化氮合酶的神经纤维。
阿扑吗啡试验和 ICP 监测评估勃起功能。荧光金示踪和烟酰胺腺嘌呤二核苷酸磷酸（NADPH）-黄递酶染色判断 CN 再生。
阿扑吗啡试验结果显示，B 组 58%的大鼠出现勃起反应，C 组无勃起。ICP 监测也显示 B 组勃起功能较 C 组明显恢复。B 组较 C 组骨盆主要神经节内荧光金染色细胞更多、更亮。NADPH 黄递酶染色也显示 B 组较 C 组阴茎背神经内阳性纤维更多。
自体静脉移植物可提供引导通道，诱导 CN 再生，成功恢复大鼠 CN 切除后自主勃起功能。
