Department of Urology, West China Hospital, Sichuan University, Chengdu, China.
Eur Urol. 2010 Nov;58(5):773-80. doi: 10.1016/j.eururo.2010.07.005. Epub 2010 Jul 16.
Penile rehabilitation (PR) is widely applied after radical prostatectomy. Vacuum erectile device (VED) therapy is the one of three PR methods used in the clinical setting that improve erectile function (EF) and is the only PR method which may preserve penile length. However, its unknown mechanism hampered doctors' recommendations and patients' compliance.
To assess the effects of VED therapy on erectile dysfunction (ED) in a rat model of bilateral cavernous nerve crush (BCNC) and to investigate the molecular mechanism of VED in postprostatectomy ED.
DESIGN, SETTING, AND PARTICIPANTS: This was an experimental study using Sprague-Dawley rats in three groups: sham, BCNC, and BCNC plus VED.
Intervention included BCNC, electrical stimulation of the cavernous nerve (CNS), and VED therapy.
At the end of a 4-wk period, CNS was used to assess EF by maximum intracavernosal pressure (ICP)/mean arterial pressure (MAP) ratio and duration (area under the curve [AUC]). For the structural analyses, whole rat penis was harvested. Terminal deoxynucleotidyl transferase biotin-dUTP nick end labeling assay was used for the assessment of apoptotic indices (AI). Immunohistochemistry was performed for endothelial nitric oxide synthase (eNOS), α-smooth muscle actin (ASMA), transforming growth factor beta 1 (TGF-β1), and hypoxia inducible factor-1α (HIF-1α). Staining for Masson's trichrome was utilized to calculate the smooth muscle/collagen ratios.
EF was improved with VED therapy measured by ICP/MAP ratios and AUC. VED therapy reduced HIF-1α expression and AI significantly compared with control. Animals exposed to VED therapy had decreased TGF-β1 expression, increased smooth muscle/collagen ratios, and preserved ASMA and eNOS expression.
To our knowledge, this is the first scientific study to suggest that VED therapy in the BCNC rat model preserves EF through antihypoxic, antiapoptotic, and antifibrotic mechanisms.
阴茎康复（PR）在根治性前列腺切除术后广泛应用。真空勃起装置（VED）治疗是临床应用的三种 PR 方法之一，可改善勃起功能（EF），是唯一可能保留阴茎长度的 PR 方法。然而，其未知的机制阻碍了医生的建议和患者的依从性。
评估 VED 治疗对双侧海绵体神经挤压（BCNC）大鼠模型中勃起功能障碍（ED）的影响，并探讨 VED 在前列腺切除术后 ED 中的分子机制。
设计、地点和参与者：这是一项使用 Sprague-Dawley 大鼠的实验研究，分为三组：假手术组、BCNC 组和 BCNC+VED 组。
干预包括 BCNC、海绵体神经电刺激（CNS）和 VED 治疗。
在 4 周的治疗结束时，通过最大海绵体腔内压（ICP）/平均动脉压（MAP）比值和持续时间（曲线下面积[AUC]）使用 CNS 评估 EF。对于结构分析，收获整个大鼠阴茎。末端脱氧核苷酸转移酶生物素-dUTP 缺口末端标记法用于评估凋亡指数（AI）。免疫组织化学用于检测内皮型一氧化氮合酶（eNOS）、α-平滑肌肌动蛋白（ASMA）、转化生长因子β1（TGF-β1）和缺氧诱导因子-1α（HIF-1α）。Masson 三色染色用于计算平滑肌/胶原比。
VED 治疗可通过 ICP/MAP 比值和 AUC 改善 EF。与对照组相比，VED 治疗显著降低了 HIF-1α 表达和 AI。接受 VED 治疗的动物 TGF-β1 表达降低，平滑肌/胶原比增加，ASMA 和 eNOS 表达得到保留。
据我们所知，这是第一项科学研究表明，VED 治疗在 BCNC 大鼠模型中通过抗缺氧、抗凋亡和抗纤维化机制来保留 EF。
