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电灼诱导的大鼠海绵体神经损伤,模拟人类根治性前列腺切除术。

Electrocautery-induced cavernous nerve injury in rats that mimics radical prostatectomy in humans.

机构信息

Department of Urology, Shanghai Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, Shandong, China.

出版信息

BJU Int. 2014 Jul;114(1):133-9. doi: 10.1111/bju.12348. Epub 2013 Oct 31.

Abstract

OBJECTIVE

To investigate the early and delayed effects of cavernous nerve electrocautery injury (CNEI) in a rat model, with the expectation that this model could be used to test rehabilitation therapies for erectile dysfunction (ED) after radical prostatectomy (RP).

MATERIALS AND METHODS

In all, 30 male Sprague-Dawley rats were randomly divided equally into two groups (15 per group). The control group received CNs exposure surgery only and the experimental group received bilateral CNEI. At 1, 4 and 16 weeks after surgery (five rats at each time point), the ratio of maximal intracavernosal pressure (ICP) to mean arterial pressure (MAP) was measured in the two groups. Neurofilament expression in the dorsal penile nerves was assessed by immunofluorescent staining and Masson's trichrome staining was used to assess the smooth muscle to collagen ratio in both groups.

RESULTS

At the 1-week follow-up, the mean ICP/MAP was significantly lower in the CNEI group compared with the control group, at 9.94% vs 70.06% (P < 0.05). The mean ICP/MAP in the CNEI group was substantially increased at the 4- (35.97%) and 16-week (37.11%) follow-ups compared with the 1-week follow-up (P < 0.05). At all three follow-up time points, the CNEI group had significantly decreased neurofilament staining compared with the control group (P < 0.05). Also, neurofilament expressions in the CNEI group at both 4 and 16 weeks were significantly higher than that at 1 week (P < 0.05), but there was no difference between 4 and 16 weeks (P > 0.05). The smooth muscle to collagen ratio in the CNEI group was significantly lower than in the control group at the 4- and 16-week follow-ups (P < 0.05), and the ratio at 16 weeks was further reduced compared with that at 4 weeks (P < 0.05).

CONCLUSIONS

In the CNEI rat model, we found the damaging effects of CNEI were accompanied by a decline in ICP, reduced numbers of nerve fibres in the dorsal penile nerve, and exacerbated fibrosis in the corpus cavernosum. This may provide a basis for studying potential preventative measures or treatment strategies to ameliorate ED caused by CNEI during RP.

摘要

目的

通过建立大鼠海绵体神经电灼伤(CNEI)模型,探讨其早期和迟发性损伤效应,期望该模型能用于检测根治性前列腺切除术后(RP)ED 的康复治疗方法。

材料与方法

将 30 只雄性 Sprague-Dawley 大鼠随机均分为 2 组(每组 15 只)。对照组仅接受 CNs 暴露手术,实验组接受双侧 CNEI。术后 1、4、16 周(每组各 5 只)时,测量两组大鼠海绵体最大腔内压(ICP)与平均动脉压(MAP)的比值。免疫荧光染色评估背神经中的神经丝表达,Masson 三色染色评估两组平滑肌与胶原的比值。

结果

术后 1 周时,CNEI 组的平均 ICP/MAP 明显低于对照组,为 9.94%比 70.06%(P < 0.05)。与术后 1 周相比,CNEI 组在术后 4 周(35.97%)和 16 周(37.11%)时的平均 ICP/MAP 显著升高(P < 0.05)。在所有 3 个随访时间点,CNEI 组的神经丝染色均明显低于对照组(P < 0.05)。而且,CNEI 组在术后 4 周和 16 周时的神经丝表达均显著高于术后 1 周(P < 0.05),但 4 周和 16 周时无差异(P > 0.05)。CNEI 组在术后 4 周和 16 周时的平滑肌与胶原比值均明显低于对照组(P < 0.05),且 16 周时的比值较 4 周时进一步降低(P < 0.05)。

结论

在 CNEI 大鼠模型中,我们发现 CNEI 的损伤作用伴随着 ICP 的下降、背神经中神经纤维数量的减少以及海绵体纤维化的加剧。这可能为研究根治性前列腺切除术中 CNEI 导致 ED 的潜在预防措施或治疗策略提供依据。

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