Andrology Laboratory, West China Hospital, Sichuan University, Chengdu 610041, China.
Department of Urology, West China Hospital, Sichuan University, Chengdu 610041, China.
Asian J Androl. 2021 Mar-Apr;23(2):215-221. doi: 10.4103/aja.aja_17_20.
Penile length shortening and erectile dysfunction are common complications after radical prostatectomy. Various methods have been used to maintain erectile function, but less attention has been paid to preserving penis length. N-acetylcysteine (NAC) has the effect of antioxidation and antifibrotic, which may be beneficial to improve those postoperative complications. This study investigated the effect of NAC on maintaining the penile length and the erectile function after bilateral cavernous nerve crush (BCNC) and its underlying mechanism. Twenty-four male rats were randomly divided into three groups: control group, BCNC group, and BCNC + NAC group. NAC or equal volume of saline was daily administrated by intragastric gavage for 4 weeks. The initial and end penile lengths were measured. Intracavernosal pressure/mean arterial pressure (ICP/MAP) ratio was calculated to assess erectile function. Hematoxylin-eosin staining, Masson's trichrome staining, immunohistochemistry, and Western blot were performed to explore cellular and molecular changes of the penis. Compared to the BCNC group, the penile length, ICP/MAP ratio and smooth muscle/collagen ratio in the BCNC + NAC group were improved significantly (all P < 0.05), and the expressions of endothelial nitric oxide synthase, α-smooth muscle actin, glutathione, and glutathione peroxidase 1 were significantly increased after NAC treated (all P < 0.05), along with the decreased expressions of hypoxia-inducible factor-1α, transforming growth factor-β1, collagen I, collagen III, collagen IV, malonaldehyde, and lysine oxidase (all P < 0.05). This study demonstrated that NAC could maintain penile length and partly improve erectile function. Possible mechanism is directly and/or indirectly related to antihypoxic and antifibrosis.
阴茎长度缩短和勃起功能障碍是根治性前列腺切除术后常见的并发症。已经使用了各种方法来维持勃起功能，但对保持阴茎长度的关注较少。N-乙酰半胱氨酸（NAC）具有抗氧化和抗纤维化的作用，可能有助于改善这些术后并发症。本研究探讨了 NAC 对维持双侧海绵体神经挤压（BCNC）后阴茎长度和勃起功能的影响及其潜在机制。24 只雄性大鼠随机分为三组：对照组、BCNC 组和 BCNC+NAC 组。NAC 或等体积生理盐水通过灌胃每日给药 4 周。测量初始和终末阴茎长度。计算阴茎海绵体内压/平均动脉压（ICP/MAP）比值以评估勃起功能。进行苏木精-伊红染色、马松三色染色、免疫组织化学和 Western blot 以探讨阴茎的细胞和分子变化。与 BCNC 组相比，BCNC+NAC 组的阴茎长度、ICP/MAP 比值和平滑肌/胶原比值明显改善（均 P<0.05），NAC 处理后内皮型一氧化氮合酶、α-平滑肌肌动蛋白、谷胱甘肽和谷胱甘肽过氧化物酶 1 的表达明显增加（均 P<0.05），同时缺氧诱导因子-1α、转化生长因子-β1、胶原 I、胶原 III、胶原 IV、丙二醛和赖氨酰氧化酶的表达降低（均 P<0.05）。本研究表明 NAC 可以维持阴茎长度并部分改善勃起功能。可能的机制与抗缺氧和抗纤维化直接和/或间接相关。
