Department of Urology, Northwestern University Feinberg School of Medicine, Chicago, IL.
Division of Pediatric Urology, Department of Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Urology. 2021 Jun;152:9.e1-9.e6. doi: 10.1016/j.urology.2021.01.034. Epub 2021 Jan 29.
To determine the effects of perioperative hormone supplementation on postoperative periurethral angiogenesis in the setting of hypogonadism, we analyzed the urethral tissue of castrated Sprague Dawley rats supplemented with testosterone or estrogen who underwent a urethral surgery and compared it to those that did not.
48 Sprague-Dawley rats were divided into 4 groups: (1) non-castrate (NC) controls; (2) castrate (C) unsupplemented rats; (3) castrate rats that received testosterone (T), or (4) castrate rats that received estradiol (E). Half of each group underwent urethroplasty surgery (S) while the other half were nonsurgical controls (C). With immunohistochemistry, we measured vessel density (endothelial cell marker CD31), expression levels of androgen receptor (AR), TIE-2, and estrogen receptor GPER1.
Periurethral vascularity was significantly increased postoperatively with both testosterone and estrogen supplementation (TC vs TS: 8.92% vs 10.80%, P<.001; EC vs ES: 7.66 vs 8.73%, P = .009) as well as in noncastrated rats (NCC vs NCS: 5.86% vs 8.19%, P<.001) whereas in the absence of hormones, CD31 expression significantly decreased after surgery (CC vs CS: 3.62% vs 2.76%, P= .003). CD31 expression was strongly correlated with AR, TIE-2, and GPER1 expression indicating a mechanistic relationship.
Both testosterone and estrogen supplementation increase periurethral vascularity in castrated (hypogonadal) rats undergoing urethroplasty surgery, contrary to decreased periurethral vascularity observed in the castrated non-supplemented rats. This suggests that hormonal resupplementation benefits post-operative regeneration in rats and may provide a basis for perioperative hormone supplementation in hypogonadal men prior to urethral surgery.
为了确定围手术期激素补充对去势后尿道周围血管生成的影响，我们分析了接受雄激素或雌激素补充的去势 Sprague Dawley 大鼠的尿道组织，并将其与未接受补充的大鼠进行了比较。
48 只 Sprague-Dawley 大鼠分为 4 组：（1）非去势（NC）对照组；（2）未补充去势（C）大鼠组；（3）去势大鼠接受睾酮（T）补充组；（4）去势大鼠接受雌二醇（E）补充组。每组的一半接受尿道成形术（S），另一半为非手术对照组（C）。通过免疫组织化学方法，我们测量了血管密度（内皮细胞标志物 CD31）、雄激素受体（AR）、TIE-2 和雌激素受体 GPER1 的表达水平。
雄激素和雌激素补充均可显著增加术后尿道周围血管生成（TC 与 TS：8.92% 与 10.80%，P<.001；EC 与 ES：7.66 与 8.73%，P=.009），未去势大鼠的血管生成也增加（NCC 与 NCS：5.86% 与 8.19%，P<.001），而在缺乏激素的情况下，术后 CD31 表达明显减少（CC 与 CS：3.62% 与 2.76%，P=.003）。CD31 表达与 AR、TIE-2 和 GPER1 表达呈强相关，提示存在一种机制关系。
雄激素和雌激素补充均可增加接受尿道成形术的去势（去势）大鼠的尿道周围血管生成，与未接受补充的去势大鼠观察到的尿道周围血管生成减少相反。这表明激素补充有益于大鼠术后再生，并可能为尿道手术前低雄激素男性提供围手术期激素补充的依据。
