Ovchinnikov Roman, Pyatnitskiy Ilya
Department of Physiology, Pirogov Russian National Research Medical University, Moscow, Russia.
Department of Biomedical Engineering, The University of Texas at Austin Cockrell School of Engineering, Austin, USA.
Urol Res Pract. 2024 Oct 21;50(3):173-180. doi: 10.5152/tud.2024.23020.
Despite the number of studies on the contribution of pelvic floor muscles (PFM) to the penile erection process, their significance is still underestimated. The goal of this study was to investigate the role of PFM in the erection process in non-human primates.
First, we performed an anatomical study of the penile structures in 12 baboon cadavers. Next, we created chronic electrophysiological models of normal erectile function in 25 olive baboons. We implanted electrodes on the cavernous nerves to control penile blood filling and placed other electrodes on the pudendal nerve to stimulate the ischiocavernosus muscles (ICM) contractions after sufficient blood filling, thus simulating both vascular and muscular phases of penile erection. We controlled the intracavernous pressure (ICP) during nerve stimulations and further performed a mathematical analysis of the collected data.
We described the main pro-erectile muscle anatomy and its relationship with penile structures in monkeys. During neurostimulation studies, we showed the key role of ICM in achieving full penile rigidity with suprasystolic ICP up to 120-300 mm Hg. We also developed a math model for calculating the pro-erectile muscle's contraction force with high accuracy.
In this study, we demonstrated the crucial role of PFM in the penile erection process using the monkey model, supporting the previous studies' data. We consider these results essential for a better, more complex understanding of the penile erection process and the participating structures in each stage. This is essential for further improving and designing novel erectile dysfunction diagnostics and treatment techniques.
尽管有许多关于盆底肌肉（PFM）对阴茎勃起过程作用的研究，但其重要性仍被低估。本研究的目的是探讨PFM在非人灵长类动物勃起过程中的作用。
首先，我们对12只狒狒尸体的阴茎结构进行了解剖学研究。接下来，我们在25只东非狒狒身上建立了正常勃起功能的慢性电生理模型。我们在海绵体神经上植入电极以控制阴茎血液充盈，并在阴部神经上放置其他电极，以便在充分血液充盈后刺激坐骨海绵体肌（ICM）收缩，从而模拟阴茎勃起的血管和肌肉阶段。我们在神经刺激过程中控制海绵体内压（ICP），并对收集到的数据进行进一步的数学分析。
我们描述了猴子中主要的促进勃起肌肉的解剖结构及其与阴茎结构的关系。在神经刺激研究中，我们显示了ICM在使阴茎达到完全硬度方面的关键作用，此时收缩期以上的ICP可达120 - 300 mmHg。我们还开发了一个数学模型，用于高精度计算促进勃起肌肉的收缩力。
在本研究中，我们使用猴子模型证明了PFM在阴茎勃起过程中的关键作用，支持了先前研究的数据。我们认为这些结果对于更好、更全面地理解阴茎勃起过程以及每个阶段参与的结构至关重要。这对于进一步改进和设计新型勃起功能障碍诊断及治疗技术至关重要。
