UROLOGICAL SURVEY
Investigative urology
Intracavernosal injection of vascular endothelial growth factor improves erectile function in aged rats
Park K, Ahn KY, Kim MK, Lee SE, Kang TW, Ryu SB
Department of Urology, Chonnam National University Medical School, Donggu, Gwangju, Republic of Korea
Eur Urol. 2004; 46: 403-7
OBJECTIVES: To investigate whether intracavernosal injection of vascular endothelial growth factor (VEGF) can restore erectile function in the aging rat.
MATERIALS AND METHODS: Ten young (4-5 months) and 30 old (24 months) Sprague-Dawley male rats were used. The old rats were divided into 3 groups: vehicle-only (phosphate buffered saline plus 0.1% bovine serum albumin; n = 10), VEGF 1 microg/kg (n = 10), and VEGF 10 microg/kg (n = 10). At 2 and 4 weeks after treatment, erectile function and histology were evaluated by hiodynamic study, histomorphometric analysis, and immunohistochiistry.
RESULTS: After 4 weeks of treatment, the ratio of peak intracavernosal pressure to systiic arterial blood pressure in response to neurostimulation was significantly higher in both the VEGF 1 microg/kg (79.9 +/- 7.7%) and the VEGF 10 microg/kg group (76.8 +/- 5.8%) compared to the vehicle-only group (63.1 +/- 8.5%; p < 0.05). The percentage of cavernosal smooth muscle was significantly higher in the VEGF 10 microg/kg group (16.1 +/- 1.4%) compared to the vehicle-only group (12.8 +/- 2.2%; p = 0.047). VEGF treatment in old rats increased e-NOS and VEGF expression in both treatment groups.
CONCLUSION: Intracavernosal injection of VEGF appears to restore smooth muscle integrity and improve erectile function in aged rats.
Editorial Comment
This is an interesting and welcome study in the era of tissue engineering techniques. After old rats treatment as described, the authors elegantly evaluated through hiodynamic study, histomorphometric analysis and immunohistochiistry, whether an intracavernosal injection of VEGF could restore erectile function and whether it was related to trabecular structural changes in aged rats.
The authors found that intracavernosal injection of VEGF resulted in significant increases in intracavernous pressure in response to neurostimulation after 4 weeks in both VEGF treatment groups. VEGF treatment in old rats increased not only e-NOS and VEGF expression in endothelial lining, but also the percentage of corpus cavernosal smooth muscle. Thus, intracavernosal injection of VEGF improves penile erectile quality in aged rats.
Dr. Francisco J.B. Sampaio
Full-Professor and Chair, Urogenital Research Unit
State University of Rio de Janeiro
Rio de Janeiro, Brazil
Fibrin glue for the suture-less correction of penile chordee: a pilot study in a rabbit model
Hafez AT, El-Assmy A, El-Hamid MA
Urology & Nephrology Centre, Mansoura University, Mansoura, Egypt
BJU Int. 2004; 94: 433-6
OBJECTIVE: To evaluate the use of fibrin glue as a scaffold for patching defects in the tunica albuginea in a rabbit model for a future application in correcting chordee.
MATERIALS AND METHODS: Nine New Zealand white male rabbits were utilized. All had a 15 x 5-mm defect created in the ventral tunica albuginea. Fibrin glue (1 mL) was applied to cover the defect in tunica albuginea and the penile skin closed with a continuous 5/0 chromic catgut suture. Animals were killed in groups of three at 2, 6 and 12 weeks afterward. The evaluation included an artificial erection test with intracavernosal injection of prostaglandin E1 (5 microg), cavernosography and histopathological examination of sections of the penis stained with haiatoxylin and eosin or Masson trichrome.
RESULTS:None of the rabbits died during the procedure or developed bleeding or haiatoma afterward. All animals had straight erections on testing with prostaglandin (5 microg). There was no evidence of corporal narrowing or venous leakage on cavernosography. Histopathological evaluation showed evidence of the fibrin sealant layer, with angiogenesis and a cell infiltrate at 2 weeks. At 6 and 12 weeks there was completely normal regeneration of the tunica albuginea.
CONCLUSION: In this pilot study in a rabbit model the haiostatic effect of fibrin glue was confirmed on covering a defect in the tunica albuginea. Moreover, there was regeneration of normal tunica albuginea with no scarring at 6 weeks and maintained at 12 weeks. Further well-controlled studies are required before using fibrin glue for corporal body grafting to treat chordee.
Editorial Comment
Many materials have been investigated for corporal body grafting in surgical correction of chordee and Peyronie’s disease (porcine small intestinal submucosa and tunica acellular matrix, as examples). This article evaluated the feasibility of using a commercially available fibrin glue (‘Tisseel’, Baxter Healthcare Corp., Irvine, California) for covering corporal body defects, with potential application in the surgical managient of severe chordee. In rabbits, the results were excellent. Fibrin glue may be considered a suitable substance for corporal body grafting in the future.
Dr. Francisco J.B. Sampaio
Full-Professor and Chair, Urogenital Research Unit
State University of Rio de Janeiro
Rio de Janeiro, Brazil
Publication Dates
-
Publication in this collection
24 Nov 2004 -
Date of issue
Oct 2004
