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Intracavernous Injection (intracavernou + injection)
Selected AbstractsThe Effect of Intracavernous Injection of Adipose Tissue-Derived Stem Cells on Hyperlipidemia-Associated Erectile Dysfunction in a Rat ModelTHE JOURNAL OF SEXUAL MEDICINE, Issue 4pt1 2010Yun-Ching Huang MD ABSTRACT Introduction., Hyperlipidemia has been associated with erectile dysfunction (ED) via damage to the cavernous endothelium and nerves. Adipose tissue-derived stem cells (ADSC) have been shown to differentiate into endothelial cells and secrete vasculotrophic and neurotrophic factors. Aim., To assess whether ADSC have therapeutic effects on hyperlipidemia-associated ED. Methods., Twenty-eight male rats were induced to develop hyperlipidemia with a high-fat diet (hyperlipidemic rats, HR). Ten additional male rats were fed a normal diet to serve as controls (normal rats, NR). Five months later, all rats were subjected to ADSC isolation from paragonadal fat. The cells were cultured for 1 week, labeled with 5-ethynyl-2,-deoxyuridine (EdU), and then injected autologously into the corpus cavernosum of 18 HR. The remaining 10 HR rats were injected with phosphate buffered saline (PBS). At 2 and 14 days post-transplantation, four rats in the HR + ADSC group were sacrificed for tracking of the transplanted cells. At 28 days post-transplantation, all remaining rats were analyzed for serum biochemistry, erectile function, and penile histology. Main Outcome Measures., Erectile function was assessed by intracavernous pressure (ICP) measurement during electrostimulation of the cavernous nerve. Cavernous nerves, endothelium, and smooth muscle were assessed by immunohistochemistry. Results., Serum total cholesterol and low-density lipoprotein levels were significantly higher in HR than in NR. High-density lipoprotein level was significantly lower in HR than in NR. Mean ICP/mean arterial pressure ratio was significantly lower in HR + PBS than in NR + PBS or HR + ADSC. Neuronal nitric oxide synthase (nNOS)-positive nerve fibers and endothelial cells were fewer in HR + PBS than in HR + ADSC. Smooth muscle content was significantly higher in both HR groups than in NR. Conclusions., Hyperlipidemia is associated with abnormalities in both the nerves and endothelium. Treatment with ADSC ameliorates these adverse effects and holds promise as a potential new therapy for ED. Huang Y-C, Ning H, Shindel AW, Fandel TM, Lin G, Harraz AM, Lue TF, and Lin C-S. The effect of intracavernous injection of adipose tissue-derived stem cells on hyperlipidemia-associated erectile dysfunction in a rat model. J Sex Med 2010;7:1391,1400. [source] Intracavernous Growth Differentiation Factor-5 Therapy Enhances the Recovery of Erectile Function in a Rat Model of Cavernous Nerve InjuryTHE JOURNAL OF SEXUAL MEDICINE, Issue 8 2008Thomas M. Fandel ABSTRACT Introduction., Neurogenic erectile dysfunction remains a serious complication in the postprostatectomy population. Effective protective and regenerative neuromodulatory strategies are needed. Aim., To determine the effect of growth differentiation factor-5 (GDF-5) on erectile function and its mechanism in a rat model of cavernous nerve (CN) injury. Main Outcome Measures., Erectile function was assessed by CN electrostimulation at 4 weeks. Penile tissues were examined by real-time polymerase chain reaction (PCR) and immunohistochemical analyses. Methods., Forty-eight male Sprague-Dawley rats were randomly divided into six equal groups: one group underwent sham operation (uninjured controls), while five groups underwent bilateral CN crush. Crush-injury groups were treated at the time of injury with intracavernous injection of a slow-release suspension of liquid microparticles containing no GDF-5 (vehicle), 0.4 µg (low concentration), 2 µg (intermediate concentration), or 10 µg GDF-5 (high concentration). One untreated group served as injured controls. Results., GDF-5 enhanced erectile recovery and significantly increased intracavernous pressure in the low and intermediate-concentration groups vs. injured controls. Low-concentration GDF-5 demonstrated the best functional preservation, as the intracavernous pressure increase in this group did not differ significantly from uninjured controls. A dose-response relationship was confirmed for the effects of GDF-5 in penile tissue. Low-concentration GDF-5 showed better preservation of the penile dorsal nerves and antiapoptotic effects in the corpus cavernosum (P < 0.05 vs. injured controls). Although high concentration GDF-5 did not confer meaningful erectile recovery, this dose was more effective at decreasing transforming growth factor-, than low-concentration GDF-5. Conclusions., Intracavernous injection of low (0.4 µg) or intermediate-concentration GDF-5 (2 µg) was effective in preserving erectile function in a rat model of neurogenic erectile dysfunction. The underlying mechanism appears to involve neuron preservation and antiapoptosis. Fandel TM, Bella AJ, Lin G, Tantiwongse K, Lin C-S, Pohl J, and Lue TF. Intracavernous growth differentiation factor-5 therapy enhances the recovery of erectile function in a rat model of cavernous nerve injury. J Sex Med 2008;5:1866,1875. [source] Efficient Gene Expression System Using the RTP801 Promoter in the Corpus Cavernosum of High-Cholesterol Diet-Induced Erectile Dysfunction Rats for Gene TherapyTHE JOURNAL OF SEXUAL MEDICINE, Issue 6 2008Minhyung Lee PhD ABSTRACT Introduction., The application of gene therapy for a nonlife-threatening disease, such as erectile dysfunction (ED), requires a higher safety level and more efficacious systems for gene transfer. Aim., To establish a novel technique for gene expression in a rat model of hypercholesterolemic ED that uses the RTP801 promoter, a hypoxia-inducible promoter. Methods., Two-month-old male Sprague,Dawley rats were fed a diet containing 4% cholesterol and 1% cholic acid, and age-matched control animals were fed a normal diet, for 3 months. Main Outcome Measures., Cavernous expression of hypoxia-inducible factor (HIF)-1, was evaluated by Western blot. After intracavernous injection of pSV-Luc or pRTP801-Luc, gene expression was evaluated by luciferase assay, and the gene expression area was evaluated by immunohistochemistry. Results., HIF-1, was up-regulated in the corpus cavernosum of hypercholesterolemic rats. Although pSV-Luc did not induce gene expression in either the control or the cholesterol group, pRTP801-Luc significantly induced gene expression in the cholesterol group and resulted in higher luciferase activity than did pSV-Luc up to 14 days after injection. Immunohistochemistry showed that the gene expression area was also greater in the pRTP801-Luc group than in the pSV-Luc group, but the difference was not as great as that in luciferase activity. This suggests that pRTP801-Luc exerts its effect mainly by inducing promoter activity under hypoxia, not by increasing the number of transfected cells. Conclusion., The RTP801 promoter-driven gene expression system increased gene expression in the corpus cavernosum tissue of rats with cholesterol-induced ED. This may be a useful system for the development of gene therapy in vasculogenic ED. Lee M, Ryu J-K, Piao S, Choi MJ, Kim HA, Zhang L-W, Shin H-Y, Jung HI, Kim I-H, Kim SW, and Suh J-K. Efficient gene expression system using the RTP801 promoter in the corpus cavernosum of high-cholesterol diet-induced erectile dysfunction rats for gene therapy. J Sex Med 2008;5:1355,1364. [source] HISTORY: Adrian Walton Zorgniotti (1925,1994): Renaissance UrologistTHE JOURNAL OF SEXUAL MEDICINE, Issue 2 2005Eli F. Lizza MD Abstract Adrian Zorgniotti was born on March 3, 1925 and died on July 6, 1994. During his 47 years as a physician, he brought innovation and imagination to the field of Urology, especially in the field of erectile dysfunction (ED). Biographical information was obtained from Dr. Zorgniotti's curriculum vitae, his published articles, and his eulogies. Several of his colleagues and peers were also interviewed by telephone. In addition, personal experiences of this author, from the 9 years we spent as associates, and of several other friends were recounted. Dr. Zorgniotti's involvement with the history of Urology began in 1970 when he published his first historical treatise on Rome's first doctor, Arcagathus. He continued his involvement when he served as moderator for the History Forum of the American Urological Association (AUA) from 1975 to 1988 and as Historian for the AUA from 1979 to 1988. This innovator brought vision to the field of ED when he introduced the combination of papaverine and phentolamine as an intracavernous injection for the treatment of ED. He also organized the first International Conference on Corpus Cavernolum Revascularization in 1978 at New York University and published long-term results with this therapy. Adrian Zorgniotti will probably be best remembered by the multitude of Urologists whose lives he has touched for his generosity of spirit and for his ability to help shape our careers with a kind gesture, suggestion, or phone call. I am proud to call him a mentor, a colleague, and a friend. [source] Effect of mesenchymal stem cell penile transplantation on erectile signaling of aged ratsANDROLOGIA, Issue 3 2010M. T. Abdel Aziz Summary Stem cell-based therapy targeted at the penile tissue has been lately considered in preclinical studies. This work aimed to assess the effect of intracavernous administration of mesenchymal stem cells (MSCs) in aged rats (n = 100). They were subjected to single intracavernous injection (ICI) of 1.0 million MSCs, followed up for 3, 4 weeks, 3 and 4 months (each group 25 rats) and compared with both adult and aged controls (n = 50). In dissected cavernous tissues, cGMP and histopathology were assessed in addition to intracavernous pressure (ICP) measurement in some anaesthetised rats. The results showed that cavernous tissue cGMP was significantly increased in MSCs transplanted rats in all investigated groups compared with the controls. The mean cavernous cGMP levels after 3 and 4 months of MSCs transplantation were significantly increased compared with those after 3 or 4 weeks. Cavernous tissue ICP measurement showed significant increase in MSCs transplanted groups compared with the controls, more in the long-term follow up than in the shorter one. Histopathological examination detected markedly dilated sinusoidal vascular spaces in the long-term follow-up study. It is concluded that stem cell-based therapy is feasible for age-associated erectile dysfunction and could improve erectile signaling. [source] In Vitro and In Vivo Relaxation of Corpus Cavernosum Smooth Muscle by the Selective Myosin II Inhibitor, BlebbistatinTHE JOURNAL OF SEXUAL MEDICINE, Issue 10 2009Xin-hua Zhang MD ABSTRACT Introduction., Blebbistatin (BLEB) is a small cell permeable molecule originally reported as a selective inhibitor of myosin II isoforms expressed by striated muscle and non-muscle cells (IC50 = 0.5,5 µM) with poor inhibition of turkey gizzard smooth muscle (SM) myosin II (IC50,80 µM). However, recently it was found that BLEB can potently inhibit mammalian arterial SM (IC50,5 µM). Aim., To investigate the effect of BLEB on corpus cavernosum SM (CCSM) tone and erectile function (EF). Methods., CC tissue obtained from penile implant patients along with CC, aorta and bladder from adult male rats were used for BLEB organ bath studies. Intracavernosal BLEB was administered to rats and EF was assessed via intracavernous pressure (ICP). Main Outcome Measures., Effects of BLEB on agonist-induced CCSM, aorta and bladder contraction in vitro and ICP in vivo. Results., BLEB completely relaxed human CCSM pre-contracted with phenylephrine (PE) in a dose-dependent manner decreasing tension by 76.5% at 10 µM. BLEB pre-incubation attenuated PE-induced contraction of human CC by ,85%. Human CC strips pre-contracted with endothelin-1 or KCl were almost completely relaxed by BLEB. Rat CCSM pre-contracted with PE showed BLEB relaxation comparable to human CCSM. BLEB inhibition was similar for rat aorta but slower for bladder. Both maximal ICP and ICP/mean arterial pressure were dose-dependently increased by BLEB intracavernous injections with full erection at 1 micromole. Conclusion., Our novel data reveals that BLEB nearly completely relaxes rat and human CCSM pre-contracted with a variety of potent agonists and exhibits tissue selectivity. Coupled with our in vivo data in which nanomole doses of BLEB significantly increase ICP, our data substantiates an important role for the SM contractile apparatus in the molecular mechanism for EF and suggests the possibility of BLEB binding at myosin II as a therapeutic treatment for ED by targeting SM contractile pathways. Zhang X, Aydin M, Kuppam D, Melman A, and DiSanto ME. In vitro and in vivo relaxation of corpus cavernosum smooth muscle by the selective myosin II inhibitor, blebbistatin. J Sex Med 2009;6:2661,2671. [source] ORIGINAL RESEARCH,ED PHARMACOTHERAPY: Intracavernous Injections of Prostaglandin E1 for Erectile Dysfunction: Patient Satisfaction and Quality of Sex Life on Long-Term TreatmentTHE JOURNAL OF SEXUAL MEDICINE, Issue 2 2007Benjamin Alexandre MD ABSTRACT Introduction., Since the availability of oral type 5 phosphodiesterase (PDE5) inhibitors for the treatment of erectile dysfunction (ED), patients' views on the use of intracavernous injections (ICI) of prostaglandin E1 (PGE1) may have changed. Aim., To assess the satisfaction of patients with long-term ICI. Methods., Patients with ED (>18 years old) who had used ICI of PGE1 for at least 3 months were asked to complete the "EASY" (Evaluation de l'Acceptation des injectionS dans la dYsfonction érectile) questionnaire. Main Outcome Measures., Overall patient satisfaction with ICI, impact on quality of life, ease of use, satisfaction with the quality of erections, and perceived partner satisfaction. Results., Overall, 596 questionnaires met our inclusion criteria. Mean patient age was 62.1 years, mean duration of ED was 61 months, and mean duration of ICI treatment was 35 months. Before using ICI, 43% of patients had taken at least one PDE5 inhibitor; 81% discontinued PDE5 for want of efficacy. The overall satisfaction rate with ICI was 78.3%. ICI met expectations each time in 78.6% of patients and at least half the time in 90% of patients; 86% were ready to recommend ICI to friends. Patients noted improvements in their sex life (70.1%), relationship with their partner (50%), quality of life (44.8%), and confidence in attempting sexual intercourse (80.3%). The mean number of injections was 4.4 per month. Most patients (81.1%) found the injections easy to use. The mean score for pain on injection was 2.09/10 and for pain on erection was 2.15/10. Three-quarters of patients (73.1%) thought that their partners were satisfied with ICI. Conclusion., Patients on long-term ICI/PGE1 can recover a very satisfying sex life. ICI met patients' expectations in terms of efficacy, ease of use, tolerance, and improved sex life. These results should encourage physicians and patients to use ICI when PDE5 fails, is not well tolerated, or is contraindicated. Alexandre B, Lemaire A, Desvaux P, and Amar E. Intracavernous injections of prostaglandin E1 for erectile dysfunction: Patient satisfaction and quality of sex life on long-term treatment. J Sex Med 2007;4:426,431. [source] | ||||||||||