Adenoviral gene transfer of eNOS significantly increased peak and total intracavernous pressure to cavernous nerve stimulation in streptozotocin diabetic rats to a value similar to the response observed in control rats. Our results suggest that eNOS contributes significantly to the physiology of penile erection. These data demonstrate that in vivo adenoviral gene transfer of eNOS can physiologically improve erectile function in the streptozotocin diabetic rat.
Peyronie's disease can best be described as a localized connective tissue disorder that primarily affects the tunica albuginea of the penis. The disease may be attributed to repetitive vascular trauma that initiates an inflammatory process and ultimately leads to the formation of a fibrous penile plaque. The plaque consists mainly of collagen and can significantly alter penile anatomy and function. Patients with Peyronie's disease will most often present with penile curvature, pain on erection, a palpable nodule most commonly located on the dorsal shaft of the penis, and erectile dysfunction. There is no definitive treatment for Peyronie's disease and the treating physician has many options. They may wait for spontaneous resolution of the plaque, choose medical therapy (which includes both oral and intralesional regimens), or opt for surgical management. The main purpose of this article is to discuss the advances in medical therapy for Peyronie's disease, in particular intralesional injection of interferon-alpha-2b (IFN-a-2b). Several studies have concluded that IFN-a-2b can be an effective modality of treatment and that many patients placed on a regimen of IFN-a-2b experienced a significant reduction in penile curvature, diminished pain with erection, and decreased size of the plaque. Further clinical studies are currently being undertaken to determine the precise quantity and frequency of administration of IFN-a-2b that is most effective with the least amount of side effects.
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