Despite the central and peripheral effects of androgens on the nervous system, the local effects of androgens in the corpus cavernosum penis and their importance for erectile function is still unclear. In this study corpus cavernosum biopsies of eight adult potent patients, aged 19-63 years, undergoing penile deviation surgery (group A) and 12 patients undergoing male-to-female transsexual surgery (group B) were immunostained for nuclear androgen and estrogen-alpha receptors. Additionally, primary corpus cavernosum endothelial cell cultures were obtained from six transsexual patients and exposed to testosterone, dihydrotestosterone, estradiol and progesterone likewise for 7 days. Total cell count was performed and cell metabolic activity was measured by a tetrazolium salt-based assay. Androgen and estrogen-alpha receptors were detected in stromal as well as in endothelial cells. Of all cell nuclei, 74.9% (SD 16.4) in group A and 63.5% (SD 17.1) in group B were positively stained for androgen receptors. The respective percentage of estrogen receptors was 11% (SD 9.5) and 21.2% (SD 12.6). An age-dependent difference in receptor distribution was not observed in either group. In the cell culture system only cultures exposed to testosterone and dihydrotestosterone showed a dose-dependent increase of cell metabolic activity compared to the cultures supplemented with estradiol and progesterone. The significant and age-independent high androgen and low estrogen-alpha receptor distribution found in both groups suggests a possible peripheral effect of androgens at the level of the corpus cavernosum penis in adult humans. This is supported by the observed effect of testosterone and dihydrotestosterone on cell count and endothelial cell metabolism in our cell culture system. The role of estrogens remains unclear.
Our study was designed to establish the necessity of routine evaluation of patients with inflammatory (IIIA) and noninflammatory (IIIB) types of nonbacterial prostatitis (NBP) for chlamydial and ureaplasmal infections. From 1999 to 2001, 165 patients with a mean age of 35 years (range 20-54 years) were evaluated for the syndrome of chronic prostatitis. The evaluation included scoring with Prostate Symptom Score Index (PSSI) and NIH Chronic Prostatitis Symptom Index (CPSI), Meares-Stamey test and culturing of post-massage urine portion (fourth glass). In all cases, polymerase chain reaction (PCR)-testing of the semen was performed to establish the persistence of Chlamydia trachomatis (ChT) and Ureaplasma urealyticum (UU). Based on laboratory findings (four glass test and post-massage urine culture), in 69 (42%) of 165 cases, NBP was diagnosed, which includes 30 patients with type IIIA and 39 with type IIIB of NBP. According to semen PCR tests, in 11 (36.6%) of 30 cases with IIIA type of NBP, chlamydial (six cases), ureaplasmal (four cases) and a mixture of both (one case) infections were described. Among 39 patients with IIIB type of NBP test was positive in 14 cases (36%), where UU was presented in eight and ChT in six cases. In patients with previously diagnosed inflammatory as also noninflammatory NBP, according to four glass test, chlamydial and/or ureaplasmal infections can be presented. Although their role in pathogenesis of prostatitis remains speculative, however, testing for infections is highly recommended.
Our study was designed to establish the necessity of routine evaluation of patients with inflammatory (IIIA) and noninflammatory (IIIB) types of nonbacterial prostatitis (NBP) for chlamydial and ureaplasmal infections. From 1999 to 2001, 165 patients with a mean age of 35 years (range 20-54 years) were evaluated for the syndrome of chronic prostatitis. The evaluation included scoring with Prostate Symptom Score Index (PSSI) and NIH Chronic Prostatitis Symptom Index (CPSI), Meares-Stamey test and culturing of post-massage urine portion (fourth glass). In all cases, polymerase chain reaction (PCR)-testing of the semen was performed to establish the persistence of Chlamydia trachomatis (ChT) and Ureaplasma urealyticum (UU). Based on laboratory findings (four glass test and post-massage urine culture), in 69 (42%) of 165 cases, NBP was diagnosed, which includes 30 patients with type IIIA and 39 with type IIIB of NBP. According to semen PCR tests, in 11 (36.6%) of 30 cases with IIIA type of NBP, chlamydial (six cases), ureaplasmal (four cases) and a mixture of both (one case) infections were described. Among 39 patients with IIIB type of NBP test was positive in 14 cases (36%), where UU was presented in eight and ChT in six cases. In patients with previously diagnosed inflammatory as also noninflammatory NBP, according to four glass test, chlamydial and/or ureaplasmal infections can be presented. Although their role in pathogenesis of prostatitis remains speculative, however, testing for infections is highly recommended.
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