Introduction Significant progress has been made in the understanding of physiological and pharmacological mechanisms of human sexual functioning through preclinical research in animal models. Aim To provide an evidence-based documentation of the experimental models evaluating male and female sexual function for useful clinical translation. Methods Consensus discussion over the past 18 months leading to summarized views of seven experts from six countries. Main Outcome Measure Report was based on the critical analysis of scientific information available in literature and subcommittee presentations, discussions, and exchanges of ideas and feedback. Results Fundamental research in animal models has led to considerable understanding of the physiological mechanisms underlying desire, arousal, genital, and other sexual responses and the design of rational pharmacological treatments for certain sexual dysfunctions in the male and female. Tissue and cellular in vitro systems have provided critical information on the in vivo interactions and modulations in the presence and absence of chemical, biological, vascular, neurologic, endocrine, and genetic inputs. The animal models seem indispensable for elucidating the biophysiological and etiopathological aspects of male and female sexual disorders. Conclusions Useful insights into the human experience have been derived from basic research in ways that are far more difficult to obtain in humans, both scientifically and ethically. The animal model with a good predictive value can be used as a successful preclinical tool so long as the functional end points are homologous or analogous. The key issue is whether further evaluations are warranted to extrapolate the results in a clinical setting.
Objectives: To establish a new experimental rat model in order to define the mechanisms of erectile dysfunction (ED) and to evaluate the changes of neuronal nitric oxide synthase (nNOS) in the pelvic ganglia following nerve-sparing radical prostatectomy. Methods: Sprague-Dawley rats were randomized to sham operation, bilateral cavernous nerve dissection (BCND) and bilateral cavernous nerve resection (BCNR) groups. In the BCND group, the cavernous nerves were only dissected bilaterally from the major pelvic ganglion (MPG) to the apex of the prostate without crushing or cutting. At 1, 2, 4 and 8 weeks after surgery, we examined intracavernous pressure along with arterial pressure (ICP/AP), retrograde dye tracing using Fluorogold (FG) and expression of nNOS in the MPG. Results: Intracavernous pressure and arterial pressure in the BCND group was significantly decreased at 2 and 4 weeks after surgery compared with the sham group, and improved at 8 weeks. The number of FG-positive cells in the MPG also recovered at 8 weeks. ICP/AP and FG-positive cells in the BCNR group were greatly decreased until 8 weeks. The percentage of nNOS-positive cells per total cells was not different between the sham and BCND groups during the experimental period , whereas that in the BCNR group gradually decreased with time. Conclusions:We established a novel rat model, in which cavernous nerve dissection alone caused nerve injury-related ED. We believe that this cavernous nerve dissection model might help clarify the mechanism of nerve injury-related ED and the recovery from ED after nerve-sparing radical prostatectomy.
Objectives: Lower urinary tract symptoms (LUTS) are frequently associated with erectile dysfunction (ED) in aged men, and both significantly influence quality of life. However, the mechanism linking LUTS to ED has not been clarified completely. The purpose of the present study was to establish an animal model of ED following LUTS/bladder outlet obstruction (BOO) and investigate the expression of molecules related to the cause of this type of ED. Methods: Male Sprague-Dawley rats with partial BOO were used as an experimental model of LUTS. Sham-operated animals served as controls. Voiding and erectile function were evaluated 4, 8, and 16 weeks after obstruction or sham operation. The mRNA expression of penile tissue genes related to penile corporal smooth muscle relaxation was examined by quantitative real-time reverse transcription-polymerase chain reaction. Results: Voiding and bladder function of BOO rats were significantly worse than in sham-operated rats 4, 8, and 16 weeks after obstruction. The erectile function of BOO rats was significantly decreased compared with that of the sham-operated controls (P < 0.01) 16 weeks after obstruction, although it was similar to that of sham-operated animals at 4 and 8 weeks after obstruction. The expression of endothelial nitric oxide synthase (eNOS) mRNA was significantly decreased 16 weeks after obstruction compared with that in sham-operated rats (P < 0.01). Conclusion: An animal model for investigations into the association between LUTS and ED is described herein. Endothelial dysfunction induced by impaired eNOS function is likely to be involved in ED following LUTS/BOO.
For patients with serum PSA levels of 10 ng/ml or lower, bone scanning may be eliminated because of the negligible risk of bone metastases. In addition, scanning may not be necessary for those with PSA levels between 10 and 20 ng/ml, when they have T1 disease and Gleason scores of 6 or lower.
Objectives: Priapism is a rare condition whose management differs according to the etiology. We report the clinical course of three forms of priapism to assess the feasibility and safety of recent management strategies. Methods: The study included eight patients complaining of persistent erection for Ն4 h who were treated in our institution between January 1996 and July 2007. Results: Overall, we categorized 12 cases of priapism in eight patients divided as follows: five cases of ischemic priapism (IP), three of stuttering priapism (SP), and four of non-ischemic priapism (NIP). Two of five IP patients needed a shunt procedure, which led to the subsequent erectile dysfunction. The other three were treated successfully with a corporal injection of sympathomimetic agents and subsequently suffered from SP. One of the three SP patients suffered from mimicked NIP with increased arterial blood flow during the initial treatment for IP. Four of the NIP patients including the mimicked one achieved complete detumescence, through arterial embolization in two and conservative management in two. Conclusions: Current management seems effective and safe in the short-term. However, the long-term outcome of the treatment for IP is still disappointing. Careful long-term observation is needed for an appropriate management.
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