Comparative Study between Corpus Cavernosum‐Electromyography Findings and Electron Microscopy of Cavernosal Muscle Biopsies in Erectile Dysfunction Patients

Başar, M. Murad; Sargon, Mustafa F.; Başar, Halil; Atan, Ali; Ak, Fikri; Çelik, H. Hamdi; Başar, Ruhgün; Akalin, Z

doi:10.1111/j.1442-2042.1998.tb00599.x

Cited by 17 publications

(17 citation statements)

References 22 publications

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“…17 It is found to be the etiologic connection between ED and systemic vascular disease, 18,19 and defined as a functional deterioration of the endothelium characterized by vasospasm, vasoconstriction, alterations in coagulation mechanisms and fibrinolysis, and increased vascular proliferation. It has been related with coronary risk factors, and decreased level has been seen even in early stages in patients with hypercholesterolemia and hypertension, smokers and patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Is endothelial function impaired in erectile dysfunction patients?

2005

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Erectile dysfunction (ED) and vascular disease are thought to be linked at the level of the endothelium. Endothelial dysfunction, resulting in the inability of the smooth muscle cells lining the arterioles to relax, prevents vasodilatation. Likewise, penile erection depends on the relaxation of smooth muscle in the corpus cavernosum and the wall of small arteries. The aim was to assess the systemic vascular function in patients with ED. In all, 32 ED patients diagnosed with Doppler Ultrasound and the International Index of Erectile Function-5-item questionnaire and 25 healthy men as a control group enrolled to the study. They all underwent the tests including serum glucose and lipid levels. Echocardiography and exercise stress test was performed routinely. Baseline demographics (body mass index, heart rate and blood pressures), fasting glucose and lipid levels were not significantly different between ED and control groups. Endothelial-dependent brachial artery flow-mediated vasodilatation and brachial artery response to 0.4 mg nitroglycerine (NTG) were measured. Participants were negative on exercise stress test, and echocardiographic parameters including ejection fraction were similar. Endothelial-dependent brachial artery percent diameter change with flow-mediated dilatation (6.0172.9 vs 12.373.5) and brachial artery response to NTG (12.874.2 vs 17.875.2) were significantly different between groups (Po0.001). We found that endothelial function was impaired in ED patients with no apparent cardiovascular disease and diabetes mellitus. This impaired function might be explained by the abnormality in systemic nitric oxide-cyclic guanosine monophosphate vasodilator system and suggest that ED and vascular disease may be linked at the level of the endothelium.

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Section: Discussionmentioning

confidence: 99%

Is endothelial function impaired in erectile dysfunction patients?

2005

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“…The pathology of the corpus cavernosum biopsy specimens in ED patients revealed a smooth muscle cell thickened basal membrane, dilated rough endoplasmic reticulum, and increased numbers of fibroblasts, but ultrastructurally normal endothelial cells lining the sinusoids. 7 A reduction in the elastic fibers in the tunica albuginea and disorders in the arrangement of the collagenic fibers also have been observed in impotent men. 8 Hypertension is one of the important risk factors resulting in ED.…”

Section: Introductionmentioning

confidence: 99%

Ultrastructural comparison of penile cavernous tissue between hypertensive and normotensive rats

et al. 2005

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Our aim was to compare the ultrastructure of penile cavernous tissue in the spontaneous hypertensive rat (SHR) and normotensive rat, and study the relation of blood pressure with erectile function. After injection of apomorphine (APO), penile erectile frequency in 16-week-old SHR (group A) and Wistar-Kyoto rat (WKY) (group B) was observed and noted. The ultrastructure of the penile cavernous tissue was studied by scanning electron microscope and transmission electron microscope. The mean blood pressures were significantly higher in group A than in group B (P ¼ 0; 171.20710.94 and 117.60712.38, n ¼ 5, for group A and group B, respectively). After treatment of the two groups with APO, the erectile frequency in group A was significantly less than in group B (P ¼ 0.007; 0.4070.55 and 2.4071.14, n ¼ 5, for group A and group B, respectively). Significant ultrastructural pathological changes were observed in the tunica albuginea and penile cavernous tissue of SHR. The elastic fibers were decreased and the collagen fibers of the sinusoid were increased in group A. The tunica albuginea thickness (mean7s.d.) was 100.2077.22 lm and 126.0077.65 lm in group A and group B, respectively. The tunica albuginea of group A was significantly thinner than that in B (P ¼ 0.001). Some endothelial cells and smooth muscle cells exhibited damaged mitochondria, and endoplasmic reticulums and Schwann cells were degenerated in group A. Although the function of penile erection might be affected by a secondary effect related to endothelial dysfunction of hypertension, these ultrastructural pathological changes of the penile cavernous tissue might also be one of the important mechanisms of erectile dysfunction caused by hypertension.

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“…Because the smaller arteries of the penis are more susceptible to atherosclerotic occlusion than the larger vessels of the Erectile dysfunction as a harbinger of CVD KL Billups et al heart and limbs, 35,39,40 atherosclerotic lesions may first become clinically manifest in the penile arteries. 41 Many research studies have hypothesized that occlusion of the smaller penile arteries (1-2 mm in diameter) occurs well before occlusion of the coronary (3-4 mm) or peripheral (5-7 mm carotid or 6-8 mm femoral) arteries. This artery size/lumen occlusion hypothesis is one reason used to explain why the symptom of erectile difficulty occurs before other clinical vascular symptoms.…”

Section: Erectile Dysfunction As An Ideal Barometer Of Atherosclerosimentioning

confidence: 99%

Erectile dysfunction as a harbinger for increased cardiometabolic risk

et al. 2008

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In August 2003, the Minority Health Institute (MHI) convened an Expert Advisory Panel of cardiologists and urologists to design a new practice model algorithm that uses erectile dysfunction (ED) as a clinical tool for early identification of men with systemic vascular disease. The MHI algorithm noted ED as a marker for the presence of cardiovascular disease and suggested that ED may well be a cardiovascular risk equivalent warranting aggressive secondary prevention management strategies, even in the absence of other cardiac or peripheral vascular symptoms. The MHI algorithm stipulates that all men 25 years of age and older should be asked about ED as a routine part of the cardiovascular history during any office visit. The presence of ED should prompt an aggressive assessment for occult vascular disease; many men with erectile difficulty would benefit from early, aggressive management of cardiovascular risk factors with both lifestyle modification and pharmacotherapy to achieve optimal target goals under the existing treatment guidelines. Since publication of the algorithm in 2005, additional research studies have further supported the advisory panel recommendations.

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Comparative Study between Corpus Cavernosum‐Electromyography Findings and Electron Microscopy of Cavernosal Muscle Biopsies in Erectile Dysfunction Patients

Abstract: CC-EMG is less invasive and a valuable method in patients with erectile dysfunction, whereas no specific findings were observed from penile biopsy specimens.

Cited by 17 publications

References 22 publications

Is endothelial function impaired in erectile dysfunction patients?

Is endothelial function impaired in erectile dysfunction patients?

Ultrastructural comparison of penile cavernous tissue between hypertensive and normotensive rats

Erectile dysfunction as a harbinger for increased cardiometabolic risk

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