Effect of tadalafil on penile nitric oxide synthase and corporal smooth muscle in rats under dutasteride treatment

Gül, Abdullah; Altınay, Serdar; Kabasakal, Levent; Yavuz, Abdülmecit; Semerciöz, Atilla; Şerefoğlu, Ege Can

doi:10.1080/13685538.2020.1739019

Cited by 4 publications

(1 citation statement)

References 31 publications

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“…Animal studies, case reports, human studies and AE data provide converging evidence for an association of 5ARI treatment with penile alterations. 20 Animal research has found 5ARI treatment is associated with: reduced size and weight of the penis 21,22 ; reduced erectile response; apoptosis 23 ; decreased smooth muscle density and increased collagen density in corpus cavernosum 21,23,24 ; fibrosis [25][26][27] ; reduced size of sinusoidal spaces in corpus cavernosum 21,26 ; reduced expression of endothelial nitric oxide synthase (eNOS) 24,28 ; reduced expression of erectile neurotransmitter calcitonin gene-related peptide (CGRP) 29 ; and, in a dutasteride study, reduced expression of androgen receptor. 27 A review noted that an animal study's findings "indicate that 5ARIs have a significant pathogenic impact on the penile histo-architecture and attenuate the NOS signaling pathway."…”

Section: Ari Treatment Has Been Associated With Penile Abnormalitiesmentioning

confidence: 99%

From organ injury to disability: a proposed model for 5-alpha reductase inhibitor syndrome

Montaigne¹

2022

Preprint

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Persistent dysfunctions emerging from use and discontinuation of 5-alpha reductase inhibitors (PD-5ARI) may be explained as the aftermath of a pathological recovery from microvasculopathy or ischemia in multiple systems. Focusing on persistent sexual dysfunction, the most common class of symptoms: 5ARIs’ inhibition of angiogenesis leads to stress on penile microvasculature, depriving the tissue of blood supply and oxygen. These hypoxic conditions lead to tissue injury and atrophy, triggering a pathological recovery that further alters penile tissue, including smooth muscle loss, fibrosis, damage to vascular architecture and impairment of neural pathways supporting arousal and erectile function. This damaging cascade may result in severe and lasting sexual dysfunction. Persistent neuropsychiatric, cognitive, sensory and sleep dysfunctions emerging from 5ARI treatment may similarly be explained as pathological responses to microvasculopathy or ischemia in supporting structures, particularly those in the limbic system. Systemic spread is proposed to arise from a vicious cycle of tissue injury, oxidative stress and proinflammatory activity which spreads via the vascular network, leading to systemic endothelial dysfunction. The latter may in turn set off a damaging cascade in other organs and tissues. Risks of developing PD-5ARI may arise from 5ARI-mediated disruptions of vascular tone, angiogenesis and neoangiogenesis. Pharmacovigilance data, animal studies and human studies provide converging evidence for the proposed etiopathology. It is, moreover, consistent with variable presentation and severity of PD-5ARI symptoms; irreversibility of symptoms; typically normal results of clinical lab tests; and resistance to treatment.

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Section: Ari Treatment Has Been Associated With Penile Abnormalitiesmentioning

confidence: 99%

From organ injury to disability: a proposed model for 5-alpha reductase inhibitor syndrome

Montaigne¹

2022

Preprint

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Tadalafil versus tamsulosin as combination therapy with 5-alpha reductase inhibitors in benign prostatic hyperplasia, urinary and sexual outcomes

Tawfik,

Abo-Elenen,

Gaber

et al. 2024

World J Urol

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Beneficial Effects of Human Umbilical Cord Blood Mononuclear Cells on Persistent Erectile Dysfunction After Treatment of 5-Alpha Reductase Inhibitor in Rats

Öztekin¹,

Yilmaz‐Oral

Kaya‐Sezginer

et al. 2021

The Journal of Sexual Medicine

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Effect of tadalafil on penile nitric oxide synthase and corporal smooth muscle in rats under dutasteride treatment

Cited by 4 publications

References 31 publications

From organ injury to disability: a proposed model for 5-alpha reductase inhibitor syndrome

From organ injury to disability: a proposed model for 5-alpha reductase inhibitor syndrome

Tadalafil versus tamsulosin as combination therapy with 5-alpha reductase inhibitors in benign prostatic hyperplasia, urinary and sexual outcomes

Beneficial Effects of Human Umbilical Cord Blood Mononuclear Cells on Persistent Erectile Dysfunction After Treatment of 5-Alpha Reductase Inhibitor in Rats

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