Erectile Response to Acute and Chronic Occlusion of the Internal Pudendal and Penile Arteries

Abstract

We designed two animal experiments to elucidate the effect of obstruction of the internal pudendal artery on erectile function. In five dogs the internal pudendal or penile artery was acutely clamped unilaterally or bilaterally with a non-crushing vascular clamp. In eight dogs, the internal pudendal or penile artery was ligated, unilaterally or bilaterally, and occlusion was maintained for two months. In both models, electrodes were implanted around the cavernous nerves for electroerection. In unilateral occlusion, blood flow in the contralateral internal pudendal artery was recorded via an ultrasonic probe. In both unilateral and bilateral occlusion, intracavernous pressure in both corpora cavernosa was recorded through a 21-gauge butterfly needle connected to a Statham transducer. In the chronic model, selective pudendal angiography was done after the erection study was completed; the dogs were then sacrificed and the penile tissue was examined histologically under light microscopy. Unilateral acute clamping of the internal pudendal or penile artery caused a compensatory increase in arterial flow in the contralateral pudendal artery with only moderate impairment of intracavernous pressure on the ipsilateral side, but bilateral occlusion resulted in a marked reduction in the intracavernous pressure response to neurostimulation. In contrast, chronic obstruction of penile vessels had a minimal effect on erectile function due to the development of a rich network of collaterals around the penis. Histological evaluation revealed mild local changes in the cavernous tissue with characteristic compensatory enlargement of branches of the cavernous artery on the control side in cases of unilateral occlusion.

Does kidney transplantation onto the external iliac artery affect the haemodynamic parameters of the cavernosal arteries?

“…14 These findings imply that haemodynamic changes occurring after unilateral exclusion of the internal iliac artery should exert negligible effects on erectile function in the presence of normal baseline PSVs, and they confirm earlier experimental data in canine models in which occlusion of one hypogastric artery did not produce significant changes to the cavernosal arterial supply. 21 Similar conclusions were drawn in a recent Chinese study on internal iliac artery KT recipients. 22 To the best of our knowledge, a comparative evaluation of haemodynamic parameters before and after KT onto the external iliac artery has not been carried out.…”

“…A serum sample was stored for the determination of testosterone and prolactin levels. Erectile function was assessed on the basis of the score on the six questions from the erectile function domain of the International Index of Erectile Function-Erectile Function (IIEF-EF) and ED and categorized according to Cappelleri et al 18 into: absent ED (EF score, 26-30), mild ED (EF score, [17][18][19][20][21][22][23][24][25], moderate ED (EF score, 11-16) and severe ED (EF score, f10).…”

Traumatic arteriogenic erectile dysfunction: a rat model

“…Chronic mechanical ligation of the penile vessels had only a minimal effect on the erections induced by neurostimulation as a result of the development of numerous arterial collaterals to the penis. 11 Vasculogenic ED in an atherosclerotic rabbit model has been extensively studied, 12,13 We elected to investigate the feasibility of using a smaller animal model for the studying of traumatic arteriogenic ED.…”

Oxidative Stress and Molecular Reactions in Arteriogenic Erectile Dysfunction

“…4,5 The development of atherosclerotic lesion and occlusion of the hypogastric-pudendal arterial bed diminish arterial perfusion pressure, decrease arterial inflow to the lacunar spaces of the corpora cavernosa, and lead to progressive impairment of erectile tissue structure and function. [6][7][8][9][10][11][12] This is evidenced by clinical and basic research data showing that decreased cavernosal perfusion pressure is the initial hemodynamic phenomenon that leads to a series of deleterious cytotoxic events with adverse impact on erectile tissue endothelium, smooth muscle, nerves and microvasculature. 7,[10][11][12][13][14][15][16] In this review, we summarize oxidative activities and molecular reactions in arteriogenic ED that result from prolonged exposure to ischemia.…”