The corpus cavernosum after treatment with dutasteride or finasteride: A histomorphometric study in a benign prostatic hyperplasia rodent model

Abstract

Erectile dysfunction is a common side effect of finasteride and dutasteride treatments. The objective of this study was to investigate the structural changes in the penis using a benign prostatic hyperplasia (BPH) rodent model treated with dutasteride or finasteride. Sixty male rats were divided into the following groups: C, untreated control rats; C + D, control rats receiving dutasteride; C + F, control rats receiving finasteride; H, untreated spontaneously hypertensive rats (SHRs); H + D, SHRs treated with dutasteride; and H + F, SHRs treated with finasteride. Treatments were performed for 40 days, and penises were collected immediately thereafter. The organs were analyzed using histomorphometric methods to determine the cross-sectional penile area, as well as the surface density (Sv) of smooth muscle fibers, connective tissue, elastic system fibers, and sinusoidal spaces of the corpus cavernosum. The results were compared using a one-way ANOVA with Bonferroni's posttest. Groups C + D and C + F had a significantly smaller penile cross-sectional area, but more elastic system fiber Sv compared to Group C. Group C + D showed less smooth muscle Sv, and Group H showed more connective tissue but a smaller sinusoidal space Sv in the corpus cavernosum compared to Group C. Groups H + D and H + F had less smooth muscle Sv than Group H. Group H + D also had more connective tissue and elastic system fiber Sv than Group H. Both dutasteride and finasteride promoted penile modifications in the control rat penis, although this affect was greater in Group H animals. In this rodent model, dutasteride was the drug that most affected the corpus cavernosum.

Does treatment with dutasteride or finasteride has impact on renal morphology? Experimental study

“…It is well known that the treatment of BPH or alopecia with 5-ARIs may be associated with side effects. These side effects are mainly seen in the penis and characterized by morphological alterations in the corpora cavernosum and transient or permanent erectile disfunction [5][6][7] . However, information regarding side effects in other organs is scarce, especially in tissues not typically recognized as androgen-dependent.…”

“…• Fin (n = 8): received 5 mg/kg/day of finasteride (Finasterida, Eurofarma, São Paulo, SP, Brazil) 5,10,12 .…”

“…The first-line pharmacological treatment for BPH indicated by the European Association of Urology and the American Urological Association comprises 5-alpha reductase inhibitors (5-ARIs) 3,4 . This class of drugs prevents the conversion of testosterone to dihydrotestosterone (DHT), which is the most active androgen 2,5 . As the prostate is an androgen-dependent organ, the reduction of DHT levels is often enough to reduce prostate volume and treat clinical symptoms associated with BPH.…”

“…However, treatment with 5-ARIs may result in adverse effects. For example, histomorphometrical alterations of the corpus cavernosum associated with erectile function have been previously described [5][6][7] . Furthermore, 5-ARIs decrease the expression of endothelial growth factor (VEGF) and inhibit angiogenesis in the prostate, which explains decreased bleeding observed following prostatectomies 8,9 .…”

Current evidence for the involvement of sex steroid receptors and sex hormones in benign prostatic hyperplasia

“…The most effective and utilized treatment worldwide is based on 5-alpha-reductase enzyme inhibitors 3,25,28. However, various studies have reported that this treatment generates changes in the morphology of the corpus cavernosum that are linked to erectile dysfunction, after or during therapy 3,72,73…”