A histological and immunohistochemical study on human penile cavernosal tissue with viewpoints of venogenic erectile dysfunction

Abstract

Objective To determine the histological and immunohistochemical alterations of human penile cavernosal tissue in venogenic erectile dysfunction (ED) compared with potent controls regarding collagen fibres, elastic fibres, smooth muscle content and inducible nitric oxide synthase (i-NOS) expression. Materials and methods Cavernous biopsies were obtained from four potent men (two with penile fracture and two with congenital penile curvature) regarded as controls and from 15 patients with venogenic ED undergoing implantation of penile prosthesis. The specimens obtained were subjected to haematoxylin and eosin, Masson's trichrome and orcein stains and antismooth muscle α-actin and i-NOS immunostaining. Evaluation was carried out using computerized morphometric analysis and results were statistically compared. Results A significant increase of collagen fibres with reduced smooth muscle and elastic fibre content was shown in patients with venogenic ED compared with controls. There was also an increased expression of i-NOS immuonoreactivity. Conclusion Histological alterations of cavernosal tissue structure in venogenic ED point to progressive fibrosis. Early diagnosis by penile biopsy may help to combat fibrosis and preserve the integrity of erectile tissue and accordingly the penile erection.