MP43-01 EFFECTS OF COMBINATION THERAPY WITH SILDENAFIL AND LOW-ENERGY SHOCKWAVE THERAPY IN A PELVIC NEUROVASCULAR TRAUMA MODEL

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology I1 Apr 2018MP43-01 EFFECTS OF COMBINATION THERAPY WITH SILDENAFIL AND LOW-ENERGY SHOCKWAVE THERAPY IN A PELVIC NEUROVASCULAR TRAUMA MODEL Alexandria Hertz, Evalyn George, Amanda Reed-Maldonado, Timothy Brand, and Shashikumar Salgar Alexandria HertzAlexandria Hertz More articles by this author , Evalyn GeorgeEvalyn George More articles by this author , Amanda Reed-MaldonadoAmanda Reed-Maldonado More articles by this author , Timothy BrandTimothy Brand More articles by this author , and Shashikumar SalgarShashikumar Salgar More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1400AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Erectile dysfunction (ED) following trauma is challenging as traditional therapies are often ineffective. Low-energy shockwave therapy (LESWT) has shown promise in recovery of erectile function. This study aimed to determine whether the combination of phosphodiesterase-5 inhibitors (PDE5i) and LESWT would result in improved erectile function after pelvic crush injury. METHODS 30 Lewis rats, aged 10-12 weeks, were divided into five groups: sham operation, bilateral cavernous nerve crush injury and bilateral internal pudendal bundle ligation without treatment (control), injury with PDE5i, injury with LESWT, and injury with LESWT and PDE5i (n=6 rats/group). Forty-eight hours after injury groups were started on three times weekly LESWT (1000 pulses at 0.06 mJ/mm2 and 3Hz) or sildenafil was given by mouth mixed into daily drinking water at 5-20 mg/kg/day (water intake ad libitum) with a 1% sucrose additive, for four weeks. Following a one week washout period (week 5), final intracavernous pressure (ICP) was then taken at week 6 as the final outcome measure. RESULTS Pelvic neurovascular injury resulted in a significant decrease in erectile function as measured by maximum ICP, average ICP and change in ICP (p=0.003, 0.001, 0.007, respectively). Erectile function was recovered completely with combination PDE5i and LESWT as measured by maximum ICP, average ICP, and change in ICP (when compared to the sham group p=0.636, 0.184, 0.5; control group p=0.0006, 0.0001, 0.0002). LESWT alone was seen to have partial recovery as measured by maximum ICP (compared to sham p=0.066) and change in ICP (versus control p=0.05, versus sham p=0.2). PDE5i alone was not shown to have significant erectile recovery. CONCLUSIONS Combination therapy with sildenafil and LESWT resulted in complete recovery of erectile function in a rat model of pelvic nerve injury. Combination therapy was superior to individual therapy alone. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e579-e580 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Alexandria Hertz More articles by this author Evalyn George More articles by this author Amanda Reed-Maldonado More articles by this author Timothy Brand More articles by this author Shashikumar Salgar More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...