Abstract
The aim of this study is to determine the presence of adipocyte accumulation under penile tunica albuginea in a group of refractory erectile dysfunction patients. Nine erectile dysfunction patients (case group) and eleven potent patients with Peyronie’s disease (control group) underwent penile prosthesis implantation and curvature correction surgeries, respectively. In both groups, sub-albuginean tissue samples were taken within the operative time. Groups were compared in terms of clinical characteristics, co-morbidities and presence of sub-albuginean adipocyte accumulation. Of the nine patients in the case group, eight presented cavernous fat cell accumulation, while only one patient in the control group presented this finding (p<0.05). A significant association (p<0.05) was found between adipocyte accumulation and erectile dysfunction (OR 35 CI 95% 1.98-1727.62). A similar association with chronic arterial hypertension was also found (OR 20 CI 95% 1.29-1008.46). This is the first human study to report an association between erectile dysfunction and penile sub-albuginean fat accumulation. Metabolic syndrome-related conditions could cause disruption in androgen homeostasis, leading to adipocyte accumulation. Venous leakage secondary to accumulation of fat under tunica albuginea could be an important element in the pathophysiology of erectile dysfunction, especially in metabolic syndrome patients that do not respond to medical therapy.
Highlights
Erectile function depends on the interaction of psychological factors and an appropriate balance between the endocrine and nervous systems, together with an adequate vascular bed [1]
Several studies have shown that patients not responding to oral Phosphodiesterase 5 Inhibitors (PDI5), especially those affected by Metabolic Syndrome (MS), may have a quantitative or qualitative alteration in androgen metabolism [2,3,4,5]
Adipocyte accumulation was significantly higher in Erectile Dysfunction (ED) patients compared with potent patients
Summary
Erectile function depends on the interaction of psychological factors and an appropriate balance between the endocrine and nervous systems, together with an adequate vascular bed [1]. Testosterone may play a pivotal role in maintaining penile nerve, smooth muscle and endothelium structure and function; maintaining tunica albuginea structural integrity and connective tissue matrix fibroelastic properties; and regulating differentiation of cavernous pluripotent cells into trabecular smooth muscle [1]. Several studies have shown that patients not responding to oral Phosphodiesterase 5 Inhibitors (PDI5), especially those affected by Metabolic Syndrome (MS), may have a quantitative or qualitative alteration in androgen metabolism [2,3,4,5]. Obesity and MS related androgen alterations are thought to play a pivotal role in the pathophysiology of Erectile Dysfunction (ED) [4,5,6]
Sign-in/Register to view highlights & summary 
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call