Abstract
Objective:Tadalafil is a selective phosphodiesterase type-5 inhibitor with a long half-life. It has a dual function in ischaemic and re-perfused tissues, i.e. vasodilatation and anti-oxidant effects. These features of tadalafil distinguish it from other anti-oxidants. We investigated the dual effect of tadalafil on ischaemia and reperfusion injury in the rat ovary.Material and Methods:We established five study groups. Group 1 (n=6): sham-operated; group 2 (n=6): torsion; group 3 (n=6): torsion and Tadalafil; group 4 (n=6): torsion/de-torsion; and group 5 (n=6): torsion/de-torsion and tadalafil. Ovarian samples were harvested from animals and evaluated in terms of histopathologic changes, tissue malondialdehyde (MDA) concentrations, lactate production, and plasma cyclic guanosine monophosphate (cGMP).Results:Follicular degeneration, oedema, haemorrhage, and inflammatory cells were significantly decreased in group 5 in comparison with group 4. Group 2 and group 3 were compared in terms of vascular congestion and haemorrhage; these parameters were significantly decreased in group 3. In addition, significantly decreased MDA and lactate concentrations were observed in group 5 in comparison with group 4. Increased cGMP concentrations were detected in group 3 and group 5.Conclusion:We conclude that tadalafil might be useful in protecting the ovary against ischaemia and reperfusion injury. In the evet of ovarian torsion, it will provide a greater therapeutic effect than only performing de-torsion of the ovary or using other anti-oxidant agents.
Highlights
Ovarian torsion is an emergency condition in gynaecology practice
Histopathologic results The histopathologic results of ovarian tissue samples of the five groups are presented in Figure 1, with no histopathologic changes observed in the group that received sham surgery
When tadalafil was administered before torsion, a statistically significant decrease in vascular congestion (p
Summary
Ovarian torsion is an emergency condition in gynaecology practice. It is important when diagnosed in the reproductive period. The reoxygenation of ischemic tissues results in the production of reactive oxygen species (ROS), including superoxide anions (O2-), hydrogen peroxide, and hydroxyl radicals (OH-), among others These ROS damage phospholipids and proteins of the cell membrane and promote mitochondrial permeability which can cause a reduction in ATP and lead to cell death [2]. Recent studies have demonstrated a potential beneficial effect of PDE-5 inhibitors on IR injury in the brain [4], kidney [5], and heart [6] These authors found that increasing cGMP attenuates lipid peroxidation [7] and nicotinamideadenine dinucleotide phosphate [NAD(P)H] oxidase activity, which are the main sources of ROS production in oxidative stress [6]. We investigated the effect of tadalafil on the ischemic stage and on reperfusion injury
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