Abstract

We performed this study to evaluate the effect of cavernous nerve (CN) traction on erectile function in rats. Thirty-two 8- week-old Sprague–Dawley rats were divided into four groups: control, 1-minute CN traction, 2-minute CN traction, and 2-minute CN crush. CN traction was performed using a glass hook with a tensile force of 0.2 Newton. One month later, the mean arterial pressure (MAP) and intracavernosal pressure (ICP) in response to CN stimulation were measured to assess erectile function. The penis and major pelvic ganglion (MPG) were harvested to explore the expression of neuronal nitric oxide synthase (nNOS) and neurofilament, fibrosis and apoptosis. The ICP/MAP ratio was reduced in the 2-minute CN traction group compared with the control group (P < 0.05). The ICP/MAP ratio in the CN crush group was lower than in the other three groups (P < 0.05, for each). Expression of nNOS in both MPG and dorsal penile nerve was lower in the CN traction group than in the control group, but was higher than in the CN crush group (P < 0.05). Nerve fiber number in the dorsal penile nerve was reduced by 2-minute CN traction (P < 0.05). The ratios of collagen to smooth muscle content and the apoptosis were both increased the in 2-minute CN traction group compared with the control group (P < 0.05). The findings indicate that CN traction is an effective CN injury model and the injury it caused is relatively mild compared with the CN crush model.

Highlights

  • Iatrogenic cavernous nerve (CN) injuries resulting from some types of pelvic surgeries, such as abdominoperineal resection, radical prostatectomy (RP), and radical cystoprostatectomy, often lead to severe erectile dysfunction (ED) [1]

  • The 1-min CN traction group showed no significant decrease in intracavernosal pressure (ICP)/mean arterial pressure (MAP) compared with the control group at different levels of voltage (2.5, 5.0 and 7.5V, P>0.05 for each)

  • Immunofluorescence staining showed that both the total number of nerve fibersand the number of neuronal nitric oxide synthase (nNOS) positive nerve fibers were reduced in the dorsal penile nerve in the 2-min CN traction group, compared with the control group (P

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Summary

Introduction

Iatrogenic cavernous nerve (CN) injuries resulting from some types of pelvic surgeries, such as abdominoperineal resection, radical prostatectomy (RP), and radical cystoprostatectomy, often lead to severe erectile dysfunction (ED) [1]. It is estimated that 26% to 100% patients suffer from ED after RP [2]. The main reason for this complication is the injury to the penile nerve supply [3]. With the development nerve-sparing prostatectomy, the postoperative ED rate has reduced. The application of robot-assisted radical prostatectomy is beneficial in preserving erectile function [4,5]. These improved RP techniques have not been able to eliminate postoperative ED [6]

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