The investigation of putative agents, using an in vitro model, to prevent cavernosal smooth muscle dysfunction during low‐flow priapism

Abstract

To investigate the effect of putative agents for preventing irreversible smooth muscle dysfunction, using an in vitro model of low-flow priapism (a condition conventionally managed using a combination of corporal blood aspiration and instillation of alpha-adrenergic agonists), as failure of detumescence results in a high incidence of erectile dysfunction. We investigated the effects of several agents (N-acetylcysteine, BayK 8644, glutathione, digoxin, calcium and N(omega)-nitro-l-arginine methyl ester) on the recovery of smooth muscle tone after exposure to 4 h of a combination of hypoxia, glucopenia and acidosis in corpus cavernosum isolated from rabbit. After 4 h of ischaemia, none of the agents were able to prevent irreversible smooth muscle dysfunction. Prolonged low-flow priapism leads to smooth muscle dysfunction and fibrosis within the corpus cavernosum. When alpha-adrenergic agents fail to reverse the condition, surgical intervention is required. We showed that the administration of novel agents, including antioxidants, does not prevent smooth muscle dysfunction.