Search

Electrophysiological examination of penile nerves involves detection of somatic and autonomic nerves, including dorsal nerve somatosensory evoked potential, cavernous muscle reflex, skin sympathetic response, cavernous electromyography, and others, which plays an important role in the diagnosis of male sexual dysfunction, such as ED and premature ejaculation, as well as in the selection of treatment methods and evaluation of therapeutic effects. Due to the complex mechanisms of the brain, spinal cord and peripheral nerve pathways relating to erectile and ejaculatory centers in men and many unknown areas in penile electrophysiological techniques, penile electrophysiological examination has not been widely accepted by doctors and patients. Further studies are needed to provide more scientific and convincing evidence in this field.

Objective: To investigate the safety and efficacy of pancreatic kininogenase combined with sildenafil in the treatment of erectile dysfunction(ED) in type 2 diabetes mellitus (DM) patients in the high-altitude area., Methods: This study included 93 ED patients with type 2 DM, all residents of the Xining area 1500 meters above sea level. We randomly divided them into an experimental group (n = 48) and a control group (n = 45), the former treated with pancreatic kininogenase(120 u, tid) and sildenafil (25 mg, qd at bedtime), while the latter with sildenafil only (25 mg, qd at bedtime).After 4 and 8 weeks of medication, we obtained the penile hemodynamic parameters,IIEF-5 scores, and sexual intercourse satisfaction(SIS) scores and compared them between the two groups of patients., Results: There were no statistically significant differences in age or DM course between the two groups of patients (P >0.05).Compared with the baseline, both the experimental and control groups showed remarkably improvement inthe IIEF-5 score (8.81 ± 2.06 vs 11.54 ± 7.72 and 8.29 ± 1.91 vs 9.37± 1.65, P <0.05), SIS score (3.35 ± 2.43vs6.83± 2.61and 3.41 ± 2.38 vs 4.92± 2.49, P <0.05), and penile hemodynamic parameters obtained by color duplex Doppler ultrasonography(P <0.05), with significant differences between the two groups in the IIEF-5 score (11.54 ± 7.72 vs 9.37± 1.65, P <0.05) and SIS score (6.83± 2.61 vs 4.92± 2.49, P <0.05) but not in the penile hemodynamic parameters (P >0.05). Even more remarkable improvement was observed at 8 weeks in the experimental and control groups in the IIEF-5 score (19.29± 1.85 and 15.43± 1.74)(P <0.05), SIS score (11.73 ± 2.57 and 6.55± 2.71) (P <0.05), and penile hemodynamic parameters(P <0.05), all with significant differences between the two groups (P <0.05)., Conclusions: Pancreatic kininogenase combined with sildenafil has a better clinical effect than sildenafil alone on ED in type 2 DM patientsin the high-altitude area.

Objective: To investigate the impact of hyperglycemia on the hydrogen sulfide (H2S) signaling pathway in rat penile tissue and its relationship with erectile function., Methods: Twenty healthy male Sprague Dawley (SD) rats aged 8 weeks were randomly divided into groups A (4-week healthy control), B (4-week diabetes mellitus model), C (6-week healthy control) and D (6-week diabetes mellitus model). The rats in groups B and D were injected intraperitoneally with streptozotocin at 50 mg/kg to induce diabetes mellitus, while those in groups A and C with the same volume of normal saline. The animals were killed at 4 (groups A and B) and 6 weeks (groups C and D) after treatment for measurement of the maximal intracavernous pressure/mean arterial blood pressure (ICP(max)/MAP) by electrostimulation, determination of the H2S concentration in the plasma and penile tissue, and detection of the expressions of cystathionine-beta-synthetase (CBS) and cystathionine-gamma-lyase (CSE) in the penile corpus cavernosum by immunohisto- chemistry and Western blot., Results: With electrostimulation of the pelvic ganglia at 5V and 7 V, ICP(max)/MAP was significantly reduced in groups B (0.19 +/- 0.03 and 0.29 +/- 0.04) and D (0.14 +/- 0.04 and 0.25 +/- 0.04) as compared with A (0.46 +/- 0.07 and 0.68 +/- 0.09) and C (0.43 +/- 0.07 and 0.65 +/- 0.16) (P < 0.05). No statistically significant differences were found in the level of serum testosterone either between groups A and B ([469.19 +/- 126.46] ng/dl vs [359.08 +/- 60.06] ng/dl, P > 0.05) or between C and D ([470.44 +/- 209.28] ng/dl vs [297.01 +/- 96.58] ng/dl, P > 0.05). Groups B and D showed remarkable reduction in the H2S concentration (P < 0.05) and the expressions of CBS and CSE (P < 0.05) in comparison with A and C, and the CBS and CSE expressions were even more significantly decreased in D than in B (P < 0.05)., Conclusion: The reduced concentration of H2S and decreased expressions of CBS and CSE in the penile corpus cavernosum of the diabetic rats suggested that the H2S signaling pathway might be involved in hyperglycemia-induced erectile dysfunction.

Objective: To investigate the selective innervation of sacral anterior rootlets to micturition and erection function in SD rats., Methods: Forty male SD rats of clean grade, aged 6 weeks old, were selected. Ten rats received a retrograde nerve tract tracing study. Thirty rats were chosen for an electro-physiological study. The L6, S1 spinal cord segment anterior rootlets of anesthetic rats were electrostimulated respectively. The intravesical pressure, urethral perfusion pressure and intracavernous pressure were recorded simultaneously and innervation effectiveness was analyzed., Results: CB-HRP labeled neurons were observed mainly in L6 and S1 spinal cords. When some anterior rootlets of L6 and S1 were electrostimulated, the intravesical pressure rose gradually, but the urethral perfusion pressure and the intracavernous pressure curve changed slightly; when other rootlets of the same anterior root were stimulated, the urethral perfusion pressure could reach the peak; while others were stimulated, the intracavernous pressure rose quickly, but there were no great changes in intravesical pressure and urethral perfusion pressure. Some other rootlets might lead to the simultaneous changes of 2 or 3 above-mentioned pressures., Conclusion: The innervations of L6 and S1 anterior rootlets to rats' bladder detrusor, external urethral sphincter and penile cavernous body are significantly distinct. Different rootlets may be distinguished by microanatomy and electrostimulation.

Penile erection is regulated by the relaxation of corpus cavernosum smooth muscle cells (CCSMCs). It has been recognized that the Ras/MEK/ERK1/2 signaling pathway is closely related to the functions of CCSMCs and endothelial cells, and it is involved in the regulation of penile erection, mainly via phosphorylation of NO synthase. ERK1/2 phosphorylates, inhibits eNOS activity, and thus reduces the relaxation of CCSMCs and penile erection. But the site of phosphorylation is not yet clear. In CCSMCs and endothelial cells, the ERK1/2 pathway interacts with other cascades and regulates the erectile function of the penis. This article presents an overview of the researches on the ERK1/2 signaling cascade, its regulatory role and its interaction with other signaling pathways in penile erection.

Seeing that the invasive measuring technique has many disadvantages, we have designed a noninvasive technical system for measuring isovolumetric bladder pressure by controlled inflation of a penile cuff. This system is easy-to-use and the measuring result provides quantitative information on isovolumetric bladder pressure during voiding. The doctor can discriminate obstruction from non-obstruction according to the data of measurement and flow rate.

Objective: To investigate the effect of platelet rich plasma (PRP) on the regeneration of injured cavernous nerve (CN)., Methods: Blood was collected from the hearts of 6 SD rats to prepare PRP. 24 male adult rats were randomly divided into 3 equal groups: pure suture group undergoing bilateral CN transaction and pure suture immediately, PRP group undergoing bilateral CN transaction + suture + PRP 200 microl to the site of suture, and sham operation group. 3 months later intracavernous pressure (ICP) was measured by CN electrostimulation and then samples of CN were obtained to undergo pathological examination., Results: 3 months later after surgery, the ICP of the pure suture group was (46 +/- 8) cm H2O, significantly lower than that of the sham group [(109 +/- 13) cm H2O, P < 0.01], and that of the PRP group was (94 +/- 13) cm H2O, significantly higher than that of the pure sutured group (P < 0.01), however, still significantly lower than that of the sham operation group (P < 0.05). The number of axons of CN in the PRP group was (121 +/- 16), significantly higher than that of the pure sutured group (70 +/- 14, P < 0.01); however, still significantly lower than that of the sham operation group (181 +/- 21, P < 0.01)., Conclusion: PRP can promote the regeneration of injured CN and the recovery of erectile function.

Objective: To study the relaxant effect of ethanol on the isolated rabbit corpus cavernosum and its possible mechanism., Methods: The tension of isolated smooth muscle strips was recorded by the platform physiological graphed, and the concentrations of cAMP and cGMP in the rabbit corpus cavernosum were measured by 125I radioimmunoassay., Results: The 1.25% (V/V) ethanol significantly augmented the corporal relaxation induced by isoprenaline (10(-9) - 10(-5) mol/L). Ethanol-induced relaxation was inhibited by 100 micromol/L and 300 micromol/L SQ22536 (an adenylate cyclase inhibitor). Emax was depressed from (105.12 +/- 3.39) % to (97.00 +/- 2.57) % in the presence of 100 micromol/L SQ22536 or (91.09 +/- 2.42) % in the presence of 300 micromol/L SQ22536. EC50 was increased from (1.18 +/- 0.09)% (V/V) to (1.36 +/- 0.10) % in the presence of 100 micromol/L SQ22536 (P < 0.05) or (1.68 +/- 0.13) % (in the presence of 300 micromol/L SQ22536) (P < 0.05) respectively. Ethanol significantly elevated the level of cAMP but not that of cGMP in the isolated rabbit corpus cavernosum, and it also significantly enhanced the activity of the adenylate cyclase (AC) extracted from the rabbit corpus cavernosum in a dose-dependent manner., Conclusion: Ethanol has a relaxant effect on the isolated rabbit corpus cavernosum, which may be associated with the cAMP signaling pathway.

Tissue engineering techniques, with their potential applied value for penile reconstruction, are of special interest for andrologists. The purpose of this review is to appraise the recent development and publications in this field. In the past few years, great efforts have been made to develop corpus cavernosum tissues by combining smooth muscle and endothelial cells seeded on biodegradable polyglycolic acid polymer (PGA) or acellular corporal collagen matrices scaffolds. Animal experiment demonstrated that the engineered corpus cavernosum achieved adequate structural and functional parameters. Engineered cartilage rods as an alternative for the current clinical standard of semirigid or inflatable penile implants could be created by seeding chondrocyte cylindrical PGA. A series of studies showed that, compared to commercially available silicone implants, the engineered rods were flexible, elastic and stable. Besides, a variety of decellularized biological materials have been used as grafts not only for substitution of tunica albuginea but also for penile enhancement, with promising results. For treating erectile dysfunction, a new approach to recovering erectile function by cell-based therapy could be the injection of functional cells into corpus cavernosum, which seemed to be promising when combined with cell manipulation by gene therapy prior to cell transfer.

Objective: To study the effect of endogenous carbon monoxide (CO) on the smooth muscle function of the dog penile corpus cavernosum in vitro., Methods: Tissue bioassay was used to measure the corpus cavernosum muscle contraction and relaxation. The production of CO was induced in the corpus cavernosum smooth muscle, and the effect of CO on the penile corpus cavernosum smooth muscle pre-contracted by phenylephrine (PE) was determined., Results: Chlorinous hemoglobin could relax the smooth muscle stripes pre-contracted by 10 micromol/L PE. A dose-dependent relaxation was observed. The relaxation responses by 10 -100 micromol/L chlorinous hemoglobin were significant compared with the control group (P < 0. 01). The pretreatment of the muscle stripes with ZnPP-IX or methylthioninium significantly reduced the relaxing effect of chlorinous hemoglobin (P < 0.01)., Conclusion: The relaxing effect of endogenous CO on the smooth muscle of the penile corpus cavernosum depends on the concentration of endogenous CO. The underlying mechanism may involve the pathway from CO to cGMP production.

Objective: To study the relaxants effects of six extractions from Chinese Herbs (neferine, tetrandrine, kakonein, scutellarin, ginsenoside Rgl and ginsenoside Rb1) on the corpus cavernosum tissue of rabbit in vitro., Methods: Isolated stripes of rabbit corpus cavernosum tissue were precontracted with 10(-5) mol/L phenylephrine (PE). Relaxation in response to cumulative doses of six extracts at (10(-8) - 10(-3)) mol/L was determined., Results: On rabbit cavernosal muscle stripes precontracted with PE, neferine, tetrandrine, kakonein and scutellarin showed dose dependent relaxation. IC50 values were 4.60 x 10(-6), 3.73 x 10(-5), 8.03 x 10(-4) and 3.33 x 10(-3) mol/L, respectively. However, in the meantime, it was found that the relaxant effects of ginsenoside Rgl and ginsenoside Rbl less significant to stripes precontracted with PE. When the final concentration was 10(-3) mol/L, the relaxations were only (16.32 +/- 5.45)% and (11.21 +/- 3.10)%., Conclusion: Among the six extracts which showed relaxant effects to rabbit cavernosal muscle stripes precontracted with PE, neferine had greater functions than the other five extracts.

Objective: To investigate the effect of FK506 on the cavernous nerve regeneration after injury and to discuss its possible action mechanisms., Methods: Fifty-four male adult Sprague-Dawley rats were randomized into three groups: Group 1 (sham control), Group 2 (unilateral cavernous nerve ablation), and Group 3 (unilateral cavernous nerve ablation with subsequent injection of FK506). Electrostimulation of the cavernous nerve was performed at 1 and 3 months after surgical injury. The intracavernous pressure was continuously detected and the rats were followed by nicotinamide adenine dinucleotide phosphate diaphorase (NADPH-d) staining to identify NOS in the penile nerve fibers of the penile shaft., Results: At 1 month, the number of NOS-positive nerve fibers significantly decreased with no statistical difference among the three groups except the sham controls (P > 0.05). At 3 months, electrostimulation revealed greater maximal intracavernous pressure in Group 3 than in Group 2 (P < 0.01). Furthermore, the number of NOS-positive nerve fibers showed a significant increase (P < 0.01), but not in Group 2 (P > 0.05)., Conclusion: FK506 injection enhances the regeneration of cavernous nerves after injury and the recovery of erectile function in rats.

The regulation of vascular and trabecular smooth muscle relaxation or contraction in the penis, that is, the physiology of corporal smooth muscle tone, determines penile erection or flaccidity. There is considerable evidence that the potassium channel and calcium channel, like many other vascular tissues, are the major modulators of smooth muscle tone in the corpora. Moreover, data on cultured corporal smooth muscle cells and isolated corporal tissue strips have demonstrated that the neurotransmitters participating in erection modulate corporal smooth muscle tone largely through their effects on ionic channels and transmembrane ionic flux.

Objective: To evaluate the effect of aging on the endothelial function of the penile corpus cavernosum in rats., Methods: The intracavernosal pressure (ICP) was compared in response to acetylcholine (Ach, endothelium-dependent vasodilator), sodium nitroprusside (SNP, an NO donor) and A23187 (a calcium ionophore)in the young (5 months old) and aged (20 months old) rats. In addition, the activity of nitric oxide synthase (NOS)in penile cavernosal tissues was examined., Results: Ach-mediated ICP was significantly attenuated from the maximum of (54.8 +/- 4.2) in the young rats to (40.3 +/- 2.8) mm Hg in the aged ones (Ach = 0.1 mmol/L), P < 0.01. The ICP to SNP (0.1 mmol/L) was (58.9 +/- 4.7) mm Hg in the young rats and (51.7 +/- 5.3) mm Hg in the aged. No statistically significant difference was noted between the two groups, P > 0.05. The Ach-mediated ICP in the young rats was not significantly augmented from the maximum of (54.8 +/- 4.2) to (55.8 +/- 4.7) mm Hg in the presence of the calcium ionophore A23187 (10 micromol/L), P > 0.05. However, A23187 significantly augmented Ach-mediated ICP in the aged from the maximum of (40.3 +/- 2.8) to (56.2 +/- 4.1) mm Hg, P < 0.01. Finally the activity of nitric oxide synthase was not significantly attenuated in either the aged or the young, P > 0.05., Conclusion: The endothelial function of the penile cavernosum declines with the advance of age. And endothelial dysfunction may play some role in the mechanisms of age-related erectile dysfunction.

Objective: To investigate the effects of chuanxiongzine on the relaxation of isolated rabbit corpus cavernosum tissues., Methods: Observations were made on the relaxing effect of chuanxiongzine on phenylephrine (PE)-precontracted corpus cavernosum and cavernosal strips preincubated with L-NAME, and ODQ, using endothelium removal and experimental method of smooth muscle strips. The effect of chuanxiongzine on cAMP and cGMP levels in corpus cavernosum was measured by 125I radioimmunoassay., Results: Chuanxiongzine had concentration-dependent relaxing effect on the cavernosal muscle contraction induced by PE (EC50 1.58 x 10(-4) mol/L). This relaxing effect was partially antagonized by ODQ and not blocked by L-NAME or endothelium removal. In PE-precontracted cavernosal strips, chuanxiongzine induced relaxation accompanied with an increase in cAMP and cGMP levels., Conclusion: Chuanxiongzine was effective in relaxing cavernosal muscle precontracted by PE in vitro. And its relaxing effect may be enhanced by increasing cGMP and cAMP levels in the corpus cavernosum.

Erectile dysfunction (ED) is a commonly and frequently encountered disease among middle-aged and old males. The traditional Chinese medicine has a long history of medical treatment for ED has been focusing too much on clinical experience researches, without obtaining sufficient evidence for the curative effect of related traditional medicines. Recently, with important breakthroughs the researches on the molecular biochemical mechanisms of erection, sildenafil(Viagra), a phosphodiesterase type 5 (PDE5) inhibitor, has been developed, and exciting progress achieved in the treatment of ED with Chinese herbal medicine and the presentation of the pharmacological mechanism. This article presents an overview on recent advances in the studies of ED treatment with traditional Chinese medicine.

Objectives: To study the relaxation effects of tetrandrine on the corpus cavernosum tissue of rabbit in vitro., Methods: 1. The fluctuation of the dose-response relaxation curves for the contraction of KCl induced by tetrandrine was observed with isolated rabbit corpus cavernosum tissue. 2. Isolated strips of rabbit corpus cavernosum tissue were precontracted with 10 mumol/L phenylephrine(PE). Relaxation in response to cumulative doses of tetrandrine was determined in the absence and presence of nitric oxide synthase inhibitor (L-NNA) and soluble guanylate cyclase inhibitor (methylthioninium)., Results: 1. The dose-response curves of KCl were shifted to the right nonparallelly, and the maximal responses were depressed to (73.0 +/- 3.8)% and (41.5 +/- 3.4)%, respectively, in the presence of tetrandrine(10 mumol/L, 30 mumol/L). 2. On rabbit cavernosal muscle stripes precontracted with PE(10 mumol/L), increasing concentrations of tetrandrine (1 mumol/L, 10 mumol/L, 30 mumol/L and 100 mumol/L) showed dose dependent relaxation [(6.0 +/- 1.4)%, (21.3 +/- 2.2)%, (47.4 +/- 3.3)%, and (68.1 +/- 3.6)%, P < 0.01]. However, in the meantime, it was found that these relaxation effects were not affected by the presence of L-NNA and methylthioninium (P > 0.05)., Conclusions: Tetrandrine was effective in relaxing rabbit corpus cavernosum tissue in vitro in a dose-dependent style. The mechanism might be related with its blocking effect on calcium channel, but not the NO-cGMP passage.

Objectives: To investigate the effects of antihypertensive drugs on the erectile function and number of nNOS-containing nerve fibers in spontaneously hypertensive rats(SHRs)., Methods: Eighteen male SHRs of six-weeks old were randomized into three groups: Vilsartan intervention group, Aldactone intervention group and control group. Vilsartan [30 mg/(kg.d)] and Aldactone [20 mg/(kg.d)] were administered by gavage to respective groups. After twelve weeks treatment, all SHRs were tested for erectile function and then killed for the detection of nNOS-containing nerve fibers by Streptaridin-peroxidase immunohistochemistry techniques (SP method)., Results: The erection frequency in Vilsartan group was higher, compared with other two groups(P < 0.05), in which no significant difference was observed (P > 0.05). There was no significant difference in erection rates among these three groups. The number of nNOS-containing nerve fibers in two intervention groups was higher than the control group(P < 0.01), but no significant difference existed between these two groups(P > 0.05)., Conclusions: Vilsartan improves erectile function in SHRs while Aldactone doesn't. The difference can't be explained by the number of nNOS-containing nerve fibers, and it is probably related to the vascular reconstruction induced by angiotensin II receptor antagonists.

Objectives: The investigation of the testicular volume, the penis length and the T, FSH, LH, PRL levels in serum were taken in 289 adolescent males to provide the valuable data for andrology., Methods: The adolescent males were grouped according to their age. The testicular volume was measured with testicular model and the T, FSH, LH, PRL levels in serum were determined by immunoenzymetric assay., Results: The male sexual development was rapid from age 11 to 16 and close to that of adult at age 18. Serum PRL of adolescent males was higher than that of adult males., Conclusions: The age 11 to 16 is a period of rapid growth in sexual maturation. PRL may play an important role in sexual maturation.

Objectives: To investigate the development and the health of reproductive organs of male children and juvenile between the Meng and the Han nationality in the Meng nationality area., Methods: Male juvenile(4-18 years old) of the Meng nationality (n = 2,315) and the Han nationality (n = 2,832) were divided into four age groups. Height, weight, length and perimeter of penis, volume of left and right testis and reproductive organs illness were examined., Results: In 13-18 years group, the developmental speed of reproductive organs was faster in Mongolia male juvenile than that in the Han nationality (P < 0.02). After 13 years old, the developmental speed of reproductive organs of male living in town is faster than that in the country (P < 0.05). Illness of male reproductive organs was common such as hernia, varicocle etc., Conclusions: There was difference of developmental status and the prevalence rate of reproductive organs of male children and juvenile between the Meng and the Han nationality.