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The effect of intracavernosal growth differentiation factor‐5 therapy in a rat model of cavernosal nerve injury
Author(s) -
FANDEL THOMAS M.,
BELLA ANTHONY J.,
TANTIWONGSE KAVIRACH,
GARCIA MAURICE,
NUNES LORA,
THüROFF JOACHIM W.,
TANAGHO EMIL A.,
POHL JENS,
LUE TOM F.
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06375.x
Subject(s) - erectile function , nerve injury , nerve growth factor , crush injury , medicine , erectile dysfunction , urology , stimulation , nitric oxide , regeneration (biology) , endocrinology , penis , anesthesia , anatomy , surgery , biology , receptor , microbiology and biotechnology
OBJECTIVE To determine whether the intracavernosal application of growth differentiation factor‐5 (GDF‐5) influences nerve regeneration and erectile function after cavernosal nerve injury in a rat model. MATERIALS AND METHODS Thirty‐two male Sprague‐Dawley rats were randomly divided into four equal groups: eight had a sham operation (uninjured controls), while 24 had bilateral cavernosal nerve crush. The crush‐injury groups were treated at the time of injury with an impregnated collagen sponge implanted into the right corpus cavernosum. The sponge contained no GDF‐5 (injured controls), 2 µg (low concentration), or 20 µg GDF‐5 (high concentration). Erectile function was assessed by cavernosal nerve electrostimulation at 8 weeks. Midshaft penile tissue samples were histochemically evaluated for neuronal nitric oxide synthase (nNOS)‐containing fibres in the dorsal penile nerve. RESULTS There was no erectile dysfunction in the uninjured control group, as shown by a mean ( sem ) maximal increase in intracavernosal pressure (ICP) of 149.5 (17.0) cmH 2 O on stimulation. By comparison, the ICP decreased in the injured control group, by 21.3 (6.7) cmH 2 O. After cavernosal nerve injury, the recovery of erectile function was greatest in the low‐concentration GDF‐5 group; the maximum ICP increase was 40.8 (13.3) cmH 2 O, vs 24.3 (5.9) cmH 2 O for 20 µg GDF‐5. Histologically, the low‐concentration group had significantly more nNOS‐containing nerve fibres, at 163 (24.7), than the high‐concentration group, at 76 (17.3), or injured controls, at 67 (23.8). By contrast, the uninjured controls had a mean of 538 (40.6) nerve fibres in the dorsal nerve. CONCLUSION Bilateral cavernosal nerve crush resulted in erectile dysfunction with accompanying neurological changes in the rat. The intracavernosal application of GDF‐5 enhanced the recovery of erectile function and n‐NOS nerve preservation, with a 2‐µg dose giving the most promising results.