PURPOSE: There has been a scarcity of integrated, long-term (>4 week) studies on structural and functional alterations in the penis according to the period following cavernous nerve (CN) injury. The aim of this study was to investigate time-dependent structural and functional changes in the corpus cavernosum following CN injury in a rat model. MATERIALS AND METHODS: Ninety male Sprague-Dawley rats (10 weeks old) were divided into 4 groups: normal control (C), sham (S), bilateral CN resection (R), and bilateral CN crush injury (I) groups. At 1, 4, and 12 weeks after the procedure, erectile function was assessed by electrostimulation. The terminal deoxynucleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate nick end labeling (TUNEL) assay was performed for detection of apoptosis. Masson's trichrome staining and immunohistochemistry were performed for detection of alpha smooth muscle actin (alpha-SMA). Western blot analysis was then performed. RESULTS: The R and I groups showed persistent impairment of erectile function at all three points in time. Apoptosis peaked at 1 week after resection or crush injury and then gradually subsided. The smooth muscle cell/collagen ratio and expression of alpha-SMA gradually decreased over time after CN resection or crush injury. Myosin phosphatase target subunit 1 phosphorylation progressively increased over time after CN resection or crush injury. On the other hand, expression of phospho-protein kinase B, phospho-endothelial nitric oxide synthase, and neuronal nitric oxide synthase transiently decreased at 1 week after resection or crush injury and then recovered to the control values. CONCLUSIONS: Our results suggest that persistent up-regulation of the RhoA/Rho-kinase pathway and structural change such as decreased smooth muscle cell and increased cavernosal fibrosis might play an important role in persistent erectile dysfunction following CN injury.
Actins ; Animals ; Apoptosis ; Blotting, Western ; Caves ; Deoxyuracil Nucleotides ; Erectile Dysfunction ; Fibrosis ; Hand ; Humans ; Immunohistochemistry ; Male ; Muscle, Smooth ; Myocytes, Smooth Muscle ; Myosin-Light-Chain Phosphatase ; Nitric Oxide Synthase ; Nitric Oxide Synthase Type I ; Penis ; Phosphorylation ; Phosphotransferases ; Prostatectomy ; Rats ; Rats, Sprague-Dawley ; Salicylamides ; Up-Regulation

PURPOSE: To examine the effectiveness of small-molecule inhibitor of transforming growth factor-beta (TGF-beta) type I receptor, an activin receptor-like kinase 5 (ALK5), on erectile dysfunction (ED) in a rat model of cavernous fibrosis, in which fibrosis was induced by intracavernous injection of adenovirus expressing TGF-beta1 (Ad-TGF-beta1). MATERIALS AND METHODS: Four-month-old Sprague-Dawley rats were divided into four groups (n=10 per group): age-matched controls without treatment, age-matched controls receiving intracavernous injection of LacZ adenovirus, and cavernous fibrosis rats receiving an intracavernous injection of saline or ALK5 inhibitor (5 mg/kg). ALK5 inhibitor or saline was administered on day 5 after injection of Ad-TGF-beta1. On day 30, erectile function was assessed by electrical stimulation of the cavernous nerve and the penis was then harvested for histologic studies (n=6 per group) and for the measurement of the hydroxyproline level (n=4 per group). RESULTS: Ad-TGF-beta1-induced cavernous fibrosis rats treated with saline showed a significant decrease in cavernous smooth muscle and endothelial content, and an increase in collagen deposition, which resulted in profound deterioration of all erectile function parameters, such as the ratios of maximal intracavernous pressure (ICP), total ICP, and slope to mean arterial pressure. ALK5 inhibitor significantly restored erectile function in a rat model of cavernous fibrosis by increasing cavernous smooth muscle and endothelial content, and by blocking cavernous fibrosis. CONCLUSIONS: The results suggest that inhibition of the TGF-beta pathway is a promising therapeutic strategy for the treatment of ED related to cavernous fibrosis from various causes.
Activin Receptors ; Adenoviridae ; Animals ; Arterial Pressure ; Caves ; Collagen ; Electric Stimulation ; Erectile Dysfunction ; Fibrosis ; Hydroxyproline ; Male ; Muscle, Smooth ; Penis ; Protein-Serine-Threonine Kinases ; Rats ; Rats, Sprague-Dawley ; Receptors, Transforming Growth Factor beta ; Transforming Growth Factor beta ; Transforming Growth Factor beta1

Female sexual function is highly complex and deeply influenced by hormonal and non-hormonal factors. As sexual dysfunction becomes a common and important problem for women of all ages with related quality of life issues, we need to understand more about the effect of sex steroid hormones in female sexual function. However, there are limited data about the correlation between the value of sex steroid hormones- testosterone, in particular-and female sexual function. In a certain type of female sexual dysfunction (FSD), hypoactive sexual desire disorder, for example, there is evidence that treatment with androgens or with estrogens is effective. To widen the therapeutic options of hormone replacement therapy in FSD, further research is needed as to the benefits and risks of hormonal treatments in both pre- and post-menopausal women. Although important unanswered questions still exist in hormonal treatment of FSD, new therapeutic strategies are being studied and many ongoing clinical trials are expecting favorable results leading to more successful treatment of FSD.
Androgens ; Estrogens ; Female ; Gonadal Steroid Hormones ; Hormone Replacement Therapy ; Humans ; Quality of Life ; Risk Assessment ; Sexual Dysfunctions, Psychological ; Testosterone

Androgen acts via the androgen receptor and can play a critical role in the development and growth of the prostate and the pathophysiology of prostatic diseases. Testosterone is the most abundant circulating androgen and is converted to dihydrotestosterone (DHT), a more potent androgen, by steroid 5alpha-reductase. There are two 5alpha-reductase isoenzymes, type 1 and type 2, in humans and animals. Type 2 5alpha-reductase predominates in the prostate. While deficiency of type 2 5alpha-reductase causes male pseudohermaphroditism, increased DHT has been implicated in benign prostatic hyperplasia and prostate cancer. The aim of this article is to highlight the significance of 5alpha-reductase in the development and growth of the prostate and pathogenesis of prostatic diseases.
46, XY Disorders of Sex Development ; Animals ; Dihydrotestosterone ; Growth and Development ; Humans ; Isoenzymes ; Prostate ; Prostatic Diseases ; Prostatic Hyperplasia ; Prostatic Neoplasms ; Receptors, Androgen ; Sexual Development ; Testosterone

The seminiferous tubules merge and connect with the tubuli recti that form the spaces known as the rete testis. Cystic ectasia of the rete testis is a rare benign testicular lesion. We report the cystic ectasia of the rete testis in a 66-year-old man.
Aged ; Dilatation, Pathologic ; Humans ; Rete Testis ; Seminiferous Tubules ; Testis

We recently encountered a very rare case of torsion of an intrascrotal testicular tumor in a 26-year-old male. Unlike the intra-abdominal undescended testis, intrascrotal spermatic cord torsion associated with a testicular tumor has rarely been reported. We write to report a case of intrascrotal spermatic cord torsion accompanied by a testicular tumor that had been overlooked preoperatively.
Adult ; Cryptorchidism ; Humans ; Male ; Seminoma ; Spermatic Cord ; Spermatic Cord Torsion

PURPOSE: To maintain physiologic intravesical pressure is important in preventing secondary renal functional impairment in patients with voiding problems like neurogenic bladder or severe bladder outlet obstruction. Therefore, if real-time monitoring of the intravesical pressure were possible, physicians could not only monitor voiding status more precisely but also manage patients with voiding problems appropriately to protect renal function. In this study, we evaluate the validity of the prototype intravesical pressure sensor in a rabbit model. MATERIALS AND METHODS: The manufactured prototype intravesical pressure sensor was placed into the intravesical space of each of 3 rabbits. Conventional cystometry was performed and the intravesical pressure was measured by the prototype intravesical pressure sensor at the same time in all of the animals. The measured intravesical pressure by the prototype intravesical pressure sensor was compared with the measured value by conventional cystometry. The reliability between the two methods was determined using cross-table analysis. RESULTS: In each of the 3 animals, the index of coincidence was observed as 0.70, 0.79, and 0.77, respectively. This result meant that the intravesical pressure monitoring by the prototype intravesical pressure sensor showed good reproducibility with respect to the continuous intravesical pressure monitoring by conventional cystometry. CONCLUSIONS: In this study, we demonstrated the reliability of the prototype intravesical pressure sensor to monitor intravesical pressure change compared with the conventional cystometric result. Further investigations to overcome the limitations of the prototype intravesical pressure sensor will be necessary for real clinical application.
Animals ; Humans ; Organothiophosphorus Compounds ; Rabbits ; Urinary Bladder Neck Obstruction ; Urinary Bladder, Neurogenic ; Urination Disorders ; Urodynamics

PURPOSE: A prospective multi-center study was conducted to evaluate the safety and efficacy of alfuzosin (10 mg), for male lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH) in primary care clinics. MATERIALS AND METHODS: Three hundred twenty-four patients with complaints of LUTS associated with BPH were enrolled from 17 clinics. Patients received a 12-week course of 10 mg alfuzosin (Bearxat(R)XL Tablet) once daily, and underwent follow-up at 2~4 and 12 weeks post-treatment. The maximum flow rate (Qmax) and residual urine volume (RUV) were measured at each visit. The International Prostate Symptom Score (IPSS), Quality of Life (QoL), and International Index of Erectile Function (IIEF-5) were evaluated at baseline and post-treatment. During the study period, the presence of orthostatic hypotension was evaluated by blood pressure measurement before and after a postural change. Any adverse effects of alfuzosin including retrograde ejaculation were assessed. RESULTS: Of the 324 enrolled patients, 62 (19.1%) patients dropped out and a total of 262 patients were evaluated. Each value of Qmax, RUV, IPSS, QoL, and IIEF-5 was significantly improved from 14.19+/-8.85 ml/sec, 41.10+/-81.44 ml, 18.04+/-7.36, 3.81+/-0.86, and 11.75+/-6.91, respectively, at baseline, to 15.68+/-6.25 ml/sec, 24.29+/-29.46 ml, 12.19+/-5.59, 2.54+/-0.91, and 12.33+/-7.55, respectively, at end-point. Retrograde ejaculation was found in 2 patients (2/255, 0.78%) at 2~4 weeks and 1 patient (1/152, 0.66%) at 12 weeks. The frequency of orthostatic hypotension was 13.27% (30/226) at baseline, 13.11% (27/206, p=0.8658) at 2~4 weeks, and 14.29% (19/133, p=0.8348) at end-point. The number of patients with adverse events was 36 where the number of adverse events was 60. Among those 60 adverse events, 8 events were related to treatment, which consisted of headache (2), dizziness (2), palpitation (1), voiding difficulty (1), erectile dysfunction (1), and arthralgia (1). CONCLUSIONS: Treatment with alfuzosin (10 mg) once daily led to significant improvements in LUTS associated with BPH and QoL in primary care clinic patients. alfuzosin (10 mg) use resulted in few hypotensive events, no deleterious effect on sexual function, and no drug related SAEs during the study. The study findings suggest that alfuzosin (10 mg) can be safely prescribed in primary care clinics for male LUTS with efficacy.
Arthralgia ; Blood Pressure ; Dizziness ; Ejaculation ; Erectile Dysfunction ; Follow-Up Studies ; Headache ; Humans ; Hypotension, Orthostatic ; Lower Urinary Tract Symptoms ; Male ; Primary Health Care ; Prospective Studies ; Prostate ; Prostatic Hyperplasia ; Quality of Life ; Quinazolines

PURPOSE: The conventional primary therapy for chronic bacterial prostatitis (CBP) is the use of antibiotics. However, the therapy has a low cure rate and long-term use of antibiotics can lead to adverse effects including bacterial resistance. For these reasons, a new therapy for CBP is strongly needed. MATERIALS AND METHODS: To evaluate the anti-inflammatory and antimicrobial effects of selenium-rich hot spring water on CBP, rats were divided into four groups and treatment was administered for four weeks as follows: (1) control (n=8), (2) ciprofloxacin (n=8), (3) selenium-rich hot spring water (n=8), and (4) selenium-rich hot spring water with ciprofloxacin (n=8). Drip infusion of bacterial suspension (E. coli Z17 O2:K1;H-) into Spargue-Dowley rats was then conducted to induce CBP. Four weeks later, the results of prostate tissue and urine culture and histological analysis on the prostate were analyzed in each group. RESULTS: The use of ciprofloxacin, and selenium-rich hot spring water with ciprofloxacin showed statistically significant decreases in bacterial growth and improvements in prostatic inflammation compared with the control group (p<0.05). The selenium-rich hot spring water with ciprofloxacin group showed a statistically significantly lower rate of bacterial growth and and greater improvements in prostatic inflammation than the ciprofloxacin group (p<0.05). CONCLUSIONS: These results suggest that spring water may be an effective material in the treatment of CBP. Notably, the combination treatment of selenium-rich hot spring water and ciprofloxacin has synergistic effects. Therefore, we can suggest that the combination of selenium-rich hot spring water and ciprofloxacin may be effective in the treatment of CBP, and with a higher success rate than ciprofloxacin alone.
Animals ; Anti-Bacterial Agents ; Ciprofloxacin ; Hot Springs ; Inflammation ; Infusions, Intravenous ; Prostate ; Prostatitis ; Rats ; Selenium

PURPOSE: To estimate the prevalence of and factors associated with female sexual dysfunction (FSD) in Korean women. MATERIALS AND METHODS: A total of 629 married women in the Chonnam and Gwangju area were randomly included in this study. They were asked to complete a questionnaire on FSD, which consisted of the Female Sexual Function Index (FSFI), as well as psychological, physiological, and demographic factors. RESULTS: The mean age of the women was 36.97 years and the mean FSFI score was 25.56 out of a total score of 36. Based on the total FSFI score, 42.9% of the women had scores less than the cut-off point of 25, the assessed definition of FSD. The prevalence of FSD by age group was: 31.3% for 20~29 year olds, 41.6% for 30~39 year olds, and 51.8% for 40~49 year olds. A stepwise regression analysis found that women with higher levels of sexual distress, lower frequency of sexual intercourse, lower levels of life satisfaction, a less important appraisal of sex, a higher likelihood of depression, more conservative attitude toward sex, irregular menstrual cycle, higher age, chronic disease, and a smoking habit were more likely to suffer from FSD. CONCLUSIONS: The prevalence of FSD in Korean women was common and comparable to those reported worldwide. Sexual distress, frequency of sexual intercourse, and life satisfaction were important associated factors of FSD.
Chronic Disease ; Coitus ; Depression ; Female ; Humans ; Menstrual Cycle ; Prevalence ; Surveys and Questionnaires ; Smoke ; Smoking