糖尿病大鼠阴茎海绵体神经递质和功能的改变

正常的阴茎勃起过程依赖于勃起器官的解剖结构完整,并由副交感神经和交感神经纤维介导,依赖于各种神经递质、神经调控物质和局部(内皮)合成的血管活性物质对海绵体平滑肌张力的调控相对平衡[1].     

糖尿病大鼠逼尿肌线粒体琥珀酸脱氢酶及其超微结构的改变

目的探讨能量代谢与糖尿病膀胱逼尿肌线粒体损伤的关系。方法建立2型糖尿病（T2DM）大鼠模型，在高糖高脂饮食喂养第4、12、24周取大鼠膀胱逼尿肌制备匀浆测定琥珀酸脱氢酶活性。并电镜观测逼尿肌线粒体的形态改变。结果T2DM组大鼠的琥珀酸脱氢酶活性在其发病早期就出现降低；随着T2DM大鼠病程的延长，逼尿肌线粒体超微结构的损伤明显加重。结论在糖尿病膀胱的发病过程中线粒体破坏所导致的逼尿肌能量代谢障碍可能是引起逼尿肌收缩功能障碍的始动因素。     

糖尿病和健康大鼠阴茎细胞凋亡的研究

目的 比较糖尿病和健康大鼠阴茎细胞调亡。方法 16只wister大鼠作为实验组,10只健康同期wister大鼠作对照组。注射链脲佐菌素(STZ,65mg/kg),建立糖尿病模型。8周后处死大鼠,测糖化血红蛋白(HBALC)并取阴茎。用流式细胞仪分析阴茎细胞凋亡。结果 流式细胞分析糖尿病组wister大鼠出现凋亡峰,同对照相比,二者有显著性差异(p<0.05)。结论 糖尿病大鼠阴茎细胞凋亡率显著高于正常健康大鼠阴茎细胞。     

糖尿病大鼠阴茎细胞凋亡及血流动力学变化的研究

目的 :比较糖尿病和健康大鼠阴茎细胞凋亡及血流动力学的变化。　方法 :16只糖尿病 (糖尿病组 )和 10只健康Wistar大鼠 (对照组 ) ,注射链脲佐菌素 (STZ ,6 5mg/kg) ,建立糖尿病模型。 8周后处死大鼠 ,测糖化血红蛋白(HbA1c)并取阴茎组织。用原位缺口末端标记 (TUNEL)法和流式细胞术分析阴茎细胞凋亡 ,并测量阴茎动脉血管管径和管壁厚度。　结果 :糖尿病组出现阴茎海绵体细胞凋亡 ,与对照组比较差异有显著性 (P <0 .0 1)。流式细胞术分析糖尿病组大鼠出现凋亡峰 ,与对照组相比差异有显著性 (P <0 .0 5 )。糖尿病组阴茎动脉血管管径变小 ,管壁增厚 ,与照组相比较差异有显著性 (P <0 .0 5 )。　结论 :糖尿病可引起大鼠阴茎细胞凋亡增加 ,导致阴茎动脉的管径变小和动脉的管壁增厚。     

两种隐匿阴茎大鼠模型的建立及比较

目的:建立稳定的大鼠隐匿阴茎模型,为探索阴茎包埋对海绵体结构和功能的影响提供实验动物模型。方法:90只2周龄雄性SD大鼠随机均分为A、B、C3组,A组采用阴茎根部内荷包缝合法,B组采用包皮折叠缝合法包埋阴茎,C组为假手术组。在180d内观察两种方法的包埋效果。结果:A组术后4只死于急性尿潴留,5只因尿道口周围软组织感染、皮肤破溃导致包埋失败,3只因包埋过松阴茎伸出;B组术后1只死于麻醉,2只死于急性尿潴留;因阴茎发育和勃起,A组有7只、B组有10只阴茎伸出;C组1只死于麻醉。A组和B组中其余大鼠均有较好的包埋效果,A组包埋成功率为36.7%,B组为56.7%,而且可以在实验中任何时候解除包埋。结论:包皮折叠缝合法和阴茎根部内荷包缝合法均能建立稳定的、且与人类隐匿阴茎自然病程较为一致的2周龄大鼠隐匿阴茎动物模型。     

大鼠隐匿阴茎动物模型的建立

目的建立大鼠隐匿阴茎动物模型，为进一步研究阴茎包埋对阴茎海绵体结构与功能的影响提供实验模型。方法取2周龄雄性SD大鼠75只，随机分为A、B、C、D、E5组各15只，A、B、C和D组分别用阴茎根部外荷包缝合法、包皮折叠缝合法、包皮切除法和阴茎根部内荷包缝合法包埋阴茎，E组为假手术组。结果术后第1天，A组有1只死于尿潴留，B和D组各有1只死于麻醉。A组手术操作最简单，B、C和D组手术操作相对复杂；A、C和D组包埋效果较B组好；A、B和D组可解除包埋，C组解除包埋困难；由于A、B和C组缝合线外露，易被大鼠撕咬致阴茎外露，而难以建立成功的包埋模型；D组可于术后第2月、第4月和第6月解除阴茎包埋。结论阴茎根部内荷包缝合法可较好地建立2周龄大鼠隐匿阴茎动物模型。     

杜仲对糖尿病大鼠阴茎组织SOD活性和α-actin表达的影响

目的:研究杜仲水提物对培养糖尿病(DM)模型大鼠阴茎组织超氧化物歧化酶(SOD)和α平滑肌肌动蛋白(αactin)的作用。方法:采用四氧嘧啶两次给药法建立DM模型;随机选取10只DM大鼠和10只正常大鼠,每只大鼠的阴茎组织块均分为4等份,分配到杜仲共培养组(A组:1μg/ml组、10μg/ml组、100μg/ml组)和空白对照组(B组)进行培养。7d后,用比色法测定培养液中SOD活性,用免疫组化技术检测αactin的表达。结果:10、100μg/ml组的正常大鼠和DM大鼠阴茎组织培养液中SOD活性与B组比较显著升高(P<0.01),培养阴茎组织中αactin免疫反应阳性细胞数与B组比较显著增多(P<0.01)。结论:杜仲可增强DM大鼠阴茎组织中SOD活性和αactin表达。     

人工血管补片置入阴茎海绵体白膜阴茎增粗术

虽然切断阴茎悬韧带延长阴茎的手术方法已被国内外一些学者作为整复阴茎短小的基本术式之一[1 ,2 ] ,但此方法仅延长阴茎 ,却无法增粗阴茎体。自 2 0 0 1年 3月以来 ,我们借鉴并改进Austoni等[3] 的方法 ,应用ePTFE人工血管补片置入扩大双侧阴茎海绵体白膜及容积的方法 ,为 7例患者行阴茎海绵体增粗同期阴茎延长手术 ,随访 6～ 2 4个月 ,形态及功能效果良好。1　手术方法先按参考文献[1 ] 行切断阴茎悬韧带的阴茎延长术。根据阴茎海绵体的长度预先裁剪为宽 1 5cm、厚 1mm的ePTFE人工血管补片 (美国GORE公司 ) 2片。在阴茎体两侧 ,分别…     

糖尿病大鼠阴茎海绵体细胞凋亡与Bcl-2和Bax基因表达

目的 :观察糖尿病 (DM)大鼠阴茎海绵体细胞凋亡、Bcl 2和Bax的基因表达及两者的相关性。　方法 :成年雄性Wistar大鼠 5 0只 ,随机分为正常对照组 (NDM组 ) 10只和造模组 4 0只。造模组以 5 0mg/kg尾静脉注射 2 %四氧嘧啶 (AXN) ,未发生DM者 ,为AXN组 ;成为DM模型者为DM组。大鼠饲养 8周后处死并取阴茎海绵体 ,用原位末端标记法 (TUNEL)检测细胞凋亡 ,用免疫组化方法检测Bcl 2、Bax的基因表达。　结果 :DM组大鼠较NDM组大鼠阴茎海绵体凋亡细胞数明显增多 (P <0 .0 1) ,Bax表达亦增强 (P <0 .0 1) ,Bcl 2表达减弱 (P <0 .0 1) ,Bcl 2 /Bax比值降低。　结论 :DM大鼠阴茎海绵体细胞凋亡率增加 ,细胞凋亡可能是糖尿病性勃起功能障碍的发病机制之一 ,Bcl 2和Bax可能参与了DM大鼠阴茎海绵体细胞凋亡的基因调控。     

Ultrastructural changes of penile tunica albuginea in diabetic rats

Aim: To clarify the ultrastructural changes of penile tunica albuginea (TA) in streptozotocin (STZ)-induced diabetic rats. Methods: Intraperitoneal injection of STZ was used to induce diabetes mellitus (DM) in 12 Sprague Dawley rats. Ten rats (age and weight-matched) were used as control. Blood samples from the tail snips of the rats were used for the determination of serum glucose levels with SureStep Plus Blood Meter. At week 4 and 10 after the injection, half of the rats in each group were sacrificed and penile samples were obtained from the middle third of the penile shaft for the examination of TA under scanning electron microscopy. Results: In the diabetic group, the serum glucose levels were higher (P<0.01 at both time points) and the TA were thinner (P<0.05) than those of the controls. In the control group, the fibers of TA were rich and arranged regularly and undulated, while in the diabetic group, the fibers were diminished, lost the undulations and were arranged irregularly. Conclusion: In rat     

A case of testicular tunica albuginea cyst with psammoma body

Cystic testicular masses have been considered rare but due to advances in ultrasonographic technologies their incidence has risen. Many testicular cystic masses are benign but there is a chance of malignancy. Psammoma bodies are found in various malignancies that occur in the genital tract of women but rarely in men. We report a case of testicular tunica albuginea cyst with psammoma bodies.     

Adenomatoid tumor of the tunica albuginea

Adenomatoid tumors are benign mesothelial tumors most commonly found in the paratesticular structures, especially the epididymis. Herein, we report a case of adenomatoid tumor originating in the tunica albuginea and mimicking an intratesticular neoplasm. We review the ultrasonographic presentation and literature regarding adenomatoid tumors originating in the tunica albuginea and testicular parenchyma.     

Technique of anterior urethra urethroplasty using tunica albuginea of corpora cavernosa

OBJECTIVE: Over previous years, urethral stricture has constantly created a great problem in efforts to find a permanent cure for it. We describe a technique of anterior urethroplasty using tunica albuginea of corpora cavernosa. METHODS: After a midline penoscrotal incision, the bulbar or penile urethra along with corpus spongiosum was dissected from the corpora cavernosa. Urethra was then rotated dorsally and the stricture was opened along its whole length. The walls of the slit urethra, along with the tunica albuginea of the corpus spongiosum, were sutured to the tunica albuginea of the corpora cavernosa at the 5 and 7 o'clock position after passing an all silicon catheter. We performed this technique on 79 male patients, having anterior urethral stricture, ranging 18-60 years of age (mean, 46 years). The etiology of stricture was trauma in 54, instrumentation in 12, infection in 10 and unknown in three. Follow ups were done at 4, 12 and 24 months by assessing patients' satisfaction rate along with a pre- and postoperative urethrogram, labeled as "good", "fair" and "poor". RESULTS: Good and fair results were considered as successful. The overall success rate was 94.9%. The success rate remained same at 4 months (64 + 11) and decreased to 93.7% (63 + 11) at 12 months and 89.9% (61 + 10) at 24 months. CONCLUSION: These observations show that anterior urethroplasty using tunica albuginea of corpora cavernosa have produced satisfactory results and are comparable with any other technique of urethroplasty. Thus, we strongly recommend the use of tunica albuginea of corpora cavernosa for anterior urethroplasty, which is histologically similar and anatomically located near the stricture.     

Ultrastructural changes of penile tunica albuginea in diabetic rats

Aim: To clarify the ultrastructural changes of penile tunica albuginea (TA) in streptozotocin (STZ)-induced diabetic rats. Methods: Intraperitoneal injection of STZ was used to induce diabetes mellitus (DM) in 12 Sprague Dawley rats. Ten rats (age and weight-matched) were used as control. Blood samples from the tail snips of the rats were used for the determination of serum glucose levels with SureStep Plus Blood Meter. At week 4 and 10 after the injection, half of the rats in each group were sacrificed and penile samples were obtained from the middle third of the penile shaft for the examination of TA under scanning electron microscopy. Results: In the diabetic group, the serum glucose levels were higher (P＜0.01 at both time points) and the TA were thinner (P＜0.05) than those of the controls.In the control group, the fibers of TA were rich and arranged regularly and undulated, while in the diabetic group, the fibers were diminished, lost the undulations and were arranged irregularly. Conclusion: In rats, DM appeared to impair the penile TA ultrastructures and this impairment could contribute to diabetic erectile dysfunction in part by impairing the veno-occlusive function. (Asian J Andro12004 Dec;6:365-368)     

Penile prosthesis implantation and tunica albuginea incision without grafting in the treatment of Peyronie's disease with erectile dysfunction

We evaluated penile prosthesis implantation with tunica albuginea-relaxing incisions without grafting in the treatment of Peyronie''s disease associated with erectile dysfunction. Between April 2005 and June 2011, 62 patients underwent surgery due to severe Peyronie''s disease associated with erectile dysfunction. Malleable and inflatable penile prostheses were inserted in 49 and 13 cases, respectively. Penile prostheses were inserted into the corpora cavernosa using the standard ventral approach. After lifting the neurovascular bundle, the tunica albuginea was incised and opened at the plaque region to correct the deformities and to lengthen the penis. Subsequently, the wide neurovascular bundle was replaced, and all incisions of the tunica albuginea were covered to prevent corporal grafting. In the median follow-up of 35 months (range 14–82 months), the penis was completely straightened in 59 (95%) patients. Numbness of the glans, which the patients found initially upsetting, decreased or disappeared spontaneously 3–6 months later. Penile prosthesis implantation with tunica albuginea incisions is a viable alternative in the treatment of Peyronie''s disease because the extensive dissection of the neurovascular bundle allows a good approach to the plaque and provides excellent covering of the incised tunica albuginea without additional grafting.     

Effects of extra—corporeal shock waves on penile hemodynamics and histopathology in rats

Aim: To study the effect of extra-corporeal shock wave (ESW) on the penile hemodynamics and histopathology in rats. Methods: Adult male Sprague-Dawley rats were divided at random into 3 groups. ESW application was performed with a Siemens Lithostar with the rats under anesthesia lying prone on the balloon probe. Rats in Group Ⅰ received a total of 1000 shocks at 18 kV and immediately underwent hemodynamic evaluation performed by direct electrostimulation of the cavernous nerve and measurement of intracavernous pressure (ICP). Rats in Group Ⅱ received 3 times 1000 shocks at 18 kV at weekly intervals and hemodynamic evaluation was performed 1 month after the last ESW application. Group Ⅲ served as the control. Histopathological examinations of penile tissues were done on Masson's trichrome and hematoxylin and eosin stained sections. Results: Penile hemodynamic evaluation showed a trend toward a diminished mean maximal ICP, duration of erection, ICP during the plateau phase and maximal ICP/blood pressur     

Testosterone immunoexpression in human Leydig cells of the tunica albuginea testis and spermatic cord. A quantitative study in normal foetuses, young adults, elderly men and patients with cryptorchidism

Summary. A semi-quantitative study of the extraparenchymal Leydig cells in the tunica albuginea testis and spermatic cord was performed on histological sections immunostained with anti-testosterone antibodies in the testes and spermatic cords obtained from human foetuses, adults and elderly men without testicular or related diseases (autopsy specimens), as well as from adult men with cryptorchidism (surgical specimens). The albugineal Leydig cells appeared in small groups in the vicinity of blood vessels. The Leydig cells of the spermatic cord usually appeared inside or around nerve trunks. The percentages of testes and spermatic cords with extraparenchymal Ley-dig cells were higher in the cryptorchid testis group than in the normal male groups. The number of Leydig cells per mm² in the tunica albuginea testis was higher in normal adult males than in foetuses. This number decreased in elderly men and increased markedly in cryptorchidism. The number of Leydig cells per mm² in the spermatic cord was also higher in normal adults than in foetuses and it did not change with either advancing age or cryptorchidism. In foetuses, the percentage of cells intensely immunostained by antitestosterone antibodies in the tunica albuginea and spermatic cord did not differ significantly from that found in the testicular parenchyma, whereas in the other three groups (adult, elderly, and cryptorchid men) the percentages of these cells in the tunica albuginea and spermatic cord were significantly lower than in the testicular parenchyma.     

Ultrastructure of the tunica albuginea in congenital penile curvature

PURPOSE: We investigated the ultrastructure of the tunica albuginea in individuals with congenital penile curvature to explain the pathology of this disease. MATERIALS AND METHODS: Included in our study were 15 patients 17 to 24 years old with congenital penile curvature. Study material consisted of samples of the tunica albuginea excised from the greater curvature of the corpus cavernosum during surgical correction. Control samples were obtained from the lesser curvature on the side opposite the study material during the same operation. The 2 types of tissue were analyzed using transmitter electron microscopy. RESULTS: Ultrastructural examination of the control material revealed numerous collagen fibers that were homogenous in size and organization on cross section. Periodic striation was typical in collagen that produced fibers. In the study group the tunica albuginea structure had a chaotic pattern of collagen fibers that formed bundles with disrupted 3-dimensional organization. Diameter of the fibers differed greatly on cross section. We observed periodic widening and fragmentation of collagen fibers with the complete disappearance of striation and transformation into electron dense, fibrous granulated material. Disrupted fibroblasts without cell membrane and cellular organelles between collagen fibers were also visible. There was elastin accumulation without any morphological differences in the control and study groups. CONCLUSIONS: Our results show that ultrastructural changes in the tunica albuginea may cause congenital penile curvature, possibly by altering mechanical properties.     

胰岛素对糖尿病大鼠阴茎内nNOS神经纤维的影响

目的探讨糖尿病性阴茎勃起功能障碍（ED）的发病机制及胰岛素的治疗作用。方法注射链脲佐菌素建立糖尿病（DM）大鼠模型，胰岛素治疗组于成模后注射胰岛素。7周和12周后注射阿扑吗啡（APO）进行大鼠阴茎勃起功能实验，取大鼠阴茎和血浆，用ABC免疫组织化学法观察nNOS神经纤维的变化。测定血浆NOS活性。结果（1）与对照组相比，DM组大鼠阴茎勃起次数明显减少;胰岛素治疗后症状缓解;（2）与对照组相比，DM组血浆NOS活性明显增高;DM组血浆NOS活性与病程延长呈负相关;与DM组比较，胰岛素治疗组血浆NOS活性明显降低;（3）与对照组相比，DM组阴茎内nNOS阳性神经纤维明显减少;与DM组比较，胰岛素治疗组nNOS阳性神经纤维表达增加。结论糖尿病性ED阴茎内nNOS阳性纤维的数量及光密度随DM病程的延长而下降;早期给予胰岛素治疗可预防糖尿病大鼠ED的出现及阴茎内nNOS含量的下降。