Changes in the Penile Arteries of the Rat after Fractionated Irradiation of the Prostate: A Pilot Study |
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| Authors: | Gerard J. Van Der Wielen Marcel Vermeij Bas W.D. De Jong Maarten Schuit Johannes Marijnissen Dik J. Kok Wytske M. Van Weerden Luca Incrocci |
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| Affiliation: | 2. Department of Pathology, Daniel den Hoed Cancer Center, Rotterdam, the Netherlands;;3. Department of Urology, Daniel den Hoed Cancer Center, Rotterdam, the Netherlands;;4. Department of Radiation Oncology, Daniel den Hoed Cancer Center, Division Medical Physics, Rotterdam, the Netherlands;1. Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA;2. Department of Radiation Physics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;3. Division of Clinical Cancer Epidemiology, Department of Oncology, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden;4. Physics and Biomedical Engineering, Sahlgrenska University Hospital, Gothenburg, Sweden;5. Division of Clinical Cancer Epidemiology, Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden |
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| Abstract: | IntroductionExternal beam radiotherapy for prostate cancer leads to erectile dysfunction in 36%–43% of patients. The underlying mechanism is largely unknown, although some clinical studies suggest that the arterial supply to the corpora cavernosa is responsible. Two animal experimental studies reported on the effects of a single fraction of prostate irradiation on the penile structures. However, irradiation in multiple fractions is more representative of the actual clinical treatment.AimThe present prospective, controlled study was initiated to investigate the effect of fractionated prostate irradiation on the arteries of the corpora cavernosa.Main Outcome MeasuresHistological evaluation of the penile tissue in comparison with control rats at 2, 4, and 9 weeks after irradiation.MethodsThe prostate of twelve rats was treated with external beam radiation in 5 daily fractions of 7.4 gray. Three control rats were treated with sham irradiation. Prostatic and penile tissue was evaluated for general histology (hematoxylin–eosin). The penile tissue was further evaluated after combined staining for collagen (resorcin fuchsin) and α-smooth muscle actin (SMA) (Biogenex).ResultsThe prostate showed adequate irradiation with fibrosis occurring at 9 weeks after irradiation. The corpora cavernosa showed arteries that had developed loss of smooth muscle cells expressing SMA, thickening of the intima, and occlusions. All the control rats maintained normal anatomy.ConclusionThis is the first animal experimental study that demonstrates changes in the arteries of the corpora cavernosa after fractionated irradiation to the prostatic area. The preliminary data suggests that erectile dysfunction after radiotherapy might be caused by radiation damage to the arterial supply of the corpora cavernosa. van der Wielen GJ, Vermeij M, de Jong BWD, Schuit M, Marijnissen J, Kok DJ, van Weerden WM, and Incrocci L. Changes in the penile arteries of the rat after fractionated irradiation of the prostate: A pilot study. J Sex Med 2009;6:1908–1913. |
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