Possible molecular mechanisms of cryoablation-induced impotence in a rat model.
OBJECTIVE
Cryoablation of the prostate has been reported to induce impotence as a consequence of cavernosal nerve injury. This study is designed to investigate the early and late effects of cavernosal nerve cryoablation on growth factor expression and erectile function in a rat model.


METHODS
Forty male rats were divided into two groups (n=20 each). The first group underwent unilateral cavernosal nerve freezing (experimental group). Before their euthanization at 1 and 3 months (10 rats each), erectile function was assessed by electrostimulation of the cavernous nerves. The second group served as the control and was killed at the same time points. Western blot and reverse transcriptase-polymerase chain reaction (RT-PCR) techniques were used to identify protein and gene expression of nerve growth factor (NGF), transforming growth factor-alpha (TGF-alpha), epidermal growth factor (EGF), and insulin-like growth factor-1 (IGF-1) in the rat penis and pelvic ganglia.


RESULTS
Electrostimulation of the frozen nerve after 3 months revealed a significantly higher maximal intracavernosal pressure and a shorter latency period than in the 1-month group. At 3 months, immunoblot showed upregulation of NGF, TGF-alpha, and the precursor form of IGF-1 protein expression in the penile tissue; RT-PCR showed downregulation of NGF gene expression in the pelvic ganglia of the frozen side.


CONCLUSIONS
The results show that erectile function decreased at 1 month and then partially recovered 3 months after cavernosal nerve freezing. This alteration in erectile function was associated with differential gene and protein expression of the growth factors (NGF, TGF-alpha, EGF, and IGF-1). Further studies are required to elucidate the potential role of these growth factors in the prevention and treatment of cryoablation-induced impotence.
El-Sakka
A
A
Department of Urology, University of California School of Medicine, San Francisco 94143-0738, USA.
Hassan
M U
MU
Bakircioglu
M E
ME
Pillarisetty
R J
RJ
Dahiya
R
R
Lue
T F
TF
D000818:Animals; D003452:Cryosurgery / Q000009:adverse effects*; D004558:Electric Stimulation; D007172:Erectile Dysfunction / Q000209:etiology*; D005786:Gene Expression Regulation; D006133:Growth Substances / Q000096:biosynthesis / Q000235:genetics; D008297:Male; D010413:Penis / Q000294:innervation / Q000502:physiology; D011467:Prostate / Q000378:metabolism; D011468:Prostatectomy / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley
D006133:Growth Substances