title: The effects of chronic 5-alpha-reductase inhibitor (dutasteride) treatment on rat erectile function.
abstract: BACKGROUND
  Numerous clinical series have reported an association between 5-alpha-reductase inhibitors (5ARIs) and sexual dysfunction, but there are limited preclinical data available.
  
  
  OBJECTIVE
  To further investigate the mechanisms of erectile dysfunction (ED) related to 5ARI therapy using a rat model.
  
  
  METHODS
  Outcome measures include serum dihydrotestosterone (DHT), relaxant and contractile properties of cavernosal muscle, and nitric oxide synthase expression.
  
  
  METHODS
  Twenty adult male Sprague-Dawley rats were randomized into control (N = 10) and dutasteride (0.5 mg/rat/day, in drinking water, N = 10) groups. Serum samples were obtained at baseline, from which DHT was measured after 30 days of treatment via radioimmunoassay (Beckman Coulter, Fullerton, CA, USA). Before the terminal blood draw, erectile response was measured using cavernosal nerve stimulation. The relaxant and contractile properties of cavernosal muscle strips were evaluated in tissue baths, and immunohistochemical (IHC) staining for nitric oxide synthase (NOS) and collagen deposition was performed.
  
  
  RESULTS
  Mean serum DHT was suppressed by 86.5% (range 64.2-94.8%) after 30 days of 5ARI treatment and was statistically significant (P = 0.0024). In vivo erectile response in the dutasteride treated group decreased significantly compared with control (P < 0.001). While electrical field stimulation (EFS)-induced and acetylcholine-induced relaxation was decreased, EFS-induced and phenlyephrine-induced adrenergic contraction was significantly enhanced in the dutasteride group (P < 0.01). IHC studies demonstrated increased collagen deposition in the treatment arm as well as altered expression of neuronal NOS (nNOS) and inducible NOS (iNOS).
  
  
  CONCLUSIONS
  The 5ARIs, as demonstrated in these rat cavernosal smooth muscle studies, have a detrimental effect on erectile function. Enhanced iNOS expression may protect penile smooth muscle from fibrosis. The effect of 5ARIs on human sexual function warrants further investigation.
authors.affiliation: Department of Urology, Tulane Health Sciences Center, New Orleans, LA 70112, USA.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Pinsky
authors.forename: Serap
authors.initials: S
authors.lastname: Gur
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Tracey
authors.forename: Andrew
authors.initials: A
authors.lastname: Harbin
authors.forename: Wayne J G
authors.initials: WJ
authors.lastname: Hellstrom
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D000818:Animals; D001378:Azasteroids / Q000008:administration & dosage / Q000097:blood / Q000494:pharmacology*; D000068538:Dutasteride; D007537:Isometric Contraction / Q000187:drug effects; D008297:Male; D009131:Muscle, Smooth, Vascular / Q000187:drug effects / Q000502:physiology; D052248:Nitric Oxide Synthase Type I / Q000187:drug effects; D052247:Nitric Oxide Synthase Type II / Q000187:drug effects; D010410:Penile Erection / Q000187:drug effects*; D010413:Penis / Q000187:drug effects; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D058891:5-alpha Reductase Inhibitors; D001378:Azasteroids; D052248:Nitric Oxide Synthase Type I; D052247:Nitric Oxide Synthase Type II; D000068538:Dutasteride