The investigation of putative agents, using an in vitro model, to prevent cavernosal smooth muscle dysfunction during low-flow priapism.

Abstract

To investigate the effect of putative agents for preventing irreversible smooth muscle dysfunction, using an in vitro model of low-flow priapism (a condition conventionally managed using a combination of corporal blood aspiration and instillation of alpha-adrenergic agonists), as failure of detumescence results in a high incidence of erectile dysfunction. We investigated the effects of several agents (N-acetylcysteine, BayK 8644, glutathione, digoxin, calcium and N(omega)-nitro-l-arginine methyl ester) on the recovery of smooth muscle tone after exposure to 4 h of a combination of hypoxia, glucopenia and acidosis in corpus cavernosum isolated from rabbit. After 4 h of ischaemia, none of the agents were able to prevent irreversible smooth muscle dysfunction. Prolonged low-flow priapism leads to smooth muscle dysfunction and fibrosis within the corpus cavernosum. When alpha-adrenergic agents fail to reverse the condition, surgical intervention is required. We showed that the administration of novel agents, including antioxidants, does not prevent smooth muscle dysfunction.