Arteriosclerosis of Penile Arteries: Histological Findings and Their Significance in the Treatment of Erectile Dysfunction

Abstract

Objectives: In this pathomorphological study, location, distribution, and degree of arteriosclerotic stenoses in penile arteries from unselected cadavers are investigated. The findings are discussed in the context of penile revascularization and may explain the poor results of this form of surgery in older patients with general arteriosclerosis. Materials and Methods: 120 penile specimens from 120 cadavers were examined histologically after van Gieson staining. Transverse sections were performed at the level of the pubic bone, in the middle of the penis, and at the sulcus coronarius. At these levels the dorsal and deep penile arteries were examined. Results: We found arteriosclerotic stenoses of the penile arteries in 65% of the specimens. Of these stenotic lesions, 20.4% were situated proximally, 37.1% centrally, and 42.5% distally. Conclusions: In patients with arteriosclerotic stenoses of the penile arteries, microsurgical penile revascularization to the proximal part of the dorsal arteries at the base of the penis seems to be without any relevant long-lasting hemodynamic effect, because the blood flow will be impeded by the peripheral stenoses. This can explain the poor results of revascularization in this group of patients.

Aging-related induction of inducible nitric oxide synthase is vasculo-protective to the arterial media

“…In addition to this aging-related fibrosis of the arterial media [3][4][5][6], it is well documented that similar fibrotic changes occur within the penile corporal sinusoids [37]. The corporal tissue comprises primarily of a syncytium of vascular SMC with an endothelium lining, which is biologically and physiologically indistinguishable from the one present in the media and intima of the vascular tree and may be considered a highly evolved extension of these arterial tissues.…”

Is penile biopsy a useful tool in the diagnosis and management of erectile dysfunction?

“…Mersdorf et al [18] found varying degrees of pathologic changes in the right and left corpora cavernosa in approximately 17% of their patients. Another study showed that atherosclerotic lesions were localized more often in the distal part of the penile arteries than in the proximal part [24].…”

Dietary antioxidants improve arteriogenic erectile dysfunction

“…, 1992). Arteriogenic ED results from haemodynamic impairment and chronic exposure of erectile tissue to ischaemia and hypoxia, nutrient deficiency and a lack of metabolic waste clearance (Grein & Schubert, 2002; Siroky & Azadzoi, 2003; Azadzoi et al. , 2005).…”