Atherosclerosis-induced chronic arterial insufficiency causes clitoral cavernosal fibrosis in the rabbit

Park, K; Tarcan, Tufan; Goldstein, Irwin; Siroky, Mike B.; Krane, Robert J.; Azadzoi, Kazem M.

doi:10.1038/sj.ijir.3900514

Cited by 27 publications

(14 citation statements)

References 21 publications

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“…The fibrosis that we observed in vaginal tissue from type 1 diabetic rats appears to be similar to that seen in vaginal tissue from spontaneous hypertensive rats (12), sex hormonedeprived rabbits (9 -11, 13), and rabbits with atherosclerotic lesions and high cholesterol (22) as well as in clitoral tissue from alloxan-induced diabetic rabbits (21,22). All these conditions are associated with the reduction of the smooth muscle content, the impairment of the hemodynamic mechanisms regulating blood flow, and the loss of tissue compliance.…”

Section: Discussionsupporting

confidence: 71%

See 1 more Smart Citation

Increased vaginal oxidative stress, apoptosis, and inducible nitric oxide synthase in a diabetic rat model: implications for vaginal fibrosis

Ferrini

Nolazco

Vernet

et al. 2006

Fertility and Sterility

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Section: Discussionsupporting

confidence: 71%

“…Similarly, clitoral fibrosis has been shown in the alloxan-induced diabetic rabbit model (21,22). In the diabetic rat vagina, this is accompanied by increased transforming growth factor ␤1 (TGF␤1) (20), a key factor in the induction of fibrosis.…”

mentioning

confidence: 95%

Increased vaginal oxidative stress, apoptosis, and inducible nitric oxide synthase in a diabetic rat model: implications for vaginal fibrosis

Ferrini

Nolazco

Vernet

et al. 2006

Fertility and Sterility

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“…While the nature of the sexual response may be more complex in females, reduction in blood flow appears to negatively impact on various aspects of sexual function [69,75]. As such, animal models to examine this link are currently being developed.…”

Section: Etiologies Of Female Sexual Dysfunction: Focus On Cardiovascmentioning

confidence: 98%

“…As such, animal models to examine this link are currently being developed. Balloon injury of aorto-iliac arteries and a high cholesterol diet has been shown to result in an increased clitoral fibrosis and an impairment of vaginal and clitoral engorgement [69,75]. Morphological characterization of clitoral and vaginal tissue revealed that in the spontaneously hypertensive rat (SHR) there is an increase in smooth muscle and fibrosis, relative to a normotensive strain [76].…”

Section: Etiologies Of Female Sexual Dysfunction: Focus On Cardiovascmentioning

confidence: 98%

Common Therapeutic Strategies in the Management of Sexual Dysfunction and Cardiovascular Disease

Hale

Hannan

Heaton

et al. 2005

CDTCHD

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Sexual dysfunction is a frequent complication of treated and untreated cardiovascular disease. In fact, approximately 30% of hypertensives have been found to suffer from erectile dysfunction (ED) resulting from arterial dysfunction. Recent evidence has suggested that ED may be an early indicator of subclinical cardiovascular disease. In women, the evidence is similar, but more limited, showing that in hypertensive patients there is an increased prevalence of sexual dysfunction involving decreased vaginal lubrication, decreased orgasm, and increased pain. Clouding the issue, however, is that some antihypertensive agents may induce sexual dysfunction in hypertensives with normal sexual function. In contrast to the chronic treatments used in hypertension, therapies for ED involve acute treatments (none currently approved for women) targeting vasodilation of penile arteries, resulting in erection. Common to the treatment of hypertension and ED is that the current therapies were not designed to target underlying disorders of local, neural, vascular, or endocrine origin. In fact, while blood pressure is lowered, and erectile responses are improved with the respective therapies, the causal abnormalities may progress thereby limiting the long-term effectiveness of the medication. Some antihypertensive agents have been shown to have additional effects beyond blood pressure reduction and their impact on sexual function is a key focus of this review. This review examines the current and future strategies for treatments of male and female sexual dysfunction and the potential for therapeutic modalities that go beyond the recovery of the responses by targeting the fundamental mechanisms common to both sexual dysfunction and cardiovascular disease.

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“…[22][23][24] In the female genital tract, diseases such as hypertension, diabetes, or lack of oestrogen can negatively impact on genital blood flow, reduce tissue oxygenation, and subsequently increase deposition of extracellular matrix, such as collagen III. [26][27][28][29] In this context, we observed that, 10 days after surgery, rats subjected to bilateral PNC exhibited more collagen III and collagen I in the vagina and a reduction of nNOS nerve fibres in both clitoral and distal vaginal tissue. Based on our data, it could be postulated that neurapraxia of the pelvic nerve induces functional damage of the nerve fibres that release NO, which would then promote hypoxiainduced fibrosis in a similar way to what happens in the penis after a cavernous nerve injury.…”

Section: Discussionmentioning

confidence: 83%

Pelvic nerve injury negatively impacts female genital blood flow and induces vaginal fibrosis—implications for human nerve‐sparing radical hysterectomy

Castiglione

Bergamini

Albersen

et al. 2015

BJOG

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Objective This study sought to develop a novel animal model to study the impact of nerve-sparing radical hysterectomy (NSRH) on female genital blood flow.Design In vivo animal study.Population Thirty Sprague-Dawley female rats.Materials and methods Female rats underwent either unilateral pelvic nerve (PN) crush (PNC; n = 9), or crush of both the PNs and all efferent nerves in the pelvic plexus ('clock-nerve crush', CNC; n = 9). Under anaesthesia, we electrically stimulated the crushed PN at 3 and 10 days after crush while monitoring blood pressure and recording clitoral and vaginal blood flows by laser Doppler. Uninjured PNs were stimulated as an internal control. Twelve additional rats were assigned either to bilateral PNC or sham surgery, and genital tissues were processed 10 days after injury for in vitro analysis. Main outcome measures Genital blood flow, nNOS, eNOS, collagen I-III.Results Stimulation of the crushed PN in both groups subjected to PNC and CNC induced significantly lower peak genital blood flow at 3 and 10 days (P < 0.05) compared to stimulation of the non-crushed control PN. The immunofluorescence and Western blot analyses revealed that all injured rats exhibited more vaginal collagen III and collagen I than rats did that ad undergone sham surgeries (P < 0.05). PCN reduced nNOS expression in both clitoral and vaginal tissue.Conclusions Based on our study it may be hypothesised that NSRH might cause reductions of genital blood flow and vaginal fibrosis due to neurapraxia of the pelvic nerve and reductions of nNOS nerve fibres in clitoral and distal vaginal tissue.

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Atherosclerosis-induced chronic arterial insufficiency causes clitoral cavernosal fibrosis in the rabbit

Cited by 27 publications

References 21 publications

Increased vaginal oxidative stress, apoptosis, and inducible nitric oxide synthase in a diabetic rat model: implications for vaginal fibrosis

Increased vaginal oxidative stress, apoptosis, and inducible nitric oxide synthase in a diabetic rat model: implications for vaginal fibrosis

Common Therapeutic Strategies in the Management of Sexual Dysfunction and Cardiovascular Disease

Pelvic nerve injury negatively impacts female genital blood flow and induces vaginal fibrosis—implications for human nerve‐sparing radical hysterectomy

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