Financial Support: This project was supported by the Dutch Society for Sexology (NVVS) Fund for Stimulation and Development of Sexology.
Changes in the Penile Arteries of the Rat after Fractionated Irradiation of the Prostate: A Pilot Study
Version of Record online: 23 APR 2009
© 2009 International Society for Sexual Medicine
The Journal of Sexual Medicine
Volume 6, Issue 7, pages 1908–1913, July 2009
How to Cite
Van Der Wielen, G. J., Vermeij, M., De Jong, B. W.D., Schuit, M., Marijnissen, J., Kok, D. J., Van Weerden, W. M. and Incrocci, L. (2009), Changes in the Penile Arteries of the Rat after Fractionated Irradiation of the Prostate: A Pilot Study. Journal of Sexual Medicine, 6: 1908–1913. doi: 10.1111/j.1743-6109.2009.01272.x
- Issue online: 24 JUN 2009
- Version of Record online: 23 APR 2009
- Erectile Dysfunction;
- Animal Experimental Study;
- Prostate Cancer;
- Fractionated Irradiation;
- Penile Arteries;
Introduction. External beam radiotherapy for prostate cancer leads to erectile dysfunction in 36%–43% of patients. The underlying mechanism is largely unknown, although some clinical studies suggest that the arterial supply to the corpora cavernosa is responsible. Two animal experimental studies reported on the effects of a single fraction of prostate irradiation on the penile structures. However, irradiation in multiple fractions is more representative of the actual clinical treatment.
Aim. The present prospective, controlled study was initiated to investigate the effect of fractionated prostate irradiation on the arteries of the corpora cavernosa.
Main Outcome Measures. Histological evaluation of the penile tissue in comparison with control rats at 2, 4, and 9 weeks after irradiation.
Methods. The prostate of twelve rats was treated with external beam radiation in 5 daily fractions of 7.4 gray. Three control rats were treated with sham irradiation. Prostatic and penile tissue was evaluated for general histology (hematoxylin–eosin). The penile tissue was further evaluated after combined staining for collagen (resorcin fuchsin) and α-smooth muscle actin (SMA) (Biogenex).
Results. The prostate showed adequate irradiation with fibrosis occurring at 9 weeks after irradiation. The corpora cavernosa showed arteries that had developed loss of smooth muscle cells expressing SMA, thickening of the intima, and occlusions. All the control rats maintained normal anatomy.
Conclusion. This is the first animal experimental study that demonstrates changes in the arteries of the corpora cavernosa after fractionated irradiation to the prostatic area. The preliminary data suggests that erectile dysfunction after radiotherapy might be caused by radiation damage to the arterial supply of the corpora cavernosa. van der Wielen GJ, Vermeij M, de Jong BWD, Schuit M, Marijnissen J, Kok DJ, van Weerden WM, and Incrocci L. Changes in the penile arteries of the rat after fractionated irradiation of the prostate: A pilot study. J Sex Med 2009;6:1908–1913.