體外震波對海綿體神經刺激引起糖尿病大白鼠海綿體內壓增加之效果

陳光國,張心湜

台北榮民總醫院泌尿部,國立陽明大學書田泌尿科學研究中心
The effect of extracorporeal shock wave on cavernous nerve stimulation-induced intracavernous pressure increase in the diabetic rat
Kuang-Kuo Chen, Luke S. Chang
Department of Urology, Taipei Veterans General Hospital, and Shu-Tien Urological Research Center, National Yang-Ming University, Taiwan
 
Purpose: Diabetes mellitus (DM) is commonly associated with erectile dysfunction (ED). Low-intensity extracorporeal shock wave therapy (LI-ESWT) has been used to treat patients with ED. However, the pre-clinical investigation of LI-ESWT for ED is still not enough. Therefore, the objective of this study was to investigate the effect of LI-ESW on cavernous nerve (CN) stimulation-induced intracavernous pressure (ICP) increase in the diabetic rat.
Materials and Methods: Male adult Sprague-Dawley rats (250-300 g) were used. Intraperitoneal injection of streptozotocin (STZ) 70 mg/kg was done to induce DM in the rats. Only rats with blood glucose levels of greater than 300 mg/dl (hyperglycemia) three days after STZ injection were used. Three groups of experimental animals were designed as following: 1)ESW (0.05 mJ/mm2) to penile shaft, 800 shocks twice a week for 2 weeks, 2)ESW (0.05 mJ/mm2) to penile shaft, 1200 shocks twice a week for 2 weeks, and 3)application of probe without ESW to penile shaft twice a week for 2 weeks as a sham control. A 26-gauge needle was inserted into the corpus cavernosum to monitor the ICP. The CN was electrically stimulated with parameters (5 and 7.5 V, 20 Hz, 2 ms, 1 minute) on the 14th day after 2-week ESW in each of the three group rats. The amount of ICP increase was the difference between the peak ICP and resting ICP. Wilcoxon signed rank test and Mann-Whitney U test were used for statistical analysis.
Results: There was a significant increase of ICP from resting 5.3 ± 0.8 mmHg, 12.0 ± 1.9 mmHg and 5.2 ± 1.3 mmHg to a peak at 74.8 ± 6.5 mmHg (p=0.027), 81.0 ± 6.1 mmHg (p=0.028) and 45.8 ± 6.2 mmHg (p=0.028) after CN stimulation with parameters 7.5 V in group 1, 2 and 3 rats, respectively. The corresponding amount of ICP increase were 69.5 ± 6.9 mmHg, 69.0 ± 5.4 mmHg and 40.7 ± 5.0 mmHg in group 1, 2 and 3 rats, respectively. There was a significant greater amount of ICP increase in the group 1 (p=0.015) and group 2 rats (p=0.015) as compared with group 3 rats (sham control), respectively.
Conclusions: The results suggest that low-intensity extracorporeal shock wave may have a significant enhancing effect on cavernous nerve stimulation-induced intracavernous pressure increase in the diabetic rat.
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    台灣泌尿科醫學會
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    2015-06-10 22:00:00
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    2015-06-10 22:01:29
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