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Alternative Pathways in the Pathophysiology of Priapism

Year 2014, Volume: 19 Issue: 1, 1 - 5, 29.07.2014

Abstract

Priapism is described as the extended unpreferred erection status without any sexual stimulus. There are three types of priapism which are classified as ischemic, non ischemic and recurrent priapism depending on the blood flow of the penile artery. Ischemic priapism is a real urological emergency which requires urgent and appropriate approach. Recently, it was shown in experimental priapism models that adenosine and hemoxygenase-1-carbonmonoxide (HO1-CO) are effective in the development of recurrent priapism attacks. Moreover, it was reported that dysregulated PDE-5 activity, decreased Norepinephrine response and altered Endothelin receptor activity may be effective in the pathophysiology of priapism. In the present study, the experimental data related to the pathways that play an active role in the pathophysiology of priapism and its reflections on the practice were evaluated.

References

  • Pryor J, Akkus E, Alter G, et al. Priapism. J Sex Med 2004; 1: 116Broderick GA, Harkaway R. Pharmacologic erection: timedependent changes in the corporal environment. Int J Impot Res 1994; 6: 9-16.
  • Muneer A, Cellek S, Doğan A, et al. Investigation of cavernosal smooth muscle dysfunction in low flow priapism using an in vitro model. Int J Import Res 2005; 17: 10-8.
  • Spycher MA, Hauri D. The ultrastructure of the erectile tissue in priapism. J Urol 1986; 135: 142-7.
  • Cherian J, Rao AR, Thwaini A, et al. Medical and surgical management of priapism. Postgrad Med J 2006; 82: 89-94.
  • Ozan T, Fırdolaş F, Orhan İ. Deneysel Çalışmalarda Priapizm: Kliniğe Yansımalar. Turk Urol Sem 2011; 2: 281-7.
  • Ul-Hasan M, El-Sakka AI, Lee C, et al. Expression of TGFbeta 1 m-RNA and ultrastructural alterations in pharmacologically indu-ced prolonged penile erection in a canine model. J Urol 1998; 160: 2263-6.
  • Sanli O, Armagan A, Kandirali E, et al. TGF-beta1 neutralizing antibodies decrease the fibrotic effects of ischemic priapism. Int J Impot Res 2004; 16: 492-7.
  • Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol 2003; 170: 1318-24.
  • Teng RB, Zhang XH. Oxytocin and male sexual function. Zhonghua Nan Ke Zue 2011; 17: 558-61.
  • Burnet A, Tillman SL, Chang TS, et al. Immunohistochemical localization of nitric oxide synthase in the autonomic innervation of the human penis. J Urol 1993; 150: 73-6.
  • Claudino MA, Franco-Penteado CF, Priviero FB, et al. Upregulation of gp91phox subunit of NAD(P)H oxidase contributes to erectile dysfunction caused by long-term nitric oxide inhibition in rats: reversion by regular physical training. Urology 2010; 75: 961-7.
  • Phatarpekar PV, Wen J, Xia Y. Role of adenosine signaling in penile erection and erectile disorders. J Sex Med 2010; 7: 3553-6
  • Patole S, Lee J, Buettner P, et al. Improved oxygenation following adenosine infusion in persistent pulmonary hypertension of the newborn. Biol Neonate 1998; 74: 345-50.
  • Tiejuan Mi, Shahrzad Abbasi, Hong Zhang, et al. Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling. J Clin Invest 2008; 118: 1491-501.
  • Filippi S, Mancini M, Amerini S, et al. Functional adenosine receptors in human corpora cavernosa. Int J Androl 2000; 23: 210Chiang PH, Wu SN, Tsai EM, et al. Adenosine modulation of neurotransmission in penile erection. Br J Clin Pharmacol 1994; 38: 357–62.
  • Yingbo Dai, Yujin Zhang, Phatarpekar MS, et al. Adenosine Signaling, Priapism and Novel Therapies. J Sex Med 2009; 6: 292–301.
  • Karakeci A, Firdolas F, Ozan T, et al. Second Pathways in the Pathophysiology of Ischemic Priapism and Treatment Alternatives. Urology 2013; 82: 625-9.
  • Shamloul R. The potential role of the heme oxygenase/carbon monoxide system in male sexual dysfunctions. J Sex Med 2009; 6: 324-33.
  • Jin YC, Gam SC, Jung JH, et al. Expression and activity of heme oxygenase-1 in artificially induced low-flow priapism in rat penile tissues. J Sex Med 2008; 5: 1876-82.
  • Ma HB, Qin WB, Gui SL. ZnPP IX andL-NAME reduce the cGMP content in the penile tissue of rats. Zhonghua Nan Ke Xue 2009; 15: 523-5.
  • Talaat M, Farid Al-Asmar M, Taymour M, et al. Assessment of heme oxygenase-1 (HO-1) activity in the cavernous tissues of sildenafil citrate-treated rats. Asian J Androl 2007; 9: 3778
  • Raja SG, Dreyfus GD. Current status of bosentan for treatment of pulmonary hypertension. Ann Card Anaesth 2008; 11: 6-14.
  • Gabbay E, Fraser J, McNeil K. Review of bosentan in the management of pulmonary arterial hypertension. sc Health Risk Manag 2007; 3: 887-900.
  • Chan SY, Loscalzo J. Pathogenic mechanisms of pulmonary arterial hypertension. J Mol Cell Cardiol 2008; 44: 14-30.
  • Masaki T. The discovery of endothelins. Cardiovasc Res 1998; 39: 530-3.
  • Jeffery TK, Morrell NW. Molecular and cellular basis of pulmonary vascular remodeling in pulmonary hypertension. Prog Cardiovasc Dis 2002; 45: 173-202.
  • Benigni A, Remuzzi G. Endothelin antagonists. Lancet 1999; 353: 133-8.
  • Filippi S, Marini M, Vannelli GB, et al. Effects of hypoxia on Endothelin–1 sensitivity in the Corpus cavernosum. Molecul Hum Repro 2003; 9: 765-74.
  • Hall SM, Davie N, Klein N, et al. Endothelin receptor expression in IPAH: effect of bosentan and epoprostenol treatment. Eur Respir J 2011.
  • Unus I, Karakeci A, Firdolas F, et al. The use of Bosentan, Theophylline and Vardenafil in the treatment of priapism. European Congress of Society for Sexual Medicine (ESSM) January 29-February 1, Istanbul, Turkey, 2014.
  • Lin CS, Lin G, Lue TF. Cyclic nucleotide signaling in cavernous smooth muscle. J Sex Med 2005; 2: 478-91.
  • Broderick GA, Gordon D, Hypolite J, et al. Anoxia and corporal smooth muscle dysfunction:a model for ischemic priapism. J Urol 1994; 151: 259-62.
  • Muneer A, Minhas S, Freeman A, et al. Investigating the effects of high-dose phenylephrine in the management of prolonged ischaemic priapism. J Sex Med 2008; 5: 2152-9.
  • Hellstrom WJ, Gittelman M, Karlin G, et al. Sustained efficacy and tolerability of vardenafil a highly potent selective phosphodiesterase type 5 inhibitor in men with erectile dysfunction: results of a randomized double-blind, 26-week placebo-controlled pivotal trial. Urology 2003; 61: 8-14.
  • Lin CS. Phosphodiesterase type 5 regulation in the penile corpora cavernosa. J Sex Med 2009; 6: 203-9.
  • Bialecki ES, Bridges KR. Sildenafil relieves priapism in patients with sickle cell disease. Am J Med 2002; 113: 252.
  • Burnett AL, Bivalacqua TF, Champion HC, et al. Longterm oral phosphodiesterase 5 inhibitor therapy alleviates recurrent priapism. Urology 2006; 67: 1043-8.
  • Loretta L Collins, Yi-Fen Lee, Huei-Ju Ting et al. The roles of testicular nuclear receptor 4 (TR4) in male fertility-priapism and sexual behavior defects in TR4 knockout mice. Reprod Biol Endocrinol 2011; 9: 138.

Priapizm Patofizyolojisinde Alternatif Yolaklar

Year 2014, Volume: 19 Issue: 1, 1 - 5, 29.07.2014

Abstract

Priapizm, cinsel uyarı olmaksızın uzamış istenmeyen ereksiyon halidir. Priapizmin penil arter kan akımına bağlı olarak iskemik, non iskemik ve tekrarlayan olmak üzere üç tipi vardır. İskemik priapizm hızlı ve doğru yaklaşım gerektiren gerçek ürolojik bir acildir. Son yıllarda özellikle adenozin ve hemoksijenaz 1-karbonmonoksit'in tekrarlayan priapizm ataklarında etkin olduğu deneysel modellerde belirlenmiştir. Ayrıca priapizm patofizyolojisinde disregüle PDE5 aktivitesi, azalmış Norepinefrin cevabı ve Endotelin-1'in değişen reseptör aktivitesinin de etkin olabileceği bildirilmektedir. Bu çalışmada, priapizm patofizyolojisinde etkin rol oynayan yolaklarla ilgili deneysel veriler ve klinik yansımaları değerlendirildi.

References

  • Pryor J, Akkus E, Alter G, et al. Priapism. J Sex Med 2004; 1: 116Broderick GA, Harkaway R. Pharmacologic erection: timedependent changes in the corporal environment. Int J Impot Res 1994; 6: 9-16.
  • Muneer A, Cellek S, Doğan A, et al. Investigation of cavernosal smooth muscle dysfunction in low flow priapism using an in vitro model. Int J Import Res 2005; 17: 10-8.
  • Spycher MA, Hauri D. The ultrastructure of the erectile tissue in priapism. J Urol 1986; 135: 142-7.
  • Cherian J, Rao AR, Thwaini A, et al. Medical and surgical management of priapism. Postgrad Med J 2006; 82: 89-94.
  • Ozan T, Fırdolaş F, Orhan İ. Deneysel Çalışmalarda Priapizm: Kliniğe Yansımalar. Turk Urol Sem 2011; 2: 281-7.
  • Ul-Hasan M, El-Sakka AI, Lee C, et al. Expression of TGFbeta 1 m-RNA and ultrastructural alterations in pharmacologically indu-ced prolonged penile erection in a canine model. J Urol 1998; 160: 2263-6.
  • Sanli O, Armagan A, Kandirali E, et al. TGF-beta1 neutralizing antibodies decrease the fibrotic effects of ischemic priapism. Int J Impot Res 2004; 16: 492-7.
  • Montague DK, Jarow J, Broderick GA, et al. American Urological Association guideline on the management of priapism. J Urol 2003; 170: 1318-24.
  • Teng RB, Zhang XH. Oxytocin and male sexual function. Zhonghua Nan Ke Zue 2011; 17: 558-61.
  • Burnet A, Tillman SL, Chang TS, et al. Immunohistochemical localization of nitric oxide synthase in the autonomic innervation of the human penis. J Urol 1993; 150: 73-6.
  • Claudino MA, Franco-Penteado CF, Priviero FB, et al. Upregulation of gp91phox subunit of NAD(P)H oxidase contributes to erectile dysfunction caused by long-term nitric oxide inhibition in rats: reversion by regular physical training. Urology 2010; 75: 961-7.
  • Phatarpekar PV, Wen J, Xia Y. Role of adenosine signaling in penile erection and erectile disorders. J Sex Med 2010; 7: 3553-6
  • Patole S, Lee J, Buettner P, et al. Improved oxygenation following adenosine infusion in persistent pulmonary hypertension of the newborn. Biol Neonate 1998; 74: 345-50.
  • Tiejuan Mi, Shahrzad Abbasi, Hong Zhang, et al. Excess adenosine in murine penile erectile tissues contributes to priapism via A2B adenosine receptor signaling. J Clin Invest 2008; 118: 1491-501.
  • Filippi S, Mancini M, Amerini S, et al. Functional adenosine receptors in human corpora cavernosa. Int J Androl 2000; 23: 210Chiang PH, Wu SN, Tsai EM, et al. Adenosine modulation of neurotransmission in penile erection. Br J Clin Pharmacol 1994; 38: 357–62.
  • Yingbo Dai, Yujin Zhang, Phatarpekar MS, et al. Adenosine Signaling, Priapism and Novel Therapies. J Sex Med 2009; 6: 292–301.
  • Karakeci A, Firdolas F, Ozan T, et al. Second Pathways in the Pathophysiology of Ischemic Priapism and Treatment Alternatives. Urology 2013; 82: 625-9.
  • Shamloul R. The potential role of the heme oxygenase/carbon monoxide system in male sexual dysfunctions. J Sex Med 2009; 6: 324-33.
  • Jin YC, Gam SC, Jung JH, et al. Expression and activity of heme oxygenase-1 in artificially induced low-flow priapism in rat penile tissues. J Sex Med 2008; 5: 1876-82.
  • Ma HB, Qin WB, Gui SL. ZnPP IX andL-NAME reduce the cGMP content in the penile tissue of rats. Zhonghua Nan Ke Xue 2009; 15: 523-5.
  • Talaat M, Farid Al-Asmar M, Taymour M, et al. Assessment of heme oxygenase-1 (HO-1) activity in the cavernous tissues of sildenafil citrate-treated rats. Asian J Androl 2007; 9: 3778
  • Raja SG, Dreyfus GD. Current status of bosentan for treatment of pulmonary hypertension. Ann Card Anaesth 2008; 11: 6-14.
  • Gabbay E, Fraser J, McNeil K. Review of bosentan in the management of pulmonary arterial hypertension. sc Health Risk Manag 2007; 3: 887-900.
  • Chan SY, Loscalzo J. Pathogenic mechanisms of pulmonary arterial hypertension. J Mol Cell Cardiol 2008; 44: 14-30.
  • Masaki T. The discovery of endothelins. Cardiovasc Res 1998; 39: 530-3.
  • Jeffery TK, Morrell NW. Molecular and cellular basis of pulmonary vascular remodeling in pulmonary hypertension. Prog Cardiovasc Dis 2002; 45: 173-202.
  • Benigni A, Remuzzi G. Endothelin antagonists. Lancet 1999; 353: 133-8.
  • Filippi S, Marini M, Vannelli GB, et al. Effects of hypoxia on Endothelin–1 sensitivity in the Corpus cavernosum. Molecul Hum Repro 2003; 9: 765-74.
  • Hall SM, Davie N, Klein N, et al. Endothelin receptor expression in IPAH: effect of bosentan and epoprostenol treatment. Eur Respir J 2011.
  • Unus I, Karakeci A, Firdolas F, et al. The use of Bosentan, Theophylline and Vardenafil in the treatment of priapism. European Congress of Society for Sexual Medicine (ESSM) January 29-February 1, Istanbul, Turkey, 2014.
  • Lin CS, Lin G, Lue TF. Cyclic nucleotide signaling in cavernous smooth muscle. J Sex Med 2005; 2: 478-91.
  • Broderick GA, Gordon D, Hypolite J, et al. Anoxia and corporal smooth muscle dysfunction:a model for ischemic priapism. J Urol 1994; 151: 259-62.
  • Muneer A, Minhas S, Freeman A, et al. Investigating the effects of high-dose phenylephrine in the management of prolonged ischaemic priapism. J Sex Med 2008; 5: 2152-9.
  • Hellstrom WJ, Gittelman M, Karlin G, et al. Sustained efficacy and tolerability of vardenafil a highly potent selective phosphodiesterase type 5 inhibitor in men with erectile dysfunction: results of a randomized double-blind, 26-week placebo-controlled pivotal trial. Urology 2003; 61: 8-14.
  • Lin CS. Phosphodiesterase type 5 regulation in the penile corpora cavernosa. J Sex Med 2009; 6: 203-9.
  • Bialecki ES, Bridges KR. Sildenafil relieves priapism in patients with sickle cell disease. Am J Med 2002; 113: 252.
  • Burnett AL, Bivalacqua TF, Champion HC, et al. Longterm oral phosphodiesterase 5 inhibitor therapy alleviates recurrent priapism. Urology 2006; 67: 1043-8.
  • Loretta L Collins, Yi-Fen Lee, Huei-Ju Ting et al. The roles of testicular nuclear receptor 4 (TR4) in male fertility-priapism and sexual behavior defects in TR4 knockout mice. Reprod Biol Endocrinol 2011; 9: 138.
There are 38 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Ahmet Karakeci This is me

Publication Date July 29, 2014
Published in Issue Year 2014 Volume: 19 Issue: 1

Cite

APA Karakeci, A. (2014). Priapizm Patofizyolojisinde Alternatif Yolaklar. Fırat Tıp Dergisi, 19(1), 1-5.
AMA Karakeci A. Priapizm Patofizyolojisinde Alternatif Yolaklar. Fırat Tıp Dergisi. February 2014;19(1):1-5.
Chicago Karakeci, Ahmet. “Priapizm Patofizyolojisinde Alternatif Yolaklar”. Fırat Tıp Dergisi 19, no. 1 (February 2014): 1-5.
EndNote Karakeci A (February 1, 2014) Priapizm Patofizyolojisinde Alternatif Yolaklar. Fırat Tıp Dergisi 19 1 1–5.
IEEE A. Karakeci, “Priapizm Patofizyolojisinde Alternatif Yolaklar”, Fırat Tıp Dergisi, vol. 19, no. 1, pp. 1–5, 2014.
ISNAD Karakeci, Ahmet. “Priapizm Patofizyolojisinde Alternatif Yolaklar”. Fırat Tıp Dergisi 19/1 (February 2014), 1-5.
JAMA Karakeci A. Priapizm Patofizyolojisinde Alternatif Yolaklar. Fırat Tıp Dergisi. 2014;19:1–5.
MLA Karakeci, Ahmet. “Priapizm Patofizyolojisinde Alternatif Yolaklar”. Fırat Tıp Dergisi, vol. 19, no. 1, 2014, pp. 1-5.
Vancouver Karakeci A. Priapizm Patofizyolojisinde Alternatif Yolaklar. Fırat Tıp Dergisi. 2014;19(1):1-5.