031
Low intensity-shockwavetherapy (Li-ESWT) deliveredby Aries® improveserectilefunctionanddecreasescavernosalfibrosisofspontaneouslyhypertensiverats (SHR)
Assaly-Kaddoum, R1;Giuliano , F2; Laurin, M1; Bernabé, J1; Behr-Roussel, D1
1: Pelvipharm, Montigny-le-Bretonneuxand UMR Inserm 1179, Université Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France; 2: UMR Inserm 1179, Université Versailles Saint Quentin en Yvelines, Montigny-le-Bretonneux, France and AP-HP, Neuro-Uro-Andrology, Dept. ofPhysicalMedicineand Rehabilitation, Raymond Poincaréhospital, Garches, France
Objectives: Li-ESWT hasbeenreportedtoimproveerectilefunction in patientswithvasculogenic ED, andconvert PDE5i non-respondersintoresponders. Erectilefunctionof SHR, a validated rat model ofhypertensionassociated ED, ispartiallyimprovedby PDE5is. Here, weinvestigatedwhether Li-ESWT couldaffecterectilefunctionwithandwithoutacutesildenafil in SHR. A pronouncedaccumulationofcollagen in erectiletissueof SHR hasbeendescribed, thuswe also investigatedthehistologicalfeaturesof SHR erectiletissue after ESWT.
Methods: 2 groupsof male SHR (CTRL and ESWT; n=14/group) weretreatedtwice/weekfor 6 weeks. Only in the ESWT group, shockwavesweredeliveredtothepenisatthemid-shaftandbase (Aries®, Dornier MedTech, Germany). Eachsessioncomprised 1000 shocks per site (total: 2000 shocks, EFD: 0.06 mJ/mm2). 4 weeks after the final session, erectilefunction was assessedbyrecordingintracavernosalpressure (ICP) andmeanarterialpressure (MAP) underelectricalstimulationofthecavernous nerve (ES CN), first in absencethen in presenceofsildenafil (0.3mg/kg iv). Thenratsweresacrificed, thecorporacavernosawereharvestedandpreparedforhistologicalanalysis. Cavernosal smooth muscle (SM)/collagenratio was assessedbytrichromestaining. Cavernosalmicrovasculatureandnitrergicnerveswereassessedbyimmunohistologyagainst CD31 andnNOS.
Results: ESWT increasederectileresponsesof SHRs (at 10 Hz, ∆ICP/MAP: +17%; AUCtot/MAP: +17%, p<0.001 vs. CTRL). Combining ESWT withsildenafilimprovederectileresponseof SHRs (at 10Hz, AUCtot/MAP: +40%, p<0.001 vs. CTRL) andfurtherenhancedtheeffectofeithertherapyalone (+20%, p<0.01 vs. SHRs treatedwith ESWT, +16%, p<0.001 vs. SHRs treatedwithsildenafil). Histologicalanalysisshowed a 2.5 foldincrease in the SM/collagenratiofollowing ESWT.
Conclusion: ESWT using Aries® improvederectilefunction in SHR andpotentiatedresponsestosildenafil. Thisimprovement was accompaniedby an increase in the SM/collagenratio. These resultssuggest ED iseffectiveforvasculogenic ED as mono-therapy, and in combinationwith PDE5i. Thisstudyisthefirsttoreportthat ESWT increasescavernosal smooth muscleproportion in the SHR.
Disclosure:
Work supportedbyindustry: yes, by Dornier Medtech (industryfundingonly - investigatorinitiatedandexecutedstudy).