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İNTRAKAVERNOSAL SİLDENAFİLİN SIÇANLARDA DUTASTERID TEDAVİSİ SONRASI GELİŞEN EREKTIL DİSFONKSİYON ÜZERİNE YARARLI ETKİSİ

Amaç: Benign prostat hiperplazisi (BPH) ve erektil disfonksiyon (ED), yaşlı erkek hastalarda en sık görülen hastalıklardır. BPH tedavisi için 5α-redüktaz inhibitörleri (5-ARI) önerilmektedir. Ayrıca, 5ARI'lerin ED ile ilişkisi belirtilmiştir.Bu çalışmada, 5ARI tedavili sıçanlarda gelişen ED üzerine intrakavernozal sildenafil enjeksiyonunun etkisinin araştırılması amaçlanmıştır.Gereç ve Yöntem: Sprague-Dawley sıçanlar (n=30) üç gruba ayrılmıştır: Kontrol; 10 haftalık dutasterid tedavili (0.5mg/kg/gün); 6 haftalık dutasterid tedavili ve 4 hafta tedavisiz. İn vivo erektil yanıtlar, sildenafilin intrakavernozal enjeksiyonundan (0.3 mg/kg) önce ve sonra değerlendirilmiştir. İzole korpus kavernozum dokularının gevşeme ve kasılma yanıtları in vitro olarak organ banyosunda değerlendirildi.Sonuç ve Tartışma: 10 haftalık dutasterid tedavisinden sonra prostat ağırlığı azalmıştır. Dutasterid gruplarında in vivo erektil yanıtlar, endotelyal ve nitrerjik gevşeme yanıtları azalmıştır. Tedavinin kesilmesi azalan erektil yanıtları kısmen geri döndürmüştür. Sildenafilin intrakavernozal enjeksiyonu, tedavi gruplarında erektil yanıtları artırmıştır. 10 hafta dutasterid ile tedavi edilen sıçanlarda kontraktil yanıtlar artmıştır. Tedavinin kesilmesi, erektil fonksiyonun yanı sıra endotelyal ve nitrerjik gevşemeyi iyileştirmemiştir. Ayrıca, intrakavernozal sildenafil, 5ARI tedavisinin neden olduğu ED'de bir iyileşmeye neden olmuştur.

Anahtar Kelimeler:

: 5-alfa redüktaz inhibitörü, dutasterid, erektil disfonksiyon, korpus kavernozum, sildenafil.

THE BENEFICIAL EFFECT OF INTRACAVERNOSAL INJECTION OF SILDENAFIL ON ERECTILE DYSFUNCTION IN DUTASTERIDE TREATED RATS

Objective: Benign prostatic hyperplasia (BPH) and erectile dysfunction (ED) are the most common illnesses in aged male patients. 5α-reductase inhibitors (5-ARIs) are suggested for the treatment of BPH. Furthermore, the association of 5ARIs with ED has been indicated. This study aimed to investigate the effect of intracavernosal injection of sildenafil on ED in 5ARI treated rats.Material and Method: Sprague-Dawley rats (n=30) were divided into three groups: Control; 10-week dutasteride treatment (0.5 mg/rat/day); and 6-week durasteride treatment followed by a 4-week washout period. In vivo erectile responses were assessed before and after intracavernosal injection of sildenafil (0.3mg/kg/rat). The relaxant and contractile responses of isolated corpus cavernosum were evaluated in in vitro organ bath.Result and Discussion: Prostate weight decreased after 10-week dutasteride treatment. In vivo erectile responses, endothelial and nitrergic relaxation responses were decreased in dutasteride groups. The washout period moderately normalized erectile responses. The intracavernosal injection of sildenafil increased erectile function in treatment groups. Contractile responses were augmented in 10-week dutasteride treated rats. The cessation of the treatment did not alter erectile function as well as endothelial relaxation and nitrergic relaxation. Also, intracavernosal sildenafil caused an improvement in 5ARI treatment-induced ED.

Keywords:

5-alpha reductase inhibitor, corpus cavernosum, dutasteride, erectile dysfunction, sildenafil.,

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