Ihsan Unus, Ahmet Karakeci, Tunc Ozan, Fatih Firdolas, Irfan Orhan

Priapizm Tedavisinde Bosentan, Teofilin ve Vardenafil Kullanımı

Amaç: Endotelin reseptör blokeri olan Bosentan, Adenozin reseptör blokeri olan Teofilin ve non selektif Fosfodiesteraz 5 enzimi inhibitörü olan Vardenafil’in iskemik Priapizm oluşturulmuş rat modelinde terapötik etkinliğinin araştırılması hedeflendi. Yöntemler: Randomize olarak 24 Sprague-Dawley rat kontrol grubu, Vardenafil grubu, Bosentan grubu ve Teofilin grubu olmak üzere 4 eşit gruba dağıtıldı. Ereksiyon her grupta vakum konstriksiyon metodu ile sağlandı ve priapizm sağlanması için 4 saat sürdürüldü. Daha sonra her gruptaki 6 rata Servikal dislokasyon yöntemi ile dekapitasyon uygulandı. Kavernöz dokular ayrıldı ve organ banyosuna bırakıldı. Doku örnekleri 0,5-0,2 cm. şeritler şeklinde ısı çeperli, çift duvarlı içinde 37°C krebs çözeltisi bulunan ve devamlı 95% O2 ve 5% CO2 ile gazlandırılan organ banyolarına istirahat gerimi 1000 mg. olacak şekilde asıldılar. Kontrol grubu dışında kalan grupların 1 saatlik kasılma kayıtları alındıktan sonra grubuna göre artan dozlarda Bosentan, Teofilin ve Vardenafil uygulandı ve şeritlerdeki ilaç ve doz bağımlı kontraksiyon değişiklikleri gözlendi.Bulgular: Bu çalışmada Bosentanın priapizm oluşturulmuş Kavernöz doku kasılmalarında frekans ve amplitüdleri istatiksel olarak anlamlı şekilde arttırıp Teofilinin ise yine anlamlı bir şekilde azalttığı gözlendi. Vardenafilin ise frekans ve amplitüd üzerinde herhangi bir etkisi gözlenmedi. Sonuç: Priapizm ile indüklenmiş apoptozisin Bosentan ile inhibe edilmesi erektil fonksiyonun korunması açısından umut vaat etmektedir

Anahtar Kelimeler:

Bosentan, iskemik priapizm, teofilin, vardenafil

Use of Bosentan, Theophylline and Vardenafil in Treatment of Priapism

Objective: To evaluate the early therapeutic alternatives such as Bosentan an Endothelin receptor blocker, Theophylline and Adenosin receptor blocker and Vardenafil a non-selective Phosphodiesterase 5 enzyme inhibitor for the therapy of ischemic priapism in the rat models.Methods: Twenty-four Sprague-Dawley rats were randomly divided into 4 equal groups. Control group, Vardenafil group, Bosentan group and Theophylline group. Erection was provided by vacuum constriction method and it was maintained for 4 hours for achieving the priapism in all groups. Then, Six rats from each group were sacrificed by cervical dislocation. Consequently, cavernous tissue samples were collected and placed in the tissue bath. Tissue samples were prepared as 0.5-0.2 cm. strips and put into heat jacketed double walled organ bath containing 37°C krebs solution which is constantly bubbled with 95% O2 and 5 % CO2 and mounted at a resting tension of 1000 mg. After taking the 1 hour record of the three groups except the control group, Bosentan, Theophylline and Vardenafil were admitted in increasing doses. Consequently the alterations of the contractions in the strips due to the drugs and their increasing doses are observed.Results: In this study we detected that Bosentan increased the frequency and amplitude of the contractions of the cavernous tissue in the Priapism status in a statistically significant manner, Theophylline decreased the frequency and the amplitude significantly and Vardenafil had statistically no effect on the frequency and amplitude.Conclusion: Inhibition of priapism induced apoptosis with Bosentan, seems promising on preserving erectile function.Key words: Bosentan, ischemic priapism, theophylline, vardenafil

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