İhsan UNUS, AHMET KARAKEÇİ, TUNÇ OZAN, Fatih FIRDOLAŞ, İrfan ORHAN

Use of Bosentan, Theophylline and Vardenafil in Treatment of Priapism

Amaç: Endotelin reseptör blokeri olan Bosentan, Ade- nozin reseptör blokeri olan Teofilin ve non selektif Fos- fodiesteraz 5 enzimi inhibitörü olan Vardenafilin iskemik Priapizm oluşturulmuş rat modelinde terapötik etkinliğinin araştırılması hedeflendi. Yöntemler: Randomize olarak 24 Sprague-Dawley rat kontrol grubu, Vardenafil grubu, Bosentan grubu ve Te- ofilin 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 de- kapitasyon 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 şekil- de asıldılar. Kontrol grubu dışında kalan grupların 1 saat- lik 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 oluşturul- muş Kavernöz doku kasılmalarında frekans ve amplitüd- leri istatiksel olarak anlamlı şekilde arttırıp Teofilinin ise yine anlamlı bir şekilde azalttığı gözlendi. Vardenafilin ise frekans ve amplitüd üzerinde herhangi bir etkisi gözlen- medi. Sonuç: Priapizm ile indüklenmiş apoptozisin Bosentan ile inhibe edilmesi erektil

Priapizm Tedavisinde Bosentan, Teofilin ve Vardenafil Kullanımı

Objective: To evaluate the early therapeutic alternatives such as Bosentan an Endothelin receptor blocker, The- ophylline 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 ran- domly divided into 4 equal groups. Control group, Var- denafil group, Bosentan group and Theophylline group. Erection was provided by vacuum constriction method and it was maintained for 4 hours for achieving the pria- pism in all groups. Then, Six rats from each group were sacrificed by cervical dislocation. Consequently, cavern- ous tissue samples were collected and placed in the tis- sue 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 in- creased the frequency and amplitude of the contractions of the cavernous tissue in the Priapism status in a sta- tistically 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.

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