Ultrastructural changes of corporeal smooth muscle cells invasculogenic impotence

Lee, Jong Moon; Song, Kye Yong; Kim, Sae Chul

Abstract

Smooth muscle cell, the main contractile-relaxing component of the corpora cavernosa, undergoes degenerative changes when the blood supply of the corpora cavernosa is disturbed and results in erectile dysfunction. Recently, the main cause of venogenic erectile dysfunction has also been reported to be a corporal veno-occulsive dysfunction that develops following the disturbance of physiologic relaxation of the smooth muscle cell of the corpora cavernosa by degenerative and fibrotic change. The outcome of corrective vascular surgeries for both the arteriogenic and venogenic impotence is not so promising so far. The ultrastructural changes of the corporeal smooth muscle cells in 21 arteriogenic, 3 venogenic and 11 diabetogenic impotent men together with 8 psychogenic impotent patients as a control group were compared each other to investigate the pathogenesis of the erectile dysfunction on morphologic basis and validity of the corrective vascular surgery for the vasculogenic impotence. The results were as follows 1. In the psychogenic impotence, the smooth muscle cells showed well preserved contractile filament and dense body. either evenly distributed or conglomated glycogen without thickening of the basal lamina. 2. In the arteriogenic impotence, nearly half of the cases we examined smooth muscle cells showed degenerative changes with thickening of the basal lamina in part, and showed a paucity or the dense bodies and contractile filaments, decreased glycogen comparing to the smooth muscle cells of the psychogenic impotence. 3. In the venogenic impotence, the smooth muscle cells showed marked atrophy and disorganization in addition the thickening of basal lamina. 4. Also in the diabetogenic impotence, the smooth muscle cells showed similar changes to those of the arteriogenic impotence and particularly the basal lamina was more remarkably thickened. It is concluded that the degenerative and fibrotic changes could be a primary. or secondary cause of the venogenic, arteriogenic and diabetogenic impotence, and therefore biopsy of the corpora may be considered to select proper patients before the corrective vascular surgeries and to enhance their success rates.