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World J Mens Health. 2017 Dec;35(3):186-195. English. Original Article. https://doi.org/10.5534/wjmh.17024
Jeong HC , Jeon SH , Qun ZG , Kim KS , Choi SW , Bashraheel F , Bae WJ , Kim SJ , Cho HJ , Ha US , Hong SH , Lee JY , Moon DG , Kim SW .
Department of Urology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea. ksw1227@catholic.ac.kr
Department of Urology, The Catholic University of Korea, Incheon St. Mary's Hospital, Incheon, Korea.
Catholic Integrative Medicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Department of Urology, Korea University College of Medicine, Seoul, Korea.
Abstract

Purpose

Gene therapy, stem cell therapy, and low-energy extracorporeal shockwave therapy (ESWT) have been investigated as treatments for refractory erectile dysfunction (ED), but inconclusive evidence has been obtained. We investigated the effect of a next-generation electromagnetic cylinder ESWT device on an animal model of ED.

Materials and Methods

Diabetes mellitus (DM)-induced rats were divided into 3 groups: group 1, control; group 2, DM; and group 3, DM+ESWT. Rats were treated with ESWT 3 times a week for 2 weeks. After the treatment course, intracavernous pressure was measured and the corpus cavernosum and cavernous nerve were evaluated.

Results

In the DM group, all parameters predicted to be significantly lower in the ED model had statistically significantly decreased (p < 0.01). As a measurement of erectile function, intracavernous pressure was evaluated. The DM+ESWT group exhibited significantly restored erectile function compared to the DM group (p < 0.05). Moreover, ESWT treatment restored smooth muscle content, as assessed by Masson's trichrome staining (p < 0.05). Finally, corporal tissue and the dorsal nerve were evaluated by immunohistochemistry, Western blotting, and ELISA. After ESWT treatment, vascular endothelial growth factor (VEGF), endothelial nitric oxide synthase (eNOS), platelet endothelial cell adhesion molecule-1, cyclic guanosine monophosphate, and neuronal nitric oxide synthase (nNOS) expression levels were restored to levels in the DM group (p < 0.05).

Conclusions

Electromagnetic cylinder ESWT device resulted in increased VEGF, nNOS, and eNOS expression; reduced smooth muscle atrophy; and increased endothelial cell regeneration in a DM-associated ED model. Our data suggest that safe and effective application could be possible in future clinical studies.

Copyright © 2019. Korean Association of Medical Journal Editors.