NEUROGENIC ERECTILE DYSFUNCTION - THE COURSE OF NICOTINAMIDE ADENINE-DINUCLEOTIDE PHOSPHATE DIAPHORASE-POSITIVE NERVE-FIBERS ON THE SURFACEOF THE PROSTATE

Objectives. Nitric oxide (NO) plays an important role as a neurotransm itter in the peripheral neural regulation of erection. A histochemical stain able to localize fibers releasing NO in combination with an in vivo study were used to evaluate the course and physiologic significan ce of the nerve fibers innervating the cavernous smooth muscle. Method s. Morphologic studies in 6 rats and 6 human cadavers were performed, tracing the course of branches of the cavernous nerve branches using a nicotinamide adenine dinucleotide phosphate diaphorase staining techn ique. Electrostimulations in rats were performed before and after tran section of the anterolateral part of the prostate capsule. Results, Mu ltiple nerve fibers were documented running on the lateral and ventral surfaces of the prostate distinct from the classically described dors olateral neurovascular bundle. Transection of these fibers resulted in a loss of electrically induced intracavernous pressure (59.4 +/- 5.6 cm H2O versus 27.0 +/- 4.6 cm H2O). Conclusions. These preliminary mor phologic and physiologic studies support a significant role for these nerve fibers in erection.