CORPOREAL VENOOCCLUSIVE DYSFUNCTION - A DISTAL ARTERIAL PATHOLOGY

Purpose: Alteration of intracavernous smooth muscle cells has been dem onstrated in patients with pure venous leakage. This modification seem s correlated with reduction of intracavernous oxygen tension. However, Doppler imaging of the cavernous arteries in these patients is normal . To understand the ischemic factor we studied the endothelium of the terminal arteries with computerized image analysis and immunohistochem ical staining with 2 types of lectin in patients with venous leakage a nd those with normal erections. Lectins are glycoproteins that can be used as histological markers to monitor functional and pathological ch anges. Materials and Methods: Four patients 44 to 59 years old with no rmal erections who were operated on for penile cancer and 11 patients 27 to 62 years old with pure venous leakage (flow to maintain erection greater than 15 mi. per minute and cavernous flow velocity greater th an 35 cm. per second) were included in the study. Immunohistochemical staining with 2 lectins, wheat germ agglutinin and Ulex europeaus aggl utinin I, was performed and analyzed with computerized image analysis. The labeling index which relates to the percentage of staining indica tes the distribution of the endothelial cells, and mean optical densit y which relates to the staining intensity indicates the function of th ese cells. Results: Mean labeling index values far the 2 lectins were similar in both groups (p >0.05). Mean optical density values for the 2 lectins were significantly greater for the patients with normal erec tions (p <0.01). Therefore, the distribution of the endothelial cells was the same while their function was different in patients with corpo real veno-occlusive dysfunction. Conclusions: Staining with wheat germ agglutinin and Ulex europeaus agglutinin I lectin types allowed us to detect alteration in the glyco-histochemistry of the endothelial cell s of the small arteries, and venous leakage could be the first step in vasculogenic impotence.