Novel image analysis of corpus cavernous tissue in impotent men

Objectives. To objectively evaluate the contents of corpus cavernous tissue in impotent men using an automated novel image analysis system. Methods. Thirty-three impotent men and 2 normal potent men (controls) under went corpus cavernous biopsies. The procedures were performed using a Biopt y gun under local anesthesia. The obtained specimens were stained with Mass on's trichome technique, and the collagen fiber contents were evaluated by a computerized morphometric analysis method. In addition, we estimated the intraobserver and interobserver reliability of this automated image analysi s system. Results. No major complication was noted during or after the biopsies. Of t he 33 impotent patients, 3 were diagnosed as having psychogenic, 11 as havi ng arteriogenic, 13 as having venogenic, 1 as having neurogenic, and 5 as h aving idiopathic impotence. The collagen fiber percentages in the 35 men we re as follows: normal potent: 48.2% +/- 1.4%, psychogenic 55.2% +/- 11.6%, arteriogenic 73.2% +/- 4,4%, venogenic 66.5% +/- 4.2%, neurogenic 76.9%, an d idiopathic 77.4% +/- 4.2%. Significant differences were found between the normal potent and arteriogenic groups (P <0.05) and between the normal pot ent and idiopathic groups (P <0.05). Patients older than 60 years had a hig her collagen fiber content (70.4% +/- 3.7%) than those younger than 50 year s old (58.6% +/- 5.2%). The interobserver and intraobserver variances were both negligible for this automated image analysis system. This method signi ficantly reduced the amount of variation introduced by the intra-rater reli ability of a technician compared with the manual method. Conclusions. The present automated image analysis system is believed to be a reliable, accurate quantitative measurement tool for studies of penile ti ssue. Cavernous biopsy is a rapid, safe, and representative modality to stu dy penile disease. An increase in cavernous collagen fibers (or corporal fi brosis) is considered an important factor in impaired erectile function. (C ) 2000, Elsevier Science Inc.