Análise estrutural do corpo cavernoso de pacientes com priapismo isquêmico

Abstract

The purpose of the present study was to evaluate through quantitative and qualitative methods, the changes in the corpora cavernosa of patients with ischemic priapism. We obtained samples of corpora cavernosa from 7 patients with ischemic priapism, aged between 28 and 44 years (mean = 38), who underwent a cavernosal-glandular shunt. The control tissues were fragments of corpora cavernosa obtained from autopsies of 7 age-matched men who died of causes not related to the urogenital tract. Histochemical and immunohistochemical techniques were used to assess and quantify the extra-cellular matrix and smooth muscle fibers. The volumetric density of smooth muscle, elastic fibers and collagen were determined in corpora cavernosa. The stereological analysis showed the following values of volumetric density in the structures studied. Collagen: controls = 34.76 ± 4.64, priapism = 39.64 ± 2.91 (p = 0.0019); elastic system fibers: controls 28.10 ± 2.85, priapism 36.10 ± 3.06 (p = 0.0012), smooth muscle fibers: controls = 43.37 ± 4.96, priapism = 26.48 ± 5.00 (p < 0.0001). Our results demonstrated a significant increase in the fibrous elements of the connective tissue and a significant decrease of smooth muscle fibers in the corpora cavernosa of patients with ischemic priapism, when compared to controls. As conclusion, this study showed that ischemic priapism is associated with early significant changes in the components of the extra cellular matrix and smooth muscle fibers of corpora cavernosa. This could explain the frequent occurrence of erectile dysfunction found in patients with ischemic priapism.