The investigation of putative agents, using anin vitromodel, to prevent cavernosal smooth muscle dysfunction during low-flow priapism

OBJECTIVE To investigate the effect of putative agents for preventing irreversible smooth muscle dysfunction, using an in vitro model of low-flow priapism (a condition conventionally managed using a combination of corporal blood aspiration and instillation of α-adrenergic agonists), as failure of detumescence results in a high incidence of erectile dysfunction. MATERIALS AND METHODS We investigated the effects of several agents (N-acetylcysteine, BayK 8644, glutathione, digoxin, calcium and Nω-nitro-l-arginine methyl ester) on the recovery of smooth muscle tone after exposure to 4 h of a combination of hypoxia, glucopenia and acidosis in corpus cavernosum isolated from rabbit. RESULTS After 4 h of ischaemia, none of the agents were able to prevent irreversible smooth muscle dysfunction. CONCLUSION Prolonged low-flow priapism leads to smooth muscle dysfunction and fibrosis within the corpus cavernosum. When α-adrenergic agents fail to reverse the condition, surgical intervention is required. We showed that the administration of novel agents, including antioxidants, does not prevent smooth muscle dysfunction.