1. ¹The St Peter's Andrology Centre, University College London, London, UK
2. ²Wolfson Institute for Biomedical Research, University College London, London, UK
3. ³Department of Histopathology, University College London, London, UK

Correspondence: S Minhas, The St Peter's Andrology Centre, Institute of Urology and Nephrology, 48 Riding House Street, London W1W 7EY, UK. E-mail: suksbec.minhas@virgin.net

Received 14 November 2003; Revised 27 February 2004; Accepted 8 March 2004; Published online 8 April 2004.

Abstract

The effects of hypoxia (pO₂: 50 mmHg), acidosis (pH: 6.9) or glucopenia (absence of glucose) in vitro on the tone of the rabbit corpus cavernosum were investigated. The recovery of smooth muscle contractility following exposure to these conditions was also assessed. Hypoxia, acidosis or glucopenia alone or in combination showed a sustained reduction in the tone. Reperfusion of tissue strips showed complete recovery of smooth muscle tone for all conditions except when hypoxia and glucopenia were combined or when hypoxia, glucopenia and acidosis were used in combination. Incomplete recovery of tone was associated with a significant reduction in tissue ATP concentrations and an increase in the number of TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP nick-end labelling)-positive nuclei. This indicates that following reversal of hypoxia, acidosis and glucopenia, failure of conventional -adrenergic agonists to produce tumescence in low flow priapism is associated with irreversible smooth muscle cell dysfunction, which is linked to ATP reduction and smooth muscle cell death.