Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Inside-out autologous vein grafts fail to restore erectile function in a rat model of cavernous nerve crush injury after nerve-sparing prostatectomy

Abstract

Some autologous tissues can restore erectile function (EF) in rats after a resection of the cavernous nerve (CN). However, a cavernous nerve crush injury (CNCI) better reproduces ED occurring after a nerve-sparing radical prostatectomy (RP). The aim was to evaluate the effect on EF of an autologous vein graft after CNCI, compared with an artificial conduit. Five groups of rats were studied: those with CN exposure, exposure+vein, crush, crush+guide and crush+vein. Four weeks after surgery, the EF of rats was assessed by electrical stimulation of the CNs. The intracavernous pressure (ICP) and mean arterial pressure (MAP) were monitored during stimulations at various frequencies. The main outcome, that is, the rigidity of the erections, was defined as the ICP/MAP ratio. At 10 Hz, the ICP/MAP ratios were 41.8%, 34.7%, 20.9%, 33.9% and 20.5%, respectively. The EF was significantly lower in rats if the CNCI was treated with a vein graft instead of an artificial guide. Contrary to cases of CN resection, autologous vein grafts did not improve EF after CNCI. In terms of clinical use, the study suggests to limit an eventual use of autologous vein grafts to non-nerve-sparing RPs.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Dubbelman YD, Dohle GR, Schroder FH . Sexual function before and after radical retropubic prostatectomy: a systematic review of prognostic indicators for a successful outcome. Eur Urol 2006; 50: 711–718, discussion 718-720.

    Article  Google Scholar 

  2. Schatloff O, Chauhan S, Kameh D, Valero R, Ko YH, Sivaraman A et al. Cavernosal nerve preservation during robot-assisted radical prostatectomy is a graded rather than an all-or-none phenomenon: objective demonstration by assessment of residual nerve tissue on surgical specimens. Urology 2012; 79: 596–600.

    Article  Google Scholar 

  3. Koehler N, Holze S, Gansera L, Rebmann U, Roth S, Scholz HJ et al. Erectile dysfunction after radical prostatectomy: the impact of nerve-sparing status and surgical approach. Int J Impot Res 2012; 24: 155–160.

    Article  CAS  Google Scholar 

  4. Mullerad M, Donohue JF, Li PS, Scardino PT, Mulhall JP . Functional sequelae of cavernous nerve injury in the rat: is there model dependency. J Sex Med 2006; 3: 77–83.

    Article  Google Scholar 

  5. Kutlu O, Ross AE, Schaeffer EM, Gratzke C, Stief CG, Strong TD et al. Increased expression of nestin in the major pelvic ganglion following cavernous nerve injury. Int J Impot Res 2012; 24: 84–90.

    Article  CAS  Google Scholar 

  6. Davis JW, Chang DW, Chevray P, Wang R, Shen Y, Wen S et al. Randomized phase II trial evaluation of erectile function after attempted unilateral cavernous nerve-sparing retropubic radical prostatectomy with versus without unilateral sural nerve grafting for clinically localized prostate cancer. Eur Urol 2009; 55: 1135–1143.

    Article  Google Scholar 

  7. Quinlan DM, Nelson RJ, Walsh PC . Cavernous nerve grafts restore erectile function in denervated rats. J Urol 1991; 145: 380–383.

    Article  CAS  Google Scholar 

  8. Alsaid B, Bessede T, Diallo D, Moszkowicz D, Karam I, Benoit G et al. Division of autonomic nerves within the neurovascular bundles distally into corpora cavernosa and corpus spongiosum components: immunohistochemical confirmation with three-dimensional reconstruction. Eur Urol 2011; 59: 902–909.

    Article  Google Scholar 

  9. May F, Vroemen M, Matiasek K, Henke J, Brill T, Lehmer A et al. Nerve replacement strategies for cavernous nerves. Eur Urol 2005; 48: 372–378.

    Article  CAS  Google Scholar 

  10. Alsaid B, Karam I, Bessede T, Abdlsamad I, Uhl JF, Delmas V et al. Tridimensional computer-assisted anatomic dissection of posterolateral prostatic neurovascular bundles. Eur Urol 2010; 58: 281–287.

    Article  Google Scholar 

  11. Wang KK, Costas PD, Bryan DJ, Eby PL, Seckel BR . Inside-out vein graft repair compared with nerve grafting for nerve regeneration in rats. Microsurgery 1995; 16: 65–70.

    Article  CAS  Google Scholar 

  12. Burgers JK, Nelson RJ, Quinlan DM, Walsh PC . Nerve growth factor, nerve grafts and amniotic membrane grafts restore erectile function in rats. J Urol 1991; 146: 463–468.

    Article  CAS  Google Scholar 

  13. Levine MH, Yates KE, Kaban LB . Nerve growth factor is expressed in rat femoral vein. J Oral Maxillofac Surg 2002; 60: 729–733, discussion 734.

    Article  Google Scholar 

  14. Risitano G, Cavallaro G, Merrino T, Coppolino S, Ruggeri F . Clinical results and thoughts on sensory nerve repair by autologous vein graft in emergency hand reconstruction. Chir Main 2002; 21: 194–197.

    Article  CAS  Google Scholar 

  15. Barcelos AS, Rodrigues AC, Silva MD, Padovani CR . Inside-out vein graft and inside-out artery graft in rat sciatic nerve repair. Microsurgery 2003; 23: 66–71.

    Article  Google Scholar 

  16. Bessede T, Alsaid B, Ferretti L, Pierre M, Bernabe J, Giuliano F et al. Effect of a local delivery of triiodothyronine (T3) within neuroregenerative guide on recovery of erectile function in a rat-model of cavernous nerve injury. J Sex Med 2010; 7: 1798–1806.

    Article  CAS  Google Scholar 

  17. Khaleel MS, Dorheim TA, Duryee MJ, Durbin HE Jr, Bussey WD, Garvin RP et al. High-pressure distention of the saphenous vein during preparation results in increased markers of inflammation: a potential mechanism for graft failure. Ann Thorac Surg 2012; 93: 552–558.

    Article  Google Scholar 

  18. Hu W, Cheng B, Liu T, Li S, Tian Y . Erectile function restoration after repair of excised cavernous nerves by autologous vein graft in rats. J Sex Med 2010; 7: 3365–3372.

    Article  Google Scholar 

  19. Ferrari F, De Castro Rodrigues A, Malvezzi CK, Dal Pai Silva M, Padovani CR . Inside-out vs standard vein graft to repair a sensory nerve in rats. Anat Rec 1999; 256: 227–232.

    Article  CAS  Google Scholar 

  20. Fujioka M, Tasaki I, Kitamura R, Yakabe A, Hayashi M, Matsuya F et al. Cavernous nerve graft reconstruction using an autologous nerve guide to restore potency. BJU Int 2007; 100: 1107–1109.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to T Bessede.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bessede, T., Moszkowicz, D., Alsaid, B. et al. Inside-out autologous vein grafts fail to restore erectile function in a rat model of cavernous nerve crush injury after nerve-sparing prostatectomy. Int J Impot Res 27, 59–62 (2015). https://doi.org/10.1038/ijir.2014.32

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijir.2014.32

This article is cited by

Search

Quick links