Abstract：
BACKGROUND: Despite the widespread use of nerve-sparing prostatectomy techniques, the incidence of post-operative erectile dysfunction (ED) remains high. Early intracavernous (IC) injection of platelet-rich plasma (PRP) after nerve crushing improves erectile function (EF) in rats by promoting cavernous nerve (CN) regeneration and preventing structural changes in the corpus cavernosum. However, the neuroprotective effects of the in situ application of PRP glue in rats after CN-sparing prostatectomy (CNSP) remain unclear.
OBJECTIVE: This study aimed to investigate the effects of PRP glue treatment on EF and CN preservation in rats after CNSP.
METHODS: After prostatectomy, male Sprague-Dawley rats were treated with PRP glue, IC PRP injection, or their combination. The intracavernous pressure (ICP), mean arterial pressure (MAP), and CN preservation status in the rats were evaluated after 4 weeks. Results were corroborated using histology, immunofluorescence, and transmission electron microscopy.
RESULTS: The PRP glue-treated rats showed 100% CN preservation and significantly higher ICP responses (the ratio of maximum ICP to MAP (0.79 ± 0.09)) than the CNSP rats (the ratio of maximum ICP to MAP (0.33 ± 0.04)). PRP glue also significantly increased neurofilament-1 expression, indicating its positive effect on the CNs. Furthermore, this treatment significantly increased the expression of α-smooth muscle actin. Electron micrographs revealed that PRP glue preserved the myelinated axons and prevented atrophy of the corporal smooth muscle by maintaining the adherens junctions.
CONCLUSIONS: These results indicate that PRP glue is a potential solution for EF preservation by neuroprotection in patients with prostate cancer who are likely to undergo nerve-sparing radical prostatectomy.
OBJECTIVE: This study aimed to investigate the effects of PRP glue treatment on EF and CN preservation in rats after CNSP.
METHODS: After prostatectomy, male Sprague-Dawley rats were treated with PRP glue, IC PRP injection, or their combination. The intracavernous pressure (ICP), mean arterial pressure (MAP), and CN preservation status in the rats were evaluated after 4 weeks. Results were corroborated using histology, immunofluorescence, and transmission electron microscopy.
RESULTS: The PRP glue-treated rats showed 100% CN preservation and significantly higher ICP responses (the ratio of maximum ICP to MAP (0.79 ± 0.09)) than the CNSP rats (the ratio of maximum ICP to MAP (0.33 ± 0.04)). PRP glue also significantly increased neurofilament-1 expression, indicating its positive effect on the CNs. Furthermore, this treatment significantly increased the expression of α-smooth muscle actin. Electron micrographs revealed that PRP glue preserved the myelinated axons and prevented atrophy of the corporal smooth muscle by maintaining the adherens junctions.
CONCLUSIONS: These results indicate that PRP glue is a potential solution for EF preservation by neuroprotection in patients with prostate cancer who are likely to undergo nerve-sparing radical prostatectomy.
摘要：
背景：尽管广泛使用保留神经的前列腺切除术技术，术后勃起功能障碍(ED)的发生率仍然很高.神经挤压后早期海绵体内（IC）注射富血小板血浆（PRP）可促进海绵体神经（CN）再生和防止海绵体结构改变，从而改善大鼠的勃起功能（EF）。然而,保留CN前列腺切除术（CNSP）后原位应用PRP胶对大鼠的神经保护作用尚不清楚。
目的：本研究旨在研究PRP胶处理对CNSP后大鼠EF和CN保存的影响。
方法：前列腺切除术后，雄性Sprague-Dawley大鼠用PRP胶治疗，ICPRP进样,或他们的组合。海绵体内压（ICP），平均动脉压(MAP),4周后评估大鼠的CN保存状态。结果用组织学证实，免疫荧光，和透射电子显微镜。
结果：与CNSP大鼠（最大ICP与MAP的比率（0.33±0.04））相比，PRP胶处理的大鼠显示出100％的CN保留和ICP响应（最大ICP与MAP的比率（0.79±0.09））。PRP胶也显著增加了神经丝-1的表达，表明其对CN的积极影响。此外，该治疗显着增加了α-平滑肌肌动蛋白的表达。电子显微照片显示，PRP胶保留了有髓鞘的轴突，并通过维持粘附连接来防止了体部平滑肌的萎缩。
结论：这些结果表明，PRP胶是可能接受保留神经的根治性前列腺切除术的前列腺癌患者通过神经保护保护EF的潜在解决方案。
目的：本研究旨在研究PRP胶处理对CNSP后大鼠EF和CN保存的影响。
方法：前列腺切除术后，雄性Sprague-Dawley大鼠用PRP胶治疗，ICPRP进样,或他们的组合。海绵体内压（ICP），平均动脉压(MAP),4周后评估大鼠的CN保存状态。结果用组织学证实，免疫荧光，和透射电子显微镜。
结果：与CNSP大鼠（最大ICP与MAP的比率（0.33±0.04））相比，PRP胶处理的大鼠显示出100％的CN保留和ICP响应（最大ICP与MAP的比率（0.79±0.09））。PRP胶也显著增加了神经丝-1的表达，表明其对CN的积极影响。此外，该治疗显着增加了α-平滑肌肌动蛋白的表达。电子显微照片显示，PRP胶保留了有髓鞘的轴突，并通过维持粘附连接来防止了体部平滑肌的萎缩。
结论：这些结果表明，PRP胶是可能接受保留神经的根治性前列腺切除术的前列腺癌患者通过神经保护保护EF的潜在解决方案。
