Radial type low-intensity extracorporeal shockwave therapy (li-eswt) as novel therapy to enhance microcirculation in aging rat penis

You have accessJournal of UrologyCME1 Apr 2023MP27-08 RADIAL TYPE LOW-INTENSITY EXTRACORPOREAL SHOCKWAVE THERAPY (LI-ESWT) AS NOVEL THERAPY TO ENHANCE MICROCIRCULATION IN AGING RAT PENIS Saager Chawla, Yong Sun Choi, Bae Woongjin, Samuel Sorkhi, Jae Hak Jeong, Tung-Chin Hsieh, and M. Raj Rajasekaran Saager ChawlaSaager Chawla More articles by this author , Yong Sun ChoiYong Sun Choi More articles by this author , Bae WoongjinBae Woongjin More articles by this author , Samuel SorkhiSamuel Sorkhi More articles by this author , Jae Hak JeongJae Hak Jeong More articles by this author , Tung-Chin HsiehTung-Chin Hsieh More articles by this author , and M. Raj RajasekaranM. Raj Rajasekaran More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003255.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Physiological aging is associated with the impairment of microvascular function in several organs, including the penis. Low-intensity extracorporeal shock-wave therapy (Li-ESWT) is a non-invasive intervention for the restoration of the pathological alterations of penile tissue. However, the effect of ESWT on penile microvascular function is still unclear. In addition, most previous studies have employed focused ESWT, which is known to target deeper organs, while radial ESWT is more superficial. Thus, our objective is to evaluate the effect of radial type Li-ESWT (targeting superficial penile tissue) on microvascular perfusion (MVP) in an aging rat model and elucidate a possible mechanism of action. METHODS: We anesthetized male rats (n=5; age 15-18 months) and subjected them to radial type Li-ESWT (Fig A-C) while monitoring penile hemodynamics via Laser Speckle Contrast imaging techniques immediately before and after Li-ESWT. The penile shaft was positioned beneath the ESWT applicator (HNT MEDICAL Co., Ltd, Seoul, Korea; Fig B). A level 1 intensity (L1i) (0.12 mJ/mm2) ESWT session for 500 counts at 120 HZ (Fig C) was chosen to increase blood penile microvascular perfusion (PMP). Baseline and peak PMP was assessed by the PeriCam PSI system (Perimed AB, Järfälla, Sweden). This technique quantifies PMP in arbitrary perfusion units (AU) and displays a real-time perfusion image. To assess the involvement of the nitric oxide (NO) pathway, an intracavernosal injection of L-NAME (NO synthase inhibitor) was given [200 µg/kg], and the response to ESWT was recorded again after 15 minutes. RESULTS: ESWT produced a 2-fold increase in PMP (mean±SEM) from baseline (68.456±9.021 AU) to max (163.742±11.787 AU). In addition, the L-NAME injection (n=4) resulted in a ∼40-50% decrease (from 185.293±20.604 AU to 101.008±13.077 AU) in ESWT-induced MVP response. CONCLUSIONS: Our results suggest ESWT is a novel, non-invasive intervention to improve penile circulation and treat erectile and sexual dysfunction following cancer treatment, possibly by improving penile hemodynamics and preventing penile hypoxia and fibrosis. Our findings suggest that the Li-ESWT-induced increase in MVP is mediated by the NO pathway, and future studies are warranted to confirm its efficacy in human subjects. Source of Funding: UCSD Academic Senate © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e365 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Saager Chawla More articles by this author Yong Sun Choi More articles by this author Bae Woongjin More articles by this author Samuel Sorkhi More articles by this author Jae Hak Jeong More articles by this author Tung-Chin Hsieh More articles by this author M. Raj Rajasekaran More articles by this author Expand All Advertisement PDF downloadLoading ...