Effects of platelet-rich plasma glue placement at the prostatectomy site on erectile function restoration and cavernous nerve preservation in a nerve-sparing prostatectomy rat model

Chun-Hou Liao; Chi-Jen Chang; Kuo-Chiang Chen; Chellappan Praveen Rajneesh; Xiao-Wen Tseng; Jai-Hong Cheng; Han-Sun Chiang; Yi-No Wu

doi:10.1016/j.biopha.2023.114499

Effects of platelet-rich plasma glue placement at the prostatectomy site on erectile function restoration and cavernous nerve preservation in a nerve-sparing prostatectomy rat model

Biomed Pharmacother. 2023 May:161:114499. doi: 10.1016/j.biopha.2023.114499. Epub 2023 Mar 11.

Authors

Chun-Hou Liao¹, Chi-Jen Chang², Kuo-Chiang Chen³, Chellappan Praveen Rajneesh⁴, Xiao-Wen Tseng⁵, Jai-Hong Cheng⁶, Han-Sun Chiang⁷, Yi-No Wu⁸

Affiliations

¹ Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 231403, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
² School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Division of Pediatric Surgery, Shin Kong Wu Ho-Su Memorial Hospital, Taipei City 111045, Taiwan.
³ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Department of Urology, Cathay General Hospital, Taipei City 106438, Taiwan.
⁴ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
⁵ Program in Pharmaceutical Biotechnology, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan.
⁶ Center for Shockwave Medicine and Tissue Engineering, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; Department of Medical Research, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; Department of Leisure and Sports Management, Cheng Shiu University, Kaohsiung 83301, Taiwan.
⁷ Division of Urology, Department of Surgery, Cardinal Tien Hospital, New Taipei City 231403, Taiwan; Graduate Institute of Biomedical and Pharmaceutical Science, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan; Department of Urology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243089, Taiwan.
⁸ School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242062, Taiwan. Electronic address: 133838@mail.fju.edu.tw.

PMID: 36913891
DOI: 10.1016/j.biopha.2023.114499

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.

Aim: 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.

Keywords: Cavernous nerve; Erectile dysfunction; Intracavernous pressure; Neuroprotection; Platelet-rich plasma; Prostate cancer; Prostatectomy.

MeSH terms

Animals
Disease Models, Animal
Erectile Dysfunction* / etiology
Erectile Dysfunction* / prevention & control
Humans
Male
Penile Erection
Penis
Platelet-Rich Plasma*
Prostatectomy / adverse effects
Rats
Rats, Sprague-Dawley