This proposal is designed to study the neuroanatomy and physiology of penile erection in monkey and dog models. The information obtained will then be used for the prevention and treatment of impotence in humans by neurostimulation. Because of socioethical reasons, impotence remains to be one of the least understood human illnesses. The etiology, differential diagnosis and prevention of this unfortunate disease are largely speculative. Our years of experience with neurostimulation have enabled us to develop a monkey model for erection studies. Sustained and controllable erection responses could be obtained even months after implantation of electrodes around the cavernous nerves in these models. Animal models will be used for these studies. 1. Physiological studies will include measurement of arterial and venous flow as well as pressures in the aorta, pudendal artery, corpora cavernosa and corpus spongiosum, during various phases of erection. This will be supplemented by pharmacologic, radiographic, and metabolic studies. 2. Neuroanatomical studies will consist of: a. Horseradish peroxidase (HRP) transport technique for identification of the spinal afferent and efferent nuclei responsible for penil erection. b. Tracing of erection nerves from the pelvic plexus to the penis by neurostimulation and microdissection. 3. Anesthesia studies will be conducted to identify suitable anesthetic procedures which do not suppress stimulated erection response. Our preliminary studies showed that suppression by inhalation anesthesia was responsible for the failure of intra-operative identification of erection nerves by neurostimulation. Therefore, proper anesthesia is essential in the prevention of iatrogenic impotence. Based on the results of these studies, we plan to submit another grant application in 2-3 years. This future application will include: 1. An erection stimulation test for differential diagnosis. 2. Using intraoperative neurostimulation to prevent iatrogenic impotence. 3. An implantable erection stimulator.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD019640-03
Application #
3317055
Study Section
Reproductive Biology Study Section (REB)
Project Start
1984-12-01
Project End
1987-11-30
Budget Start
1986-12-01
Budget End
1987-11-30
Support Year
3
Fiscal Year
1987
Total Cost
Indirect Cost
Name
University of California San Francisco
Department
Type
Schools of Medicine
DUNS #
073133571
City
San Francisco
State
CA
Country
United States
Zip Code
94143
Trigo-Rocha, F; Aronson, W J; Hohenfellner, M et al. (1993) Nitric oxide and cGMP: mediators of pelvic nerve-stimulated erection in dogs. Am J Physiol 264:H419-22
Trigo-Rocha, F; Hsu, G L; Donatucci, C F et al. (1993) The role of cyclic adenosine monophosphate, cyclic guanosine monophosphate, endothelium and nonadrenergic, noncholinergic neurotransmission in canine penile erection. J Urol 149:872-7
Paick, J S; Donatucci, C F; Lue, T F (1993) Anatomy of cavernous nerves distal to prostate: microdissection study in adult male cadavers. Urology 42:145-9
Juenemann, K P; Lue, T F; Luo, J A et al. (1987) The effect of cigarette smoking on penile erection. J Urol 138:438-41
Juenemann, K P; Luo, J A; Lue, T F et al. (1986) Further evidence of venous outflow restriction during erection. Br J Urol 58:320-4
Juenemann, K P; Lue, T F; Fournier Jr, G R et al. (1986) Hemodynamics of papaverine- and phentolamine-induced penile erection. J Urol 136:158-61
Juenemann, K P; Lue, T F; Abozeid, M et al. (1986) Blood gas analysis in drug-induced penile erection. Urol Int 41:207-11