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Dysfunctional penile cholinergic nerves in diabetic impotent men.
R Blanco1, I Saenz de Tejada, I Goldstein
1Department of Urology, Boston University School of Medicine, Massachusetts.
The Journal of Urology
|August 1, 1990
Summary
Diabetic men with impotence show impaired penile nerve function. This study found reduced acetylcholine synthesis in diabetic patients, suggesting nerve damage contributes to erectile dysfunction.
Area of Science:
- Urology
- Endocrinology
- Neuroscience
Background:
- Erectile dysfunction (ED) is a common complication in diabetic men.
- Autonomic neuropathy affecting penile nerves is a suspected cause of ED in diabetes.
Purpose of the Study:
- To investigate the functional status of penile cholinergic nerves in impotent diabetic men.
- To correlate nerve function with diabetes duration and type.
Main Methods:
- Human corporeal tissue was obtained from 19 impotent diabetic and 15 non-diabetic patients undergoing penile prosthesis implantation.
- The ability of penile cholinergic nerves to accumulate tritiated choline and synthesize/release tritiated-acetylcholine was assessed.
- Sensory vibration perception threshold testing was performed.
Main Results:
- Tritiated-choline accumulation and tritiated-acetylcholine synthesis/release were significantly reduced in diabetic patients compared to controls (p < 0.05).
- Impaired acetylcholine synthesis correlated with longer diabetes duration (p < 0.025).
- No differences were observed between insulin-dependent and non-insulin-dependent diabetic patients.
- Clinical tests like vibration perception threshold could not predict cholinergic nerve function.
Conclusions:
- Diabetic impotence is associated with a functional neuropathic condition of penile cholinergic nerves in the corpus cavernosum.
- This impairment in acetylcholine synthesis may be a primary cause of erectile dysfunction in diabetic men.
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