Morphologic changes in the arterial bed of the penis with aging. Relationship to the pathogenesis of impotence

The arterial vascular bed of the penis has been studied histologically in postmortem material from 30 males in the age range 19 to 85 years, mean 57. Fifteen of these propositi had had diabetes mellitus of average duration of 13 years. In all males more than 38 years old, there was fibrous substitution of the longitudinal smooth muscle in the Ebner pads. Later this was complemented by fibrous proliferation of the intima, medial fibrosis, calcification, and narrowing of the lumen to obilteration from thrombi. The extent of the pathology was apparently related to both age and diabetes mellitus. The nature and extent of the changes indicate that they must necessarily lead to a limitation of the basic function of this arterial tree, i.e., to increase essentially the flow of blood to the cavernous bodies at the time of the erection. These changes can play a decisive role in explaining impotence that occurs with aging, particularly in diabetics.