摘要
尽管有神经保留技术,在根治性前列腺切除术后,由于在手术过程中的海绵体神经的神经失用症,勃起功能障碍仍然可以普遍观察到。在进行根治性前列腺切除术后的勃起功能的保存和复原仍然具有挑战性,许多男性在临床实践中仍然保持当前的治疗方法。本文中我们提供了一个关于出现在根治性前列腺切除术中的神经损伤的病理生理学的全面的综述,且描述了旨在加强神经保护作用和为了一高勃起功能恢复的海绵体神经的复原性的不同的策略。这些策略包括免疫调节,神经营养,生长因子和干细胞疗法已经令人信服地证明了在大鼠海绵体神经损伤后动物模型中可以改善勃起功能和复原。此外我们对通过PDE5i使阴茎康复神经复苏的观点的基本原理进行了描述。当将这些策略从临床前模型转换到临床实际使,其中许多这些策略综述具有潜在的优化在进行根治性前列腺切除术后的勃起功能的复原。
关键词: 海绵体神经损伤,勃起功能障碍,免疫调节,神经移植,神经生长因子,神经调节,PDE5抑制剂,根治性前列腺切除术
Current Drug Targets
Title:Molecular Pathophysiology of Cavernous Nerve Injury and Identification of Strategies for Nerve Function Recovery After Radical Prostatectomy
Volume: 16 Issue: 5
Author(s): Emmanuel Weyne, John Mulhall and Maarten Albersen
Affiliation:
关键词: 海绵体神经损伤,勃起功能障碍,免疫调节,神经移植,神经生长因子,神经调节,PDE5抑制剂,根治性前列腺切除术
摘要: Despite nerve-sparing techniques, erectile dysfunction remains commonly observed after radical prostatectomy due to neuropraxia to the cavernous nerves during surgery. Preservation and rehabilitation of erectile function after radical prostatectomy remains challenging and many men stay undertreated with the current armory of therapies available in clinical practice. In this article we provide a comprehensive overview of the pathophysiology of the nerve injury occurring during radical prostatectomy and describe different strategies aimed at enhancing neuroprotection and regeneration of the cavernous nerves in order to improve erectile function recovery. These strategies include immunomodulatory, neurotrophic, growth factor and stem cell therapy have convincingly shown improved erectile function and recovery in rat animal models after cavernous nerve injury. Furthermore we describe the rationale for penile rehabilitation with PDE5i out of a neuronal recovery point of view. Many of these strategies reviewed have the potential to optimize erectile function recovery after radical prostatectomy when translated from pre-clinical models to clinical practice.
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Cite this article as:
Emmanuel Weyne, John Mulhall and Maarten Albersen , Molecular Pathophysiology of Cavernous Nerve Injury and Identification of Strategies for Nerve Function Recovery After Radical Prostatectomy, Current Drug Targets 2015; 16 (5) . https://dx.doi.org/10.2174/1389450116666150316224456
DOI https://dx.doi.org/10.2174/1389450116666150316224456 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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