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• W2009156392 abstract "No AccessJournal of UrologyInvestigative Urology1 Feb 1995Hemodynamics of Penile Erection: III. Measurement of Deep Intracavernosal and Subtunical Blood Flow and Oxygen Tension Kazem M. Azadzoi, John Vlachiotis, Michel Pontari, and Mike B. Siroky Kazem M. AzadzoiKazem M. Azadzoi More articles by this author , John VlachiotisJohn Vlachiotis More articles by this author , Michel PontariMichel Pontari More articles by this author , and Mike B. SirokyMike B. Siroky More articles by this author View All Author Informationhttps://doi.org/10.1097/00005392-199502000-00075AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Previous studies have shown that intracavernosal blood flow increases during penile erection, but little is known about intracavernosal hemodynamics. Using a previously developed canine model of erection, we measured intracavernosal blood flow and oxygen tension at 2 sites within the corpus cavernosum: directly beneath the tunica albuginea and deep within the cavernous tissue. We chose to measure oxygen tension as an indicator of arterial blood flow. Penile erection was induced by pelvic nerve stimulation as well as by injection of papaverine and phentolamine. In the flaccid penis, blood flow measured directly under the tunica albuginea was significantly higher than deep intracavernosal blood flow. Subtunical oxygen tension in the flaccid penis was consistent with a largely arterial circulation. These observations provide physiological evidence of an important subtunical circulation that carries most of the intracavernosal blood flow when the penis is flaccid. With pelvic nerve stimulation, deep intracavernosal blood flow increased significantly followed by an increase in oxygen tension. Oxygen tension deep within the corpus cavernosum increased during penile erection from a level consistent with venous blood to a level consistent with arterial blood. Injection of papaverine and phentolamine caused a significant increase in intracavernosal pressure and a significant decrease in subtunical blood flow but did not cause statistically significant change in intracavernosal blood flow or oxygen tension. In contrast to nerve-induced erection, pharmacologically induced erection appears to depend more on intracavernosal shunting of blood than on increased total arterial blood flow to the penis. Hypogastric nerve stimulation during established erection caused detumescence by contracting cavernosal smooth muscle, reducing deep cavernosal blood flow and reestablishing blood flow through the subtunical space. Our observations suggest that the subtunical space contains an important circulation that may play a role in the hemodynamics of the flaccid, as well as the erect, penis. References 1 : Further evidence of venous outflow restriction during erection. Br. J. Urol.1986; 58: 320. Google Scholar 2 : Mechanism of venous occlusion during canine penile erection: an anatomic demonstration. J. Urol.1987; 137: 163. Link, Google Scholar 3 : Hemodynamics of canine penile erection: direct measurement of venous outflow. Surg. Forum1987; 38: 649. Google Scholar 4 : A canine model for hemodynamic study of isolated corpus cavernosum. J. Urol.1987; 138: 663. Link, Google Scholar 5 : Physiology of erection and pharmacological management of impotence. J. Urol.1987; 173: 829. Google Scholar 6 : Impotence. N. Engl. J. Med.1989; 321: 1648. Google Scholar 7 : Hemodynamics of pelvic nerve induced erection in a canine model. I. Pressure and flow. J. Urol.1990; 144: 794. Abstract, Google Scholar 8 : Hemodynamics of pelvic nerve induced erection in canine model. II. Cavernosal inflow and occlusion. J. Urol.1993; 149: 910. Link, Google Scholar 9 : In vivo evaluation of microcirculation by coherent light scattering. Nature1975; 254: 56. Google Scholar 10 : Two circulatory routes within the human corpus cavernosum: a scanning electron microscopic study of corrosion casts. J. Urol.1989; 142: 879. Abstract, Google Scholar 11 : Nitric oxide: a physiologic mediator of penile erection. Science1992; 257: 401. Crossref, Medline, Google Scholar 12 : Oxygen tension regulates the nitric oxide pathway: physiologic role in penile erection. J. Clin. Invest.1993; 91: 437. Google Scholar 13 : Characterization of rabbit corpus cavernosum in vitro. Surg. Forum1988; 39: 660. Google Scholar 14 : Regulation of adrenergic activity in penile corpus cavernosum. J. Urol.1989; 142: 1117. Google Scholar From the Boston University Medical Center and the Boston Veterans Affairs Medical Center, Boston, MassachusettsRequests for reprints: Department of Urology, B5-48, Boston VA Medical Center, 150 South Huntington Ave., Boston, Massachusetts 02130© 1995 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAzadzoi K, Park K, Andry C, Goldstein I and Siroky M (2018) Relationship Between Cavernosal Ischemia and Corporal Veno-Occlusive Dysfunction in an Animal ModelJournal of Urology, VOL. 157, NO. 3, (1011-1017), Online publication date: 1-Mar-1997.Azadzoi K, Siroky M and Goldstein I (2018) Study of Etiologic Relationship of Arterial Atherosclerosis to Corporal Veno-Occlusive Dysfunction in the RabbitJournal of Urology, VOL. 155, NO. 5, (1795-1800), Online publication date: 1-May-1996. Volume 153Issue 2February 1995Page: 521-526 Advertisement Copyright & Permissions© 1995 by American Urological Association, Inc.MetricsAuthor Information Kazem M. Azadzoi More articles by this author John Vlachiotis More articles by this author Michel Pontari More articles by this author Mike B. Siroky More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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