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Age-related morpho-functional changes of the tunica albuginea and blood vessels of the penis of a man

DOI 10.18127/j20700997-201903-03


A.N. Strelkov –
Ph.D. (Med.) – Urologist, Regional Clinical Hospital (Ryazan)
A.F. Astrakhantsev –
Dr.Sc. (Med.), Professor, Нead of Department of Pathological Anatomy, N.А.Semashko Central Clinical Hospital №2 of OJSC «Russian Railways» (Moscow)
A.I. Ulitenko –
Dr Sc. (Eng.), Professor, Industrial Electronics Department, Ryazan State Radioengineering University

The aim of the study is to quantify the elasticity of the tunica albuginea, cavernous artery and deep dorsal vein of the penis, to assess the age dynamics of elasticity, as well as the morphological study of these structures. Used direct experiment according to the original method with the subsequent mathematical processing. For morphological analysis we used hematoxylin and eosin staining, collagen fibers by Mallory method and elastic fibers by Weigert method, as well as immunohistochemical – Collagen IV, AR.
The decrease of elastic properties of the albumen and vessels of the penis both at rest and under functional load with increasing age was determined. In the age range of 18 – 83 years, there is a significant decrease in the elasticity of the tunica albuginea in the circular (transverse) by 2.21 times, in the longitudinal direction by 1.98 times. Elastic properties of cavernous arteries in the studied age range reduce by 1.29 times and deep dorsal vein by 1.25 times. A significant dependence of the elasticity of all types of samples on the applied force load is noted. At the same time, the main changes in its values fall on a relatively narrow range of the applied force 0…2∙106 N/м2, actually corresponding to physiological loads. Within these limits, the elasticity of the tunica albuginea with transverse and longitudinal orientation reduces by 2.8 times and 2.6 times in comparison with the rest state, respectively. The elasticity of veins and arteries decreases by 2.4 and 1.7 times, respectively.
Age-related changes in the structure of the tunica albuginea are in violation of the order of collagen fibers, the loss of their wave-like arrangement. The assumption about the replacement of Collagen type IV collagen fibers in the protein shell was not confirmed in our study. Collagen fibers of the tunica albuginea do not give a positive staining with antibodies to Collagen type IV in all age groups. At the same time, elastic fibers undergo lytic changes in the form of swelling, thinning, fragmentation of fibers. In the wall of the cavernous arteries with age, there is an increase in sclerotic processes, primarily due to the thickening of intima, the middle shell of the vascular wall, and to a lesser extent adventitia due to an increase in the number of collagen fibers and a decrease in the number of elastic fibers. Morphological manifestations of arteriosclerosis develop in the cavernous arteries, which is the reason for reducing the elasticity of the vessel with increasing age.
The morpho-functional state of the connective tissue cell elements of the tunica albuginea is controlled by testosterone-mediated regulation processes. There is a decrease in the level of expression of androgen receptors of cell elements of the tunica albuginea with increasing age.
Complex experimental and morphological study allowed to establish changes in the physical and structural characteristics of the tunica albuginea and cavernous arteries of the human penis with age. Along with other independent factors, the established regularities can be useful in terms of understanding the processes that cause an increase in the frequency of erectile dysfunction in elderly men.

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May 29, 2020

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