Radiotekhnika
Publishing house Radiotekhnika

"Publishing house Radiotekhnika":
scientific and technical literature.
Books and journals of publishing houses: IPRZHR, RS-PRESS, SCIENCE-PRESS


Тел.: +7 (495) 625-9241

 

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

DOI 10.18127/j20700997-201903-03

Keywords:

A.N. Strelkov –
Ph.D. (Med.) – Urologist, Regional Clinical Hospital (Ryazan)
E-mail: anstrel11@yandex.ru
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)
E-mail: afastra@mail.ru
A.I. Ulitenko –
Dr Sc. (Eng.), Professor, Industrial Electronics Department, Ryazan State Radioengineering University
E-mail: aleksandrulitenko@yandex.ru


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.

References:
  1. Pushkar' D.YU., Kamalov A.A., Al'-SHukri S.H., Еrkovich A.A., Kogan M.I., Pavlov V.N., ZHuravlev V.N., Bernikov A.N. Analiz rezul'tatov epidemiologicheskogo issledovaniya rasprostranennosti erektil'noj disfunkcii v Rossijskoj Federacii // Urologiya. 2012. № 6. S. 5–9.
  2. Hallanzy J., Kron M., Goethe V.E., Kohn F.M., Schmautz M., Arsov C., Hadaschik B., Imkamp F., Gschwend J.E., Herkommer K. Erectile dysfunction in 45-year-old heterosexual german men and associated lifestyle risk factors and comorbidities: results from the German Male Sex Study // Sex. Med. 2019. Jan 9. [Internet]. pii: S2050-1161(18)30114-4. DOI: 10.1016/j.esxm.2018.11.004.
  3. Braun M., Wassmer G., Klotz T., Reifenrath B., Mathers M., Engelmann U. Epidemiology of erectile dysfunction: results of the «Cologne Male Survey» // Int. J. Impot. Res. 2000.V. 12(6). P. 305–311.
  4. Wespes E. The agening penis // World J. Urology. 2002. V. 20. P. 36–39.
  5. Quilter M., Hodges L., Hurst P., Borman B., Coad J. Male sexual function in New Zealand: A population-based cross-sectional survey of the prevalence of erectile dysfunction in men aged 40 – 70 years // J. Sex. Med. 2017. V. 14(7). P. 928–936.
  6. Strazhesko I.D., Tkacheva O.N. Kletochnye mekhanizmy morfologicheskih i funkcional'nyh izmenenij arterial'noj stenki s vozrastom i rol' terapii statinami v ih profilaktike // Kardiologiya. 2015. № 7. S.89–96.
  7. Prezioso D., Iacono F., Russo U., Romeo G., Ruffo A., Russo N., Illiano E. Evaluation of penile cavernosal artery intima-media thickness in patients with erectile dysfunction. A new parameter in the diagnosis of vascular erectile dysfunction. Our experience on 59 cases // Arch. Ital. Urol. Androl. 2014. V. 86(1). P. 9–14.
  8. Shafik A., Shafik I., Sibai O.E., Shafik A.A. On the pathogenesis of penile venous leakage: role of the tunica albuginea // B.M.C. Urol. 2007.V. 7. P. 1471–1485.
  9. Shafik A., Shafik A.I., Sibai O.E., Shafik A.A. Electrophysiologic activity of the tunica albuginea and corpora cavernosa: possible role of tunica albuginea in the erectile mechanism // J. Sex. Med. 2007. V. 4. P. 675–679.
  10. Ulitenko A.I., Strelkov A.N. Matematicheskoe opisanie vozrastnyh izmenenij uprugih svojstv biologicheskih tkanej // Tekhnologii zhivyh sistem. 2016. T.13. № 2. S.60–64.
  11. Ulitenko A.I., Strelkov A.N. Vozrastnye izmeneniya uprugosti kavernoznyh arterij // Biomedicinskaya radioelektronika. 2016. № 6. S. 65–69.
  12. Strelkov A.N., Ulitenko A.I. Vozrastnaya dinamika uprugosti glubokoj dorsal'noj veny polovogo chlena cheloveka po dannym pryamyh izmerenij // Rossijskij mediko-biologicheskij vestnik im. akad. I.P. Pavlova. 2018. T. 26. № 2. S. 238–244. DOI:10.23888/PAVLOVJ2018262238-244.
  13. Patent № 2670434 (RF). Sposob opredeleniya uprugosti biologicheskih tkanej / A.N. Strelkov, A.I. Ulitenko.
  14. Karo K., Pedli T., SHroter R., Sid U. Mekhanika krovoobrashcheniya. M.: Mir. 1981. 624 s.
  15. Iacono F., Prezioso D., Chierchia S., Galasso R., Iapicca G., Martino M. Cavernous body reduction in four patients with erectile dysfunction due to insufficient venous occlusion and a deficit of elastic fibers in the tunica albuginea // International Braz. J. Urol. 2007.V. 33(6). P. 785–794.
  16. Austoni E., red. Atlas po rekonstruktivnoj hirurgii polovogo chlena. M.: ID «ABV-press». 2012. 563 s.
  17. Inci E., Turkay R., Nalbant M.O., Yenice M.G. The value of shear wave elastography in the quantification of corpus cavernosum penis rigidity and its alteration with age // Eur. J. Radiol. 2017. V. 89(4). P. 106–110.
  18. Turkay R., Inci E., Yenice M.G., Tugcu V. Shear wave elastography: Can it be a new radiologic approach for the diagnosis of erectile dysfunction? // Ultrasound. 2017. V. 25. P. 150–155. DOI:10.1177/1742271X17697512.
  19. Kelly D.A. Penises as variable-volume hydrostatic skeletons // Ann. N.Y. Acad. Sci. 2007. V. 1101. P. 453–463.
  20. Klimachev V.V., Nejmark A.I., Gerval'd V.YA., Bobrov I.P., Avdalyan A.M., Myadelec M.N., Muzalevskaya H.I., Gerval'd I.V., Aliev P.T., Kazymov M.A. Osobennosti izmeneniya elasticheskih volokon polovogo chlena u pacientov s erektil'noj disfunkciej i bolezn'yu Pejroni // Rossijskij mediko-biologicheskij vestnik im. akad. I.P. Pavlova. 2010. № 1. S.12–17.

© Издательство «РАДИОТЕХНИКА», 2004-2017            Тел.: (495) 625-9241                   Designed by [SWAP]Studio