Pre-emptive Use of Riboflavin in a Rat Model of Bilateral Cavernous Nerve Injury/Bilateral Kavernozal Sinir Hasari Sican Modelinde Preemptif Riboflavin Tedavisinin Etkileri

• Published in: Journal of urological surgery Vol. 5; no. 2; p. 98
• Main Authors: Tavukcu, Hasan Huseyin, Sener, Tarik Emre, Albayrak, Omercan, Cevik, Ozge, Ersahin, Mehmet, Cetinel, Sule, Bulbul, Nurdan, Sener, Goksel
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2018
• Subjects: Diagnosis; Prostate cancer; Prostatectomy; Riboflavin
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.1909

Objective: Erectile dysfunction is commonly encountered after radical prostatectomy due to cavernous nerve injury (CNI). We investigated the effects of riboflavin (Rb) on bilateral CNI in a rat model. Materials and Methods: Twenty-four male rats were divided into four groups: control (C), patients with bilateral CNI, those with CNI receiving postoperative Rb treatment (CNI+Rb), and those with CNI receiving pre- and post-operative Rb treatment (Rb+CNI+Rb). Bilateral CNI was performed in all groups except for C. The CNI+Rb group was treated with 30 mg/kg Rb daily after CNI for two weeks; the Rb+CNI+Rb group was treated with 30 mg/kg Rb daily one week before CNI and then for two weeks after injury. Mean arterial pressure (MAP) and intracavernosal pressure (ICP) were measured 14 days after CNI in all groups. Tissue malondialdehyde, cyclic guanosine monophosphate, nerve growth factor, superoxide dismutase and total nitric oxide synthase (NOS) activities, neuronal NOS (nNOS) and inducible NOS (iNOS) were analyzed. Results: ICP/MAP ratio was significantly lower in the CNI (p<0.01) and CNI+Rb groups (p<0.05) compared to the control group, however, the Rb+CNI+Rb group had results comparable to the C group in terms of nNOS and iNOS expression in the Western Blot analysis. Conclusion: Rb exerted anti-oxidative and anti-inflammatory effects on CNI in a CNI rat model. Rb can be a potential beneficial agent to improve erectile function in nerve-sparing radical prostatectomy patients as a preemptive penile rehabilitation strategy, although further clinical studies are needed. Keywords: Cavernous nerve injury, Erectile dysfunction, Oxidative stress, Riboflavin Amaç: Çalismamizin amaci radikal prostatektomi modelinde erektil disfonksiyon tedavisinde riboflavinin (Rb) olasi etkilerinin arastirilmasidir. Gereç ve Yöntem: Yirmi dört erkek siçan kontrol (K), bilateral kavernoz sinir hasari (KSH), KSH+Rb ve Rb +KSH+ Rb olmak üzere 4 gruba ayrildi. Ön-tedavili KSH grubunda cerrahiden 1 hafta önce baslayarak toplam 3 hafta ve KSH+Rb grubuna ise cerrahiden sonra 2 hafta süreyle 30 mg/kg dozunda Rb uygulandi. Deney sonunda intrakavernosal basinç (IKB) ve ortalama arteryel basinç (OAB) ölçümü yapildi. Kavernoz doku örneklerinde malondialdehit (MDA), siklik guanozin monofosfat (c-GMP) ve sinir büyüme faktörü (NGF) düzeyleri ile süperoksid dismutaz (SOD) ve total nitrik oksit sentaz (NOS) aktiviteleri ölçüldü. Dokularin indüklenebilir NOS ve nöronal NOS protein ekspresyonlari Western blot yöntemi ile tayin edildi. Bulgular: KSH, IKB/OAB degerlerinde anlamli azalmaya (p<0.01) neden olurken preemptif Rb tedavili grupta bu degerler kontrol grubu degerlerine yaklasmis olarak bulundu. KSH grubunda doku MDA düzeylerinin ve NOS aktivitesinin anlamli olarak arttigi, c-GMP ve NGF düzeyleri ile SOD aktivitesinin anlamli olarak azaldigi belirlendi. KSH sonrasi uygulanan Rb tedavisi bu parametrelerdeki degisimleri geri çevirirken preemptif Rb tedavili gruplarda bu degerler kontrol gruba benzer düzeylere geldi. Sonuç: Çalismamizda Rb, hasarli kavernoz dokuda antioksidan ve anti-enflamatuvar etki göstermis ve böylece dokuyu koruyarak erektil fonksiyon kaybinda iyilesme göstermistir. Özellikle preemptif Rb kullaniminin faydali bir tedavi yaklasimi saglayabilecegini düsündürmekte olup insan çalismalariyla bu yaklasim desteklenebilir. Anahtar kelimeler: Kavernoz sinir hasari, Erektil disfonksiyon, Oksidatif stres, Riboflavin