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Chew L, Chang C, Simhan J. Climacturia: what treatment options do we offer to those with and without concomitant erectile dysfunction? Int J Impot Res 2023; 35:634-638. [PMID: 37161059 DOI: 10.1038/s41443-023-00714-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/18/2023] [Accepted: 04/26/2023] [Indexed: 05/11/2023]
Abstract
Radical prostatectomy for prostate cancer carries many sequelae, including climacturia, which is not commonly discussed and often under-recognized. To better understand treatment options for incontinence and climacturia, as well as those at time of penile implantation surgery, we completed a comprehensive literature review to identify nonoperative and operative treatments for patients with climacturia alone and those with concomitant climacturia and erectile dysfunction. Nonoperative interventions include behavioral modifications, physical therapy, and tension loops. Operative interventions include the artificial urinary sphincter, male urethral slings, Mini-Jupette sling, and a periurethral prosthesis. We also explore options that can be offered to patients who are also in need of penile prosthesis for concomitant erectile dysfunction. Contemporary work suggests that synchronous implantation of certain devices to treat both climacturia and erectile dysfunction can be done with proven safety and efficacy.
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Affiliation(s)
- Lauren Chew
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Chrystal Chang
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Jay Simhan
- Department of Urology, Fox Chase Cancer Center, Philadelphia, PA, USA.
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Zheng T, Shi X, Nie S, Yin L, Zhu J, Yu E, Shen H, Mo F. Effects of Chinese herbal diet on hematopoiesis, immunity, and intestines of mice exposed to different doses of radiation. Heliyon 2023; 9:e15473. [PMID: 37131450 PMCID: PMC10149268 DOI: 10.1016/j.heliyon.2023.e15473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/20/2023] [Accepted: 04/11/2023] [Indexed: 05/04/2023] Open
Abstract
Radiotherapy causes a series of side effects in patients with malignant tumors. Polygonati Rhizoma, Achyranthis Bidentatae Radix, and Epimedii Folium are all traditional Chinese herbs with varieties of functions such as anti-radiation and immune regulation. In this study, the above three herbs were used as a herbal diet to study their effects on the hematopoietic, immune, and intestinal systems of mice exposed to three doses of radiation. Our study showed that the diet had no radiation-protective effect on the hematopoietic and immune systems. However, at the radiation dose of 4 Gy and 8 Gy, the diet showed an obvious radiation-protective effect on intestinal crypts. At the dose of 8 Gy, we also found that the Chinese herbal diet had an anti-radiation effect on reducing the loss of the inhibitory nNOS+ neurons in the intestine. That provides a new diet for relieving the symptoms of hyperperistalsis and diarrhea in patients after radiotherapy.
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Affiliation(s)
- Tianyu Zheng
- Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Xiaohui Shi
- Department of Colorectal Surgery, The First Affiliated Hospital of Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Shuang Nie
- Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Lifeng Yin
- Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Jian Zhu
- Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Enda Yu
- Department of Colorectal Surgery, The First Affiliated Hospital of Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
| | - Hui Shen
- Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
- Corresponding author. Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Rd, Shanghai 200433, China.
| | - Fengfeng Mo
- Department of Colorectal Surgery, The First Affiliated Hospital of Naval Medical University, 800 Xiangyin Road, Shanghai 200433, China
- Corresponding author. Department of Naval Nutrition and Food Hygiene, Faculty of Naval Medicine, Naval Medical University, 800 Xiangyin Rd, Shanghai 200433, China.
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Pallas WD, Pak ES, Hannan JL. In vitro high glucose increases apoptosis, decreases nerve outgrowth, and promotes survival of sympathetic pelvic neurons. Sex Med 2023; 11:qfac009. [PMID: 37007853 PMCID: PMC10065172 DOI: 10.1093/sexmed/qfac009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/14/2022] [Accepted: 10/30/2022] [Indexed: 02/04/2023] Open
Abstract
Abstract
Background
Diabetes mellitus (DM) is a common cause of erectile dysfunction (ED), yet the molecular basis of DM neurogenic ED remains unknown.
Aim
In this study we examined the impact of high glucose on survival and growth of primary cultured pelvic neurons in a rat model and assessed whether coculturing with healthy Schwann cells (SCs) can rescue pelvic neuron growth in patients with DM.
Methods
Major pelvic ganglia (MPGs) from adult male Sprague Dawley rats (n = 8) were dissociated and plated on coverslips. Neurons were exposed to high glucose (45 mM) for 24 or 48 hours and compared to time-matched controls (25 mM). Neurons were stained for neuron-specific beta-tubulin, neuronal nitric oxide synthase, vesicular acetylcholine transferase, tyrosine hydroxylase, and TUNEL (terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick-end labeling) assay. Schwann cells were dissociated from MPGs of healthy male Sprague Dawley rats (n = 4) and grown to confluence. Additional Sprague Dawley rats were made diabetic with streptozotocin (50 mg/kg, n = 4), and 5 weeks later MPGs were collected from these rats, dissociated, and cocultured on healthy SCs. Neurons and SCs were stained with beta-tubulin and S100.
Outcomes
Length, branching, and survival of nitrergic, parasympathetic, and sympathetic neurons was assessed in neurons exposed to normal or high glucose concentrations, and neuron length was measured in neuron-SC coculture.
Results
The total number of neurons and the length and number of branches were significantly decreased after 24 and 48 hours of high glucose (P < .05). The percentage of nitrergic neurons decreased 10% after 24 hours and 50% after 48 hours of high glucose (P < .05). After 24 hours of high glucose, cholinergic-positive neurons were unchanged; however, these neurons decreased 30% after 48 hours (P < .05). The proportion of sympathetic neurons increased 25% after 48 hours of high glucose (P < .05). At both timepoints, there was a 2-fold increase in the total apoptotic neurons with high glucose (P < .05). Neurite outgrowth recovered to control lengths after coculture of diabetic neurons with healthy SCs (P < .05).
Clinical Translation
Glucose can be used as a tool to investigate the direct effects of DM on neuritogenesis. Our data suggest that an effective treatment for DM ED protects and repairs the penile neuronal supply.
Strengths and Limitations
Exposing MPG neurons to high glucose offers a quick and, inexpensive proxy for DM-related conditions. A limitation of our study is that our model reflects type 1 DM, whereas clinically, most diabetic ED patients have type 2 DM.
Conclusion
Culturing pelvic neurons in high glucose can be used as a tool to elucidate how to protect proerectile neurons from cell death and may lead to new therapeutic strategies for diabetic men suffering from ED.
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Affiliation(s)
- Wrenn D Pallas
- Department of Physiology, Brody School of Medicine at East Carolina University , Greenville, NC , United States
| | - Elena S Pak
- Department of Physiology, Brody School of Medicine at East Carolina University , Greenville, NC , United States
| | - Johanna L Hannan
- Department of Physiology, Brody School of Medicine at East Carolina University , Greenville, NC , United States
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Randolph JT, Pak ES, McMains JC, Koontz BF, Hannan JL. Cocultured Schwann Cells Rescue Irradiated Pelvic Neuron Outgrowth and Increase Survival. J Sex Med 2022; 19:1333-1342. [DOI: 10.1016/j.jsxm.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 05/13/2022] [Accepted: 06/11/2022] [Indexed: 10/17/2022]
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Guo HM, Zhang Y, Zhang Y, Jiao PF, Fan XC, Kong CL, Wang T, Li XX, Zhang HW, Zhang LR, Ma MY, Bu HL. Spinal Ninjurin2 contributes to the neuropathic pain via NF-κB-mediated neuroinflammation in the spared sciatic nerve injury rats. Int Immunopharmacol 2021; 99:107918. [PMID: 34320458 DOI: 10.1016/j.intimp.2021.107918] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 06/09/2021] [Accepted: 06/21/2021] [Indexed: 12/12/2022]
Abstract
OBJECT Ninjurin2 (nerve injury induced protein 2, NINJ2) is a molecule which mediates cell-to-cell and cell-to-extracellular matrix interactions in the nervous system. Clinical study shows NINJ2 is associated with the development of postherpetic neuralgia. However, it is lack of direct evidence that NINJ2 participated in neuropathic pain. In this study, we aim to investigate the role of NINJ2 in the development of neuropathic pain in spared sciatic nerve injury rats and the underlying mechanism. METHOD Spared sciatic nerve injury (SNI) models were established. The level of NINJ2 and p-p65 (a NF-κB family member) were measured in SNI rats by western blots and immunofluorescent staining. Lentivirus encoding small interfering RNA targeting NINJ2 (RNAi) was intrathecally injected into rats. Then the change of pain behavior of rats induced by NINJ2 RNAi was tested by Von-Frey hairs. The change of p-p65 in the spinal cord in rats after NINJ2 RNAi treatment was also measured by western blots. inhibitor of p-p65-induced change of TNF-α, IL-1β, and IL-6 levels were measured by ELISA. RESULTS NINJ2 and p-p65 were increased in the spinal cord of SNI rats on the 3, 7, 14th days after modeling. NINJ2 were mainly expressed in neurons, and co-located with p-p65 in the spinal dorsal horn. When down regulating the level of NINJ2 by RNAi, the development of pain in SNI rats was partially blocked. Phosphorylation of p65 was also inhibited by NINJ2 RNAi. Blocking the phosphorylation of NF-κB pathway could inhibit the increase of TNF-α, IL-1β, and IL-6 in the spinal cord of SNI rats. CONCLUSION NINJ2 protein was increased in the spinal cord of SNI rats. It participated in the development of nerve injury-induced neuropathic pain by activating neuroinflammation in the spinal cord via NF-κB pathway. This study provides a new target to investigate the mechanism of neuropathic pain.
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Affiliation(s)
- Hai-Ming Guo
- Department of Anesthesiology, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Yu Zhang
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China; Department of Anesthesiology, the Third Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Yan Zhang
- Department of Pain Management, Institute of Anesthesiology and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430000 Wuhan, China
| | - Peng-Fei Jiao
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Xiao-Chong Fan
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Cun-Long Kong
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Tao Wang
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Xin-Xin Li
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China
| | - Hong-Wei Zhang
- School of Basic Medical Sciences, Zhengzhou University, 450000 Zhengzhou, China
| | - Li-Rong Zhang
- School of Basic Medical Sciences, Zhengzhou University, 450000 Zhengzhou, China
| | - Min-Yu Ma
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China.
| | - Hui-Lian Bu
- Department of Pain Management, the First Affiliated Hospital of Zhengzhou University, 450052 Zhengzhou, China.
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Turner AC, Powers SA, Odom MR, Pak ES, Ashcraft KA, Koontz BF, Hannan JL. Impact of prostatic radiation therapy on bladder contractility and innervation. Neurourol Urodyn 2021; 40:1470-1478. [PMID: 34015163 DOI: 10.1002/nau.24705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/03/2021] [Accepted: 05/06/2021] [Indexed: 11/10/2022]
Abstract
AIMS To determine the effect of prostatic radiation therapy (RT) on bladder contractility and morphology, and axon, or neuron profiles within the detrusor and major pelvic ganglia (MPG) in male rats. METHODS Male Sprague-Dawley rats (8 weeks) received a single dose of prostatic RT (0 or 22 Gy). Bladders and MPG were collected 2- and 10-weeks post-RT. Detrusor contractile responses to carbachol and electrical field stimulation (EFS) were measured. Bladders were stained with Masson's trichrome, and antibodies for nonspecific neuronal marker, cholinergic nerve marker choline acetyltransferase (ChAT), and alpha-smooth muscle actin. MPG gene expression was assessed by quantitative polymerase chain reaction for ubiquitin carboxy-terminal hydrolase L1 (Uchl1) and Chat. RESULTS At 2 weeks post-RT, bladder smooth muscle, detrusor cholinergic axon profiles, and MPG Chat gene expression were increased (p < .05), while carbachol and EFS-mediated contractions were decreased (p < .05). In contrast, at 10 weeks post-RT, nerve-mediated contractions were increased compared with control (p < .05), while bladder smooth muscle, detrusor cholinergic axon profiles, MPG Chat expression, and carbachol contractions had normalized. At both 2- and 10-weeks post-RT, there was no change in detrusor nonspecific axon profiles and MPG Uchl1 expression. CONCLUSION In a rat model, RT of the prostate and MPG was associated with early changes in MPG Chat gene expression, and bladder cholinergic axon profiles and smooth muscle content which resolved over time. After RT recovery, bladder contractility decreased early and increased by 10 weeks. Long-term changes to the MPG and increased bladder cholinergic axons may contribute to RT-induced bladder dysfunction in prostate cancer survivors.
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Affiliation(s)
- Alexander C Turner
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Shelby A Powers
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.,Department of Psychiatry & Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Michael R Odom
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.,Division of Urology, Department of Surgery, Duke University, Durham, North Carolina, USA
| | - Elena S Pak
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Kathleen A Ashcraft
- Department of Radiation Oncology, Duke University, Durham, North Carolina, USA
| | - Bridget F Koontz
- Department of Radiation Oncology, Duke University, Durham, North Carolina, USA
| | - Johanna L Hannan
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
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Activation of the Hedgehog Pathway Promotes Recovery of Neurological Function After Traumatic Brain Injury by Protecting the Neurovascular Unit. Transl Stroke Res 2020; 11:720-733. [DOI: 10.1007/s12975-019-00771-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 12/06/2019] [Accepted: 12/09/2019] [Indexed: 01/01/2023]
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