Penile atrophy

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As penis atrophy of neulateinisch atrophia = "wasting", "wasting", "degeneration", English penile atrophy , is referred to in medicine the pathological tissue atrophy ( atrophy ) of the penis.

Description and causes

In most cases, penile atrophy is hormonal. It can occur as a side effect, above all, during surgical castration ( orchiectomy ) or chemical castration for the treatment of prostate cancer .

Even with untreated erectile dysfunction (erectile dysfunction) after radical prostatectomy (complete removal of the prostate), penile atrophy is a common undesirable consequence. In these cases, penile atrophy is caused by tissue changes in the penis that occur immediately after the prostate is removed. The penile atrophy itself is caused by changes in the smooth muscles and fibrotic reactions in the penis.

Another possible cause of penile atrophy can be traumatic denervation (cutting of the nerve pathways in the penis). Denervation leads to apoptosis and fibrosis. In the model organism color rat apoptosis occurred 24 hours after the severing of the nerves cavernous (erectile nerve, cavernous nerves, Nervi erigentes ) on.

treatment

PDE-5 inhibitors , such as sildenafil , tadalafil or vardenafil , are the means of choice for rehabilitation measures after a radical prostatectomy, especially for erectile dysfunction. It is assumed that long-term therapy with these medicinal substances also improves the oxygen supply to the erectile tissue and thus counteracts penile atrophy. However, there are no evidence-based studies on this yet.

Individual evidence

  1. ↑ AM Traish, P. Toselli et al .: Adipocyte accumulation in penile corpus cavernosum of the orchiectomized rabbit: a potential mechanism for veno-occlusive dysfunction in androgen deficiency. In: Journal of andrology. Volume 26, Number 2, Mar-Apr 2005, pp. 242-248. PMID 15713830 .
  2. ↑ JA Albaugh: Addressing and managing erectile dysfunction after prostatectomy for prostate cancer. In: Urologic nursing. Volume 30, Number 3, 2010, pp. 167-177, 166. PMID 20648854 .
  3. ↑ a b c d M. E. Brewer, ED Kim: Penile rehabilitation therapy with PDE-V inhibitors following radical prostatectomy: proceed with caution. In: Advances in urology. 2009, p. 852437, doi: 10.1155 / 2009/852437 . PMID 19255627 . PMC 2648049 (free full text).
  4. ^ LT Klein, MI Miller et al.: Apoptosis in the rat penis after penile denervation. In: The Journal of Urology . 158, 1997, pp. 626-630. PMID 9224381 .
  5. ↑ HM User, JH Hairston et al .: Penile weight and cell subtype specific changes in a post-radical prostatectomy model of erectile dysfunction. In: The Journal of urology. Volume 169, number 3, March 2003, pp. 1175-1179, doi: 10.1097 / 01.ju.0000048974.47461.50 . PMID 12576876 .
  6. ↑ Sildenafil strengthens potency in the long term after prostate surgery. In: Doctors newspaper. October 16, 2007.