Comparative ultrastructural study of human corpus cavernosum during ageing

Abstract

Erectile Dysfunction (ED), the inability to achieve or maintain an erection of sufficient rigidity for completion of sexual act, is a common condition affecting more than 150 million of men worldwide. This disorder is highly associated with aging, however concomitant pathologies such as hyperlipidemia, hypertension, and diabetes also contribute to ED progression. In the Massachusetts Male Aging Study, age was considered an independent variable strongly associated with ED, showing that the prevalence of this disease increased with age from 38% in the youngest group of men (mean age 40 y.) to almost 70% in the oldest group of men examined (mean age 70 y.). It is well demonstrated that aging leads to changes in the cardiovascular system, which results in a decrease in elasticity due to fibrosis and an increase in stiffness of the arterial system, independently of the effects of concurrent pathologies. Vasculogenic ED is the most prevalent condition, affecting nearly 80% of patients with organic etiology. Small vessels of the penis are very sensitive to structural and functional changes, and small disturbances can conduce to ED. ED is now considered by some authors as synonymous to endothelial dysfunction and an early manifestation of atherosclerosis, being a precursor of systemic vascular disease. Human cavernous tissue is mainly constituted by smooth muscle fibers that surround sinusoid vessels. Corpus cavernosum structural elements act in concert, allowing increase of intra-cavernous arterial flow and smooth muscle relaxation processes which are fundamental to penile erection. The aim of this study was to compare the ultrastructural anatomy of the young and aged human corpus cavernosum, in the absence of additional risk factors.