Evaluation of the efficacy of losartan on the basis of the pathophysiology of ischemic priapism

riapism is described as the extended unpreferred erection status without any sexual stimulus. There are three types of priapism which are classified as ischemic, non ischemic and recurrent priapism depending on the blood flow of the penile artery. Ischemic priapism is a real urological emergency which require urgent and appropriate approach. In order to prevent any erectile dysfunction, the urologist should know how to manage such an urgent case. In this study we aimed to research the treatment methods for the early management of ischemic priapism and evaluate the role of losartan application in the treatment on the base of ischemic priapism in the rat models. The study included 8 groups consisting of 6 rats where the first is the control and the other 7 groups were the study groups. Fourty-eight adult Sprague-Dawley rats were divided into 8 equal groups. Group 1 was the control (shame) group. Vacuum constriction method was used in all rats for obtaining erection and priapism was generated by maintaining it. Penises of the rats in the Group 1 were resected after 4 hours without generating priapism. In group 2 priapism was generated and penile resection was performed after 4 hours. In group 3 priapism was generated and losartan in 15mg/kg dose was administered i.p and penile resection was performed after 4 hours. In group 4 priapism was obtained, corrected after 4 hours and penises were resected after 8 hours. In group 5 priapism was obtained, losartan in 15 mg/kg dose was administered i.p, priapism was corrected after 4 hours and penises were resected after 8 hours. In group 6 priapism was obtained and it was corrected in the fourth hour, losartan in 15mg/kg dose was applied and penile resection was performed after 8 hours. In group 7 losartan was applied in 15 mg/kg dose in a period of 3 days then priapism was obtained and the penile resection was performed after 4 hours. In group 8 losartan was applied in 15 mg/kg dose in a period of 3 days then priapism was obtained, it was corrected in the fourth hour and the penile resection was performed after 8 hours. Apoptosis index and MDA levels were determined in the cavernosal tissue samples by using Tunel method and spectrophotometry respectively. In this study a statistically significant decrease in group 3, group 7 and a statistically significant increase in the ischemia reperfusion groups like group 4, group 5, group 6 and group 8 have been detected regarding the apoptotic index compared to group 2 (p<0.05). By making the comparison between the ischemia reperfusion groups with each other, a statistically significant decrease revealed in the losartan administered group 5, group 6 and group 8 compared to group 4 regarding the apoptotic index (p<0.05). The late losartan application group 6 showed statistically significant increase in the apoptotic index compared to group 5 and group 8 (p<0.05). These results have shown us that losartan application is decreasing the apoptotic index in the ischemia reperfusion groups and that early application is decreasing the index more significantly than late application. When comparing group 4, group 5, group 6 and group 8 with group 1, a statistically significant increase in MDA levels has been found (p<0.05). By making the comparison between the ischemia reperfusion groups with each other, a statistically significant increase revealed in the losartan administered Group 5, Group 6 and Group 8 compared to Group 4 regarding the MDA levels (p<0.05). These results have shown us that losartan application is decreasing the MDA levels in the ischemia reperfusion groups. We consider that the prevention of oxidative stress and apoptosis by the AT 1 blocker losartan in priapism status, may be a promising future for the protection of erectile function. Key words: Priapism, apoptosis, losartan