Second pathways ın the pathophysıology of ıschemıc prıapısm and treatment alternatıves

Priapism 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 evaluate the early therapeutic alternatives such as Bosentan an endotelin receptor blocker, theophylline an adenosin receptor blocker and a non-selective phosphodiesterase enzyme inhibitor and Zn Protoporphyrin a heme oxygenase-1 inhibitor for the therapy of ischemic priapism in the rat models.Twentyfour Sprague-Dawley rats were included into the study and they are divided into 4 equal groups. Erection was provided by vacuum constriction method and it was maintained for 4 hours for achieving the priapism in all groups. Then, Group 1 included controls, group 2 received Bosentan i.p. , group 3 received Theophylline i.p. , group 4 received zinc Protoporphyrin i.p. . Six rats from each group were killed after 6 hour of drug administration. Then ET-1, ADA, HO-1 enzymatic activity and apoptosis index in the cavernous tissues were estimated.Cavernous tissue ET-1, ADA, HO-1 levels and apoptosis index decreased significantly in Bosentan, Theophylline, zinc Protoporphyrin treated rats compared to the controls.Inhibition of priapism induced apoptosis with Bosentan, Theophylline, zinc Protoporphyrin seems promising on preserving erectile function.Key Words: Bosentan, Ischemic priapism, Theophylline, Zn Protoporphyrin