Expandibility As A Measure of Fibrosis Induced Impotence

描述(由申请人提供)： 勃起功能障碍很常见，在40-70岁的男性中有52%发生，而且宿主显著的生理相关性是年龄的增加。与血管疾病无关，勃起组织经历小体小叶平滑肌的进行性丧失和小体结缔组织的增加。如果临床医生能够以非侵入性的方式准确地测量躯体纤维化的程度，他们就有能力制定管理策略来预防或推迟勃起功能障碍的发生。评估海绵体纤维化的临床效用主要是早期发现最初的结构性疾病，这是勃起功能障碍预防的关键组成部分。这项以工程学为基础的医学研究的广泛和长期目标是开发一种临床适用的方法来评估海绵体纤维化。实现这一目标的具体目标将是：(I)开发一个精细的工程模型，说明海绵体平滑肌百分比和海绵体“扩张性”之间的关系。(2)在一组患者中，证明了海绵体“扩张性”(通过术前动态输注药物海绵体测量法获得)和海绵体平滑肌百分比(通过对阴茎植入手术期间采集的海绵体组织进行组织形态计量学分析获得)之间的相关性。这将验证这两个参数之间的相关性，这两个参数在之前的动物研究中也存在；以及(3)临床测试一种圆形应变仪，它自动测量阴茎几何形状与海绵体内压力，这是计算海绵体“扩张性”所必需的。预计该项目将有助于对衰老对勃起功能障碍的结构性影响进行新的临床评估，这对于制定合理有效的临床策略来抵消与年龄相关的勃起功能下降是必要的。

DESCRIPTION (provided by applicant): Erectile dysfunction is common, developing in 52% of men aged 40-70 years, and the host significant physiological correlate is increasing age. Independent of vascular disease, erectile tissue undergoes progressive loss of corporal trabacular smooth muscle and increase of corporal connective tissue. If clinicians were able to accurately measure in a non-invasive manner the degree of corporal fibrosis, they would be in a position to develop management strategies to prevent or delay the onset of erectile dysfunction. The clinical utility of an assessment of corpus cavernosum fibrosis is primarily early detection of initial structural disease, a critical component of erectile dysfunction prophylaxis. The broad, long-term objective of this engineering-based medical research is the development of a clinically-applicable method to assess corpus cavernosum fibrosis. The specific aims to achieve this goal will be to: (i) develop a refined engineering model that illustrates the relationship between cavernosal percent smooth muscle and cavernosal "expandibility". (2) demonstrate, in a group of patients, correlation between cavernosal "expandibility" (obtained during pre-operative dynamic infusion pharmacocavernosometry) and cavernosal percent smooth muscle (obtained by histomorphometric analysis of the cavernosal tissue harvested during penile implant surgery). This would verify that the correlation between these two parameters, which was shown to exist in a previous animal study, also exists in humans; and (3) clinically test a circular strain gauge device that automatically measures penile geometry versus intracavernosal pressure which is necessary for the calculation of cavernosal "expandibility". It is anticipated that this project will contribute substantially to a new clinical assessment of the structural effects of aging on erectile dysfunction which is necessary to develop rational effective clinical strategies to offset the age-related decline in erectile function.