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Histopathologically proven prevention of post-prostatectomy cavernosal fibrosis with sildenafil.

Iacono F, Prezioso D, Somma P, Chierchia S, Galasso R, Micheli P

Dipartimento di Ginecologia e Ostetricia, Medicina della Riproduzione e Urologia, Università di Napoli Federico II, Naples, Italy. fiacon@tin.itu

AIM: To evaluate whether a dose of 50 mg preserved the architecture of the corpora cavernosa biopsy in man. METHODS: 21 patients (54-70 years old) who underwent radical prostatectomy for prostate cancer were treated with sildenafil citrate (50 mg, 3 times a week for 2 months) soon after surgery. They underwent cavernous biopsy before surgery and after 2 months of sildenafil treatment. Biopsy tissues were fixed in formalin, stained with Masson's trichrome method, and evaluated with the Eureka Interface system with a per-area analysis, and elastic fibers were counted on 10-12 fields (x400) of five serial sections. RESULTS: Two months after surgery the percent of connective tissue in cavernosa samples in all patients did not differ from that before surgery, being between 30 and 40% in the per-area analysis. Similarly, the elastic fiber count did not differ significantly before and after surgery. CONCLUSIONS: Sildenafil prevented the progression of fibrosis in prostatectomized patients. Its efficacy seems to result from an antiproliferative effect exerted on fibroblasts.

Published 15 May 2008 in Urol Int, 80(3): 249-52.
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