The journal of sexual medicine · 2026
Peyronie's-like changes in the tunica albuginea were identified in reconstruction patients.
СтатьяНазвание и аннотация: Перевод в очереди
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Colombo Alberto, Deng Jiangping, Kocjancic Ervin, Acar Omer, Harrington Daniel A, McVary Kevin T, Podlasek Carol A
Аннотация
BACKGROUND: Tunica albuginea plays a critical role in the biomechanics of the penis, as the main bearer of mechanical forces during erection; collagen is central to changes that occur in the tunica of Peyronie's patients; however, our understanding of tunica collagen composition remains poorly understood.
AIM: To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25 years of 17β-estradiol and Spironolactone.
METHODS: Tunica and corpora cavernosa (n = 25) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17β-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), α-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.
OUTCOMES: Hydroxyproline, IHC, and cell culture were performed.
RESULTS: Collagen abundance did not correlate with duration of 17β-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P = .05) in tunica of patients treated with 17β-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie's patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P = .049) and was unchanged in tunica (P = .34) and corpora cavernosa (P = .41) with 17β-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17β-estradiol and antiandrogen treatment (P = .005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.
CLINICAL IMPLICATIONS: Reconstruction patients develop Peyronie's-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.
STRENGTHS AND LIMITATIONS: Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie's patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.
CONCLUSION: In addition to 17β-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie's-like collagen changes from the repeated microtrauma and/or ischemia; reconstruction patient tunica may provide a novel model to study changes in collagen signaling and offer insight into development of Peyronie's changes in tunica architecture.
STATEMENT OF SIGNIFICANCE: Reconstruction patients develop a Peyronie's like condition with increased collagen III in the tunica, that offers a unique opportunity to study how collagen signaling become dysfunctional and provide novel insight into early stage Peyronie's collagen changes.
AIM: To quantify collagen abundance and subtypes in tunica and corpora cavernosa of reconstruction patients treated with 0-25 years of 17β-estradiol and Spironolactone.
METHODS: Tunica and corpora cavernosa (n = 25) were obtained from patients undergoing penectomy with reconstruction surgery. Collagen was quantified and evaluated with 17β-estradiol treatment, age, antiandrogen, and testosterone concentration. Immunohistochemistry (IHC) for collagen I-IV was performed with ImageJ quantification. Primary tunica cell cultures were established and characterized for P4HB (fibroblast), α-ACTIN (smooth muscle), and CD31 (endothelium). Fibroblast growth with Sonic hedgehog (SHH), BMP4, and GREM1 treatment were quantified.
OUTCOMES: Hydroxyproline, IHC, and cell culture were performed.
RESULTS: Collagen abundance did not correlate with duration of 17β-estradiol and antiandrogen treatment, age, and testosterone level. Collagen III was more abundant in the corpora cavernosa than the tunica, and collagen III increased 35.4% (P = .05) in tunica of patients treated with 17β-estradiol and antiandrogen, mimicking the increased collagen III observed in Peyronie's patients. Collagen I was 12.1% higher in the corpora cavernosa than the tunica (P = .049) and was unchanged in tunica (P = .34) and corpora cavernosa (P = .41) with 17β-estradiol and antiandrogen treatment. Collagen IV increased 26.6% in corpora cavernosa with 17β-estradiol and antiandrogen treatment (P = .005). P4HB staining fibroblasts were isolated from patient tunica; fibroblasts increased growth with GREM1 and decreased growth with BMP4.
CLINICAL IMPLICATIONS: Reconstruction patients develop Peyronie's-like changes in collagen subtypes (collagen III) in the tunica that offer a unique opportunity to study how collagen signaling becomes dysfunctional and provide novel insight into early-stage collagen changes.
STRENGTHS AND LIMITATIONS: Collagen III increased in tunica of reconstruction patients. It is of interest that tunica of reconstruction patients, which do not display a plaque as in Peyronie's patients, show a similar change in collagen III abundance. It is unclear how changes in collagen subtype impact erectile function.
CONCLUSION: In addition to 17β-estradiol and antiandrogen treatment, reconstruction patients practice aggressive taping and compression of their tissue, which may induce Peyronie's-like collagen changes from the repeated microtrauma and/or ischemia; reconstruction patient tunica may provide a novel model to study changes in collagen signaling and offer insight into development of Peyronie's changes in tunica architecture.
STATEMENT OF SIGNIFICANCE: Reconstruction patients develop a Peyronie's like condition with increased collagen III in the tunica, that offers a unique opportunity to study how collagen signaling become dysfunctional and provide novel insight into early stage Peyronie's collagen changes.