Versuche zur Rekonstruktion erektiler Nerven über Silikonröhrchen in Kombination mit gezüchteten homologen Schwannschen Zellen bei der Ratte

摘要

SummaryMicrosurgical reconstruction of cavernosal nerves within silicone tubes seeded with Schwann cells in rats.Resection of the cavernosal nerves is often necessary during radical prostatectomy and causes erectile dysfunction. Autologous nerve transplantats seemed to be the treatment of choice in the past. Further detailed knowledge of the regeneration of peripheral nerves and the importance of Schwann cells provides new investigation in this topic over the last few years. Using rats as a model, we wanted to show that silicone tubes seeded with Schwann cells provide a better environment for regeneration of peripheral nerves. Resection of 0.5 cm of the cavernosal nerve was performed on both sides of Fischer 344 rats. One group received a bilateral nerve-grafting of the genitofemoral nerve, another group had implantation of empty silicone tubes and the other group had implantations of silicone tubes seeded with autologous Schwann cells. The positive control group under went a sham operation with laparotomy only. A group with resection of the cavernosal nerves on both sides served as negative control. 3 months post operation, erectile function and pressure changes in the corporal bodies are evaluated by electrostimulation of the regenerated nerves. Comparison of empty tubes, nerve grafts and those filled with homologous Schwann cells show a higher rate of erections and increased intracavernosal pressure elevation of the Schwann cell group. 3 months after the implantation of tubes with Schwann cells, erections rise up 91%. By interposition of empty silicone tubes the erection rate is only 50% and nerve grafting results in an erection rate of 30%.Histological examination reveals a more organized and thicker nerve by using silicone tubes seeded with Schwann cells.