Volume 53, Issue 3, Pages (March 2008)

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Volume 53, Issue 3, Pages 635-643 (March 2008) The Impact of Shock Wave Therapy at Varied Energy and Dose Levels on Functional and Structural Changes in Erectile Tissue Alexander Müller, Yemi Akin-Olugbade, Serkan Deveci, John F. Donohue, Raanan Tal, Keith A. Kobylarz, Michael Palese, John P. Mulhall European Urology Volume 53, Issue 3, Pages 635-643 (March 2008) DOI: 10.1016/j.eururo.2007.06.032 Copyright © 2007 Terms and Conditions

Fig. 1 Shock wave application. Photograph of shock wave application on the dorsal penile midshaft in the rat using the animal hand probe of a Storz Masterpuls MP100 shockwave machine (Storz Medical, Kreuzlingen, Switzerland). The penis has been elongated with a preputial suture. European Urology 2008 53, 635-643DOI: (10.1016/j.eururo.2007.06.032) Copyright © 2007 Terms and Conditions

Fig. 2 Intracavernosal-mean arterial pressure (ICP/MAP) comparison between C, HD-3, and LD-3 groups. Significant reduction of maximum mean ICP/MAP ratios were found for all HD-3 and LD-3 groups compared to their corresponding C groups (p<0.05). A tendency for an increase in ICP/MAP ratio was seen for LD-3 groups versus HD-3 groups over time, with a significant improvement for LD-3-28 versus HD-3-28 (#p=0.004 between LD-3-28 and HD-3-28). *p<0.05 versus corresponding C group. HD-3=three SWT sessions applying 2000 sw at 2 BAR; LD-3=three SWT sessions applying 1000 sw at 1 BAR; result assessment after 1, 7, or 28 d after the last SWT session. European Urology 2008 53, 635-643DOI: (10.1016/j.eururo.2007.06.032) Copyright © 2007 Terms and Conditions

Fig. 3 Masson's trichrome (MT) staining. Illustrated are representative MT cross-section stainings of the corpora cavernosa from the penile midshaft where SWT was applied for C28, HD-3-28, and LD-3-28 marking smooth muscle in red and collagen in blue showing a trend toward lower red/blue staining ratio on average for the HD-3-28 (13±12%) and LD-3-28 (12±10%) groups compared to the C28 group (20±5%), which was not statistically significant (p>0.05). European Urology 2008 53, 635-643DOI: (10.1016/j.eururo.2007.06.032) Copyright © 2007 Terms and Conditions

Fig. 4 Terminal deoxynucleotidyl transferase biotin-dUTP nick-end labeling (TUNEL) assay. A representative distribution of immunofluorescence TUNEL+ cells is photomicrographically (×40) illustrated. Both HD-3 and LD-3 groups showed on average a significant increase in apoptosis rates compared to the C28 group (p<0.01). The LD-3-28 group exposed to the lower energy/dose level displayed highly significantly lower apoptosis rates compared to HD-3-28 (p<0.001). White arrows point to TUNEL+ cells. European Urology 2008 53, 635-643DOI: (10.1016/j.eururo.2007.06.032) Copyright © 2007 Terms and Conditions