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

Summary Microsurgical 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.