Clinical significance of ultrastructural findings in the corpora cavernosa of normal and impotent men.

Corpora cavernosa of 5 normal and 11 impotent living men were studied by electron microscopy. Of the smooth muscle cells 42.3% from corporeal tissues of impotent men showed a pronounced thickening of the basal lamina, a paucity of dense bodies and contractile filaments, minimal or no glycogen and fewer vesicles on the cell surface, whereas only 5.4% of the smooth muscle cells from normal men showed similar alterations. These differences were statistically significant (p less than 0.003). The percentage of altered smooth muscle cells in corporeal tissues of impotent men was proportional to the severity of symptoms and clinical findings. Morphometric analysis revealed no significant differences in the relative proportions of the major components of corporeal tissue (smooth muscle cells, extracellular matrix, vascular lumina and endothelial cells). These findings suggest the need for early detection of corporeal tissue degeneration by preoperative biopsy to assist in better selection of candidates for a penile vascular operation. They also may contribute to the development of new therapeutic modalities for erectile dysfunction.