{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T16:01:36Z","timestamp":1787846496961,"version":"build-2784847793"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,4,17]],"date-time":"2018-04-17T00:00:00Z","timestamp":1523923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","award":["20160616110"],"award-info":[{"award-number":["20160616110"]}],"id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007113","name":"Sexual Medicine Society of North America","doi-asserted-by":"publisher","award":["P0522946"],"award-info":[{"award-number":["P0522946"]}],"id":[{"id":"10.13039\/100007113","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2018,7]]},"abstract":"\n Objectives<\/jats:title>\n \n To investigate the feasibility of the Zucker fatty (\n ZF<\/jats:styled-content>\n ) rat as a model for research in to obesity\u2010associated erectile dysfunction (\n OAED<\/jats:styled-content>\n ) and to determine the effect of low\u2010intensity extracorporeal shockwave therapy (Li\u2010\n ESWT<\/jats:styled-content>\n ) on penile tissue and function in these rats.\n <\/jats:p>\n <\/jats:sec>\n \n Materials and methods<\/jats:title>\n \n Eight new\u2010born male Zucker lean (\n ZL<\/jats:styled-content>\n group) rats (\n ZUC<\/jats:styled-content>\n \u2010\n Lepr<\/jats:italic>\n \n fa<\/jats:italic>\n <\/jats:sup>\n 186) and 16 new\u2010born male\n ZF<\/jats:styled-content>\n rats (\n ZUC<\/jats:styled-content>\n \u2010\n Lepr<\/jats:italic>\n \n fa<\/jats:italic>\n <\/jats:sup>\n 185) were injected with 5\u2010ethynyl\u20102\u2019\u2010deoxyuridine (EdU) at birth to identify and monitor endogenous stem cells. Insulin tolerance testing was performed at 10 weeks of age. Beginning at 12 weeks of age, eight\n ZF<\/jats:styled-content>\n rats were kept as controls, and the remaining eight\n ZF<\/jats:styled-content>\n rats were treated with Li\u2010\n ESWT<\/jats:styled-content>\n (0.02\n mJ<\/jats:styled-content>\n \/mm\n 2<\/jats:sup>\n , 3 Hz, 500 pulses;\n ZF<\/jats:styled-content>\n +\n SW<\/jats:styled-content>\n group) twice a week for 4 weeks. Following a 1\u2010week washout period, erectile function was evaluated by measuring intracavernosal pressure (\n ICP<\/jats:styled-content>\n ) and mean arterial pressure (\n MAP<\/jats:styled-content>\n ). Penile tissues were then harvested for histological study to assess smooth muscle\/collagen content and endothelium content in the corpora cavernosum. Lipid\n TOX<\/jats:styled-content>\n \u2122 staining was used to evaluate lipid accumulation. EdU, as a marker of cell activation, and phosphorylated histone 3 (H3P), as a marker of cell mitosis, were also assessed.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n The\n ICP<\/jats:styled-content>\n \/\n MAP<\/jats:styled-content>\n indicated that erectile function was severely impaired in the\n ZF<\/jats:styled-content>\n group as compared with the\n ZL<\/jats:styled-content>\n group. In the\n ZF<\/jats:styled-content>\n +\n SW<\/jats:styled-content>\n group, erectile function was significantly improved (\n P<\/jats:italic>\n < 0.05). Muscle atrophy was seen in the\n ZF<\/jats:styled-content>\n group, while Li\u2010\n ESWT<\/jats:styled-content>\n increased the muscle content in\n ZF<\/jats:styled-content>\n +\n SW<\/jats:styled-content>\n group. Moreover, the penile endothelium was damaged in the\n ZF<\/jats:styled-content>\n group, and Li\u2010\n ESWT<\/jats:styled-content>\n enhanced the regeneration of endothelial cells (\n P<\/jats:italic>\n < 0.01) in the\n ZF<\/jats:styled-content>\n +\n SW<\/jats:styled-content>\n group. Lipid accumulation was seen in the penile tissue of\n ZF<\/jats:styled-content>\n rats. Li\u2010\n ESWT<\/jats:styled-content>\n significantly reduced both the amount and the distribution pattern of Lipid\n TOX<\/jats:styled-content>\n , suggesting decreased overall lipid infiltration. Furthermore, Li\u2010\n ESWT<\/jats:styled-content>\n increased EdU\u2010positive cells and markedly enhanced the phosphorylation level of H3P at Ser\u201010 in the\n ZF<\/jats:styled-content>\n +\n SW<\/jats:styled-content>\n group. Most H3P\u2010positive cells were located within smooth muscle cells, with some located in the endothelium suggesting that these tissues are the reservoirs of penile stem\/progenitor cells.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n ZF<\/jats:styled-content>\n rats can serve as an animal model in which to study\n OAED<\/jats:styled-content>\n . This study reveals that obesity impairs erectile function by causing smooth muscle atrophy, endothelial dysfunction, and lipid accumulation in the corpus cavernosum. Li\u2010\n ESWT<\/jats:styled-content>\n restored penile haemodynamic parameters in the\n ZF<\/jats:styled-content>\n rats by restoring smooth muscle and endothelium content and reducing lipid accumulation. The underlying mechanism of Li\u2010\n ESWT<\/jats:styled-content>\n appears to be activation of stem\/progenitor cells, which prompts cellular proliferation and accelerates penile tissue regeneration. Our findings are of interest, not just as a validation of this emerging treatment for erectile dysfunction, but also as a novel and potentially significant method to modulate endogenous stem\/progenitor cells in other disease processes.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14202","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T20:58:29Z","timestamp":1521838709000},"page":"133-142","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["The effect of low\u2010intensity extracorporeal shockwave therapy in an obesity\u2010associated erectile dysfunction rat model"],"prefix":"10.1111","volume":"122","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7767-7309","authenticated-orcid":false,"given":"Yajun","family":"Ruan","sequence":"first","affiliation":[{"name":"Knuppe Molecular Urology Laboratory Department of Urology School of Medicine University of California San Francisco 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