Pirfenidone and Pentoxifylline Attenuate Ischaemia–Reperfusion Injury in Experimental Priapism: Limited Effects of Dexpanthenol

Ischaemic priapism is a urological emergency that may lead to irreversible erectile dysfunction due to cavernosal tissue damage. In this experimental study, we evaluated the acute effects of pirfenidone, pentoxifylline, and dexpanthenol on ischaemia–reperfusion injury (IRI) in a rat model of ischaemic priapism. A total of 68 male Wistar albino rats were randomly assigned to seven groups, including sham, control (IRI), and treatment groups receiving pirfenidone, pentoxifylline, dexpanthenol, or combination therapies. Ischaemic priapism was induced under anaesthesia, followed by a reperfusion period. Serum inflammatory (IL-1β, IL-10), oxidative stress (MDA, TOS, TAS), and endothelial (eNOS) markers were analysed, and histopathological evaluation was performed using semi-quantitative scoring. The control group demonstrated significantly higher IL-1β, eNOS, and MDA levels compared with treatment groups. Pirfenidone and pentoxifylline significantly reduced IL-1β and MDA levels and improved histopathological scores, while pentoxifylline also increased IL-10 levels, indicating enhanced anti-inflammatory activity. In contrast, dexpanthenol demonstrated a more limited effect, with significant improvement observed only in MDA levels. Combination therapies did not demonstrate superiority over monotherapy. These findings suggest that pirfenidone and pentoxifylline may have potential as adjunctive therapeutic options for limiting cavernosal tissue injury and preserving erectile function in ischaemic priapism.