Impotency May Soon Have a Breakthrough Treatment
(HealthDay News) -- Advertising and public relations hoopla aside, not all male sexual problems are caused by erectile dysfunction.
And ED is a relatively minor problem compared to types of impotency that came as the result of surgery or disease.
But thanks to recent laboratory research into gene therapy, scientists believe they may have found a way to help men avoid impotence caused by nerve damage, a risk faced by diabetics and those who have their prostate removed.
While they haven't tried their approach on humans yet, the researchers say tests on rats suggest that a type of gene therapy may bring back the ability to have an erection.
The treatment could make prostate removal more tolerable, says study co-author Dr. Michael Chancellor, a professor of urology at the University of Pittsburgh. "Many men are afraid of even screening for prostate cancer. They're afraid of finding it, and they're afraid of the treatment."
While prostate removal is considered the "gold standard" treatment for prostate cancer, many men refuse to have it because of the potential risks of impotency and incontinence, Chancellor says. "They'd rather settle for something else even if there's a higher risk that the cancer may recur," he adds.
An estimated 80 percent of men who have their prostate removed suffer from so-called neuropathic erectile dysfunction. The problems come during the surgery itself, Chancellor says. "The nerves from the pelvis to the penis travel immediately adjacent to the prostate gland," he explains. "If you just look at them wrong while removing the cancer, the nerves can be cut or partially damaged. Then the men don't get normal erectile function."
Other kinds of prostate cancer treatments, including radiation and cryotherapy (freezing), can also cause impotence by harming nerves, adds Dr. Allan Pantuck, an assistant professor of urology at the University of California at Los Angeles. Potential treatments for the resulting impotency include Viagra, urethral suppositories and direct injections into the penis, he says.
To give the nerves a fighting chance, Chancellor and his colleagues began examining an agent that protects nerves and encourages them to grow. But how could they deliver it to the nerves around the prostate?
In tests on rats with injured nerves, the researchers developed a way to piggyback the agent onto a harmless herpes virus and send it into the prostate region. In some of the rats, the nerves appeared to regenerate after exposure to the agent.
Ideally, the treatment could be given to men before prostate removal or during surgery, Chancellor says. It could also be used on diabetic men.
Pantuck says the findings are promising, but he cautions that the safety of gene therapy is still unclear. Many more studies have to be conducted, he said, before enough evidence was gathered to develop a human trial.
On the Web
The U.S. government Web site, http://www.4woman.gov, offers advice as to how men with diabetes can deal with impotence.
SOURCES: Michael Chancellor, M.D., professor and director, neurourology and female urology programs, University of Pittsburgh School of Medicine; Allan Pantuck, M.D., assistant professor, urology, University of California at Los Angeles; April 28, 2003, presentation, American Urological Association annual meeting, Chicago
Publication date: July 1, 2006
Author: Randy Dotinga, HealthDay Reporter
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