The problem is the nerves. They sit on either side of the prostate, and they are responsible for erection. They're a surgeon's nightmare — so tiny and fragile, and so easy to damage during radical prostatectomy.
Neuro-urologist Arthur L. Burnett, M.D., M.B.A., a surgeon who also studies these nerves, has been searching for a neuroprotective "holy grail" — an agent that will not only protect these nerves during the trauma of treatment, but that will nurture them, strengthen them, and maybe even invigorate them, as well. In this quest, he has found two candidates that look promising.
One is known familiarly as "Epo," for erythropoietin, a versatile hormone naturally made in the kidney that stimulates production of red blood cells; it also helps people with anemia. "Erythropoietin has been shown to preserve nerve function after injury," says Burnett. His preliminary studies of men who have received erythropoietin after radical prostatectomy, published in the Journal of Sexual Medicine, suggest that it may indeed be beneficial in promoting the recovery of erectile function. Unfortunately, his study in men undergoing surgery was temporarily put on hold by a nationwide alert from the Food and Drug Administration, which is looking into safety issues before allowing any investigators to proceed.
The "holy grail" here is an agent
that will not only protect these
nerves during the trauma of
treatment, but that will nurture,
strengthen, and maybe even
The other promising drug is called Losartan. It's already used to treat hypertension, and "It has been shown to maintain the health of blood vessels," says Burnett. Scientifically, it is an angiotensin II type 1 receptor antagonist agent. In laboratory studies, it has been shown to enhance erection recovery and limit penile deformity and scarring in rats. Burnett believes it may help preserve penile health in men after radical prostatectomy, and he is conducting pilot clinical studies to investigate this possibility.