Q. I recently saw a doctor on a television talk show discussing the subject of impotence. He mentioned that there is a new treatment of injecting a medicine into the penis that will produce an erection.
Could you tell me more about this treatment? Does it work? Are there any side effects?
A. Injecting a medicine into the penis to bring about an erection was first tried about eight years ago. Since then, thousands of men with impotence have successfully used this technique. When done correctly, most men can achieve a satisfactory response.
Using a tiny needle, like the one people with diabetes use to inject insulin, men can inject a small amount of a drug that will produce an erection. The erection usually occurs within five to 10 minutes and lasts 30 to 45 minutes.
Papaverine is the drug most often used. It is sometimes combined with another drug, phentolamine, to improve its action and reduce side effects.
This treatment works best in people with impotence caused by nerve damage, such as after a spinal cord injury, and less well for people with poor circulation to the penis from hardening of the arteries. Most men who are impotent because of diabetes can benefit from injection therapy.
Side effects include minor ones, such as mild pain or bruising, and potentially more serious ones, such as scarring of the underlying tissues and prolonged erections, which can cause permanent damage and threaten one's ability to achieve erections in the future.
Researchers are now studying a new drug for injection therapy, called prostaglandin E-1 (PGE-1). This medicine seems to work better than papaverine with fewer side effects. This drug is more expensive than papaverine and not widely available, but it is being used by some urologists in the Washington area.
Men with permanent impotence who respond to drug injections may want to consider using mechanical aids for erection or implants in the penis to avoid the possible long-term side effects of injection therapy.
Q. Our son has a close friend who is deaf, apparently due to something called Waardenburg's syndrome. We're interested in learning more about this problem, but couldn't find anything written about it. What exactly is this condition?
A. Named after a Dutch ophthalmologist, Waardenburg's syndrome is an uncommon hereditary condition. People with this disorder have one or more of the following features: different-colored eyes, a white streak in the front part of the hair, white eyelashes, white patches of skin and deafness. As such, Waardenburg's syndrome is one of several hereditary forms of deafness.
If one parent has the defective gene responsible for this disorder, any child born into the family has a 50-50 chance of inheriting this condition. The disorder isn't associated with any decrease in mental function. Other than being deaf, people with Waardenburg's syndrome are physically healthy in other ways.
Jay Siwek, a family physician from Georgetown University, practices at the Fort Lincoln Family Medicine Center and Providence Hospital in Northeast Washington. Consultation is a health education column and is not a substitute for medical advice from your physician.
Send questions to Consultation, Health Section, The Washington Post, 1150 15th St. NW, Washington, D.C. 20071. Questions cannot be answered individually.