Postoperative management: Erectile function

Erectile Dysfunction (ED) is among the most common and feared consequences of radical prostatectomy, irrespective of the surgical modality and approach. It can greatly affect the quality of life of both the patient and his partner and without question influences a man’s decision on if and how his prostate cancer will be treated. Improved understanding of surgical anatomy, physiology, pharmacology and biomedical technology has expanded the available options for treating ED, which currently include oral pills, externally applied penile devices, penile injections and suppositories, and penile prosthetic surgery. A relatively recent concept is that of penile rehabilitation, the attempt to, using available treatment options, restore spontaneous erectile function so that the patient may be independent of erectile aids. The employment of ED treatment and/or rehabilitation should be based on the patient’s goals after a thorough explanation of realistic expectations, risks and consequences of each treatment option. Finally, there are a multitude of possible treatment options still in the research phase which may in the future add to the available armamentarium for post-prostatectomy ED treatment and penile rehabilitation.