[Erectile dysfunction and incontinence after prostatectomy. Treating the complications of surgery for prostate...

After having undergone a radical prostatectomy, 1 out of 5 men is dissatisfied about the functional results particularly because of complications like erectile dysfunction and urinary incontinence; these complications frequently do occur. During the first postoperative year, patient counselling and guidance are necessary aspects of the management of urinary incontinence and erectile dysfunction. In order to prevent irreversible erectile dysfunction, it is important that the patient resumes sexual activity soon after the operation; if necessary, a phosphodiesterase-5 (PDE-5) inhibitor or intracavernosal injection therapy may be used. Treatment of urinary incontinence in the first postoperative year consists of pelvic floor exercises and guidance on the use of collection devices, penile clamps or condom catheters. If urogenital functional disorders persist after one year, in a way that significantly affects patient's quality of life, the implantation of an erectile prosthesis or - depending on the amount of urine loss - a sling or sphincter prosthesis is indicated.