Management of erectile dysfunction after radical prostatectomy

Sexual rehabilitation is a vital component of the overall care of the prostate cancer patient and contributes significantly to the subsequent quality of life. Despite the development of and refinements in the anatomic approach to radical prostatectomy, there will continue to be a large pool of patients with erectile dysfunction after surgery. Although cancer control is always of primary importance, potency is often a consideration of great concern to patients when deciding between the various treatment options for clinically localized prostate cancer. Preoperative counseling informing the patient that erectile dysfunction can be successfully managed in most cases with therapy tailored to the goals and expectations of both the patient and the partner is essential. This article presents an overview of the approach to and management of the patient with erectile dysfunction after radical prostatectomy focusing on three main therapies: vacuum constriction devices, intravernoal injections, and prosthetic penile implants.