Penile Rehabilitation After Prostatectomy

Erectile dysfunction (ED) is an important factor to consider when a prostatectomy is elected for the treatment of prostate cancer. Since the introduction of anatomic nerve-sparing radical prostatectomy in 1982, problems with total and stress urinary incontinence have dropped to less than 10%. ED has not enjoyed the same improvements however. There are many factors that affect ED after prostatectomy, including age at time of surgery, partner’s age, preoperative erectile function, and other medical problems. In general, a person won’t perform better after a prostatectomy than before – they will be the same or worse. ED is improved by aggressive rehabilitation after surgery, to reduce the amount of “idle time”, since this will cause the loss to be more permanent than temporary. Treatment can start within weeks of the surgery, and may continue for as long as 2 to 3 years. Treatment is usually by medication at first, but vacuum erection devices and penile prostheses are available and these work very well for a great number of patients.