A note about ED post Radical Prostatectomy

Surgery for prostate cancer is a now a common procedure. If the  neuro-vascular bundle on each side of the prostate cannot be saved, then ED will inevitably follow. Treatment with oral PDE5 inhibitors does not work without intact nerves due to the lack of neurotransmitters. Even with intact neurovascular bundles, the return of erectile function may take from six to 36 months to occur (if ever). The quality of erections also depends on the pre-surgery erectile function. Initial treatment is PGE1 injection therapy,  however, some men respond early to oral medication. It is important to keep testing with oral medication from time to time because as soon as oral medication becomes efective, injections may stopped. There is some evidence of beneft being on continuous oral medication in the presence of neuropraxia due to the positive efect of PDE5 inhibitors on the endothelium within the cavernosal tissues.