Designing the Rehabilitation of Men with Post-Prostatectomy Erectile Dysfunction Using a Pre-and Post-Operative Approach

Men with clinically localized prostate cancer are offered a variety of treatment choices, including active surveillance (AS), surgery in the form of radical retropubic prostatectomy (RRP) or robotic-assisted laparoscopic prostatectomy (RALP), radiation in the form of external beam radiotherapy (EBRT), brachytherapy or a combination, as well as newer techniques such as cryotherapy and high intensity focused ultrasound (HIFU). From a urologic perspective, radical prostatectomy (RP) with or without pelvic lymphadenectomy has been considered the gold standard for treatment. This has traditionally been accomplished by the open technique, but RALP is increasingly being utilized [1]. However, RP is associated with significant postoperative complications, including erectile dysfunction. Rabbani et al. were the first researchers to demonstrate that preoperative erectile function (EF), along with age and intraoperative neurovascular bundle preservation, was a key determinant in predicting postoperative EF