Mechanism and Recovery of Erectile Dysfunction After Prostate Removal

Factors Influencing Recovery

Recovery of erectile function is directly related to the degree of preservation of the cavernous nerves during surgery, as stated by the National Comprehensive Cancer Network 1
Recovery of erectile function depends on three critical factors: patient age at surgery, preoperative erectile function, and the extent of neurovascular bundle preservation, according to the Mayo Clinic and the National Comprehensive Cancer Network 1, 2

76% of men younger than 60 years with full preoperative erections who had bilateral nerve-sparing surgery recovered full erections, as reported by the Mayo Clinic 2
Only 7.5% of men older than 65 years with diminished preoperative erections who had unilateral bundle resection recovered potency, as reported by the Mayo Clinic 2

Recovery of erectile function is gradual and often delayed, with maximal function sometimes not returning until 12-24 months after surgery, as stated by the National Comprehensive Cancer Network, Ca-A Cancer Journal for Clinicians, and others 1, 3, 4
Phosphodiesterase-5 inhibitors, like tadalafil, can aid recovery by promoting blood flow and potentially supporting nerve regeneration, as reported by the Mayo Clinic 2
Nerve grafts to replace resected nerves do not appear effective, highlighting that prevention of injury is more important than attempted repair, according to the National Comprehensive Cancer Network 1