Open Access

HOW I DO IT

Management of post-prostatectomy erectile dysfunction

Joseph E. Jamal, Jason D. Engel

Department of Urology, George Washington University Hospital, Washington, DC, USA
Address correspondence to Dr. Joseph E. Jamal, Department of Urology, The George Washington University Hospital, 2150 Pennsylvania Avenue, NW, Washington DC, 20037 USA

Canadian Journal of Urology 2011, 18(3), 5726-5730.

Abstract

The management of post-prostatectomy erectile function has been debated since the nerve sparing radical prostatectomy was fi rst introduced. A number of penile rehabilitation protocols have been proposed with varying degrees of success and patient satisfaction. My management of post-prostatectomy erectile dysfunction has evolved based on an honest and critical appraisal of the literature and my own experience and research. A review of major studies published on the topic of post-prostatectomy penile rehabilitation is included here, in addition to a critical evaluation of my own clinical practice. After evaluating the effi cacy of these various approaches, it is clear to me that a nerve sparing procedure is only one of many factors involved in recovering erectile function. Moreover, in addition to assessing a patient’s goals and their motivation for erectile function after prostatectomy, setting appropriate patient expectations is paramount to avoiding patient frustration. A frank evaluation and discussion with a patient and their partner is paramount to managing these expectations. A “one size fi ts all” approach is not appropriate. Herein, I discuss the evolution of my approach to managing post-prostatectomy erectile dysfunction.

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