Erectile dysfunction is a moderate-to-severe problem for patients who have undergone radical prostatectomy. The main causes of erectile dysfunction are neurological and vascular. To reduce the incidence of this disorder after radical prostatectomy, nerve-sparing surgery should be performed with prevention of apoptosis and fibrosis of the cavernous tissue secondary to neuropraxia and prolonged ischemia.
In the treatment of erectile dysfunction secondary to radical prostatectomy, phosphyldiesterase inhibitors provide unsatisfactory results. However, early intracavernous injection is a major option for recovery of spontaneous erections. Lastly, penile prostheses provide excellent results. However, because these devices require surgical implantation, this option should be considered after all others have been exhausted.