Erectile recovery after radical prostatectomy can take up to two years, and prolonged absence of erections is thought to contribute to fibrosis of the corpora. Many urologists therefore start rehabilitation within weeks of catheter removal.
A practical approach is a PDE5 inhibitor started soon after surgery, with a vacuum erection device or intracavernosal injection if tablets do not work. Setting expectations — that recovery is slow and that aids are part of normal recovery — helps men persist.
- Discuss rehabilitation before surgery, not after
- Start a PDE5 inhibitor soon after catheter removal if not contraindicated
- Offer a vacuum device or intracavernosal injections if tablets fail
- Review erectile function at every follow-up for two years
- Refer to an andrology or sexual medicine service when available
Why it matters
Recovery is slow, and men who are not offered help often stop trying.
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