Emerging concepts in erectile preservation following radical prostatectomy: A guide for clinicians

D. J. Moskovic, Brian J. Miles, L. I. Lipshultz, M. Khera

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations


Radical prostatectomy (RP) is a commonly performed procedure for the management of prostate cancer. While documented oncologic outcome for early stage disease is excellent, functional impairments such as incontinence and erectile dysfunction (ED) are common after the procedure. Recent evidence has implicated cavernous nerve damage and subsequent corporal oxygen deprivation, as well as corporal inflammation, in the pathogenesis of post-RP ED. Targeted therapies such as oral phosphodiesterase-5 inhibitors, mechanical vacuum erection devices, local alprostadil delivery and testosterone replacement (for hypogonal patients) have demonstrated some efficacy in the management of post-RP ED. This review aggregates much of the recent data in support of these therapies and critically reviews them. The article then presents tools to assess patients and partner sexual function to aid in identifying and monitoring post-RP ED. Finally, the article describes a protocol in use at Baylor College of Medicine as a guide toward the development of a protocol for erectile preservation (EP). The purpose of this work is to educate clinicians on emerging concepts in EP and provide an implementable protocol for use in practice.

Original languageEnglish (US)
Pages (from-to)181-192
Number of pages12
JournalInternational Journal of Impotence Research
Issue number5
StatePublished - Sep 2011


  • intraurethral and intracavernosal therapy
  • oral vasoactive agents
  • pelvic cancer treatments and sexual dysfunction
  • pharmacologic studies in sexual function
  • vacuum devices

ASJC Scopus subject areas

  • Urology


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