March 16, 2009 -- Question: Will I experience erectile dysfunction after prostate surgery?
Answer: Many men are concerned about the side effect of erectile dysfunction after prostate surgery. The recovery of erections depends on the age at which you undergo prostatectomy -- the older you are, the less likely you are able to recover normal erectile function.
The recovery of erectile function also depends on whether your cancer allows both your neurovascular bundles to be preserved or just one. If only one bundle is preserved, your chance of recovering erectile function is cut in half.
Finally, and the most important factor about recovery of erectile function, is the skill of your surgeon. The neurovascular bundles are located only 3 millimeters away from the prostate. In order to preserve them, the surgeon has to be highly skilled. Generally speaking, an excellent surgeon should have the erectile function recover and the majority of his or her patients who have both nerves spared, and in almost all patients in whom both nerves are spared who are less than 50 years old. In fact, there's pretty good data now that in general, about 70 percent of men at centers of excellence should recover erectile function, and as I said, almost all men under age 50 should recover erectile function.
Patients should be very careful when selecting their surgeon if erectile function is important to them. Patients should ask for the personal results of their surgeon on potency preservation in men who are younger and whom both nerves are spared. If that surgeon cannot provide information about potency preservation, a patient should probably consider shopping for a different surgeon.