The severity of erectile dysfunction that may occur after prostate cancer treatment is determined by several factors including:
- the skill and experience of the surgeon performing the operation (surgeons with more experience performing prostatectomies generally have lower complication rates following surgery)
- the exact type of prostatectomy that is being done (certain types of prostatectomy such as the "nerve-sparing prostatectomy" are associated with lower rates of erectile dysfunction)
- the extent of the spread of cancer at the time of surgery (if cancer has spread outside of the prostate or has encased the nerves surrounding the prostate, then the nerves surrounding the prostate must be cut and ED will likely be more severe)
- the overall health of the man prior to and after surgery (older men and men with other health conditions such as high blood pressure or diabetes will typically have more difficulty with ED than younger, healthier men)
- the level of pre-surgery erectile function that exists (men who already had difficulty achieving erections prior to surgery are more likely to have more severe ED than men who had normal sexual function prior to surgery)
Walsh PC, Marschke P, Ricker D, Burnett AL. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. Urology 2000;55(1):58-61.