The number of newly diagnosed cases of prostate cancer continues to rise every new year. These cases (230110 in 2004 in the US), represent 33% of all new male cancer cases diagnosed in that year. 39000 men died of prostate cancer in that same year (10% of all male cancer deaths), and we can now estimate that a men born in the US today has a 1 in 6 (17%) probability of developing prostate cancer in his lifetime.

Localized prostate cancer can now be treated with a wide number of options. 61% of men are treated with surgery; 41% with hormone therapy; 33% with external radiation, 14% with brachytherapy and 7% are in watchful waiting. As disease-free survival rates are quite similar between these treatment modalities, a paradigm shift is now becoming evident in this field, that is to say, clinicians are now investing in reducing the morbidity of these procedures. Sexual function, of course, is in the front line of this subject as an even more critical factor in the choice of treatment for localized prostate cancer. It is important to stress, however, that clinical studies reporting erectile function outcomes after localized prostate cancer treatment often demonstrate poorly interpretable and inconsistent manners of assessment as well as widely disparate rates of erectile dysfunction and function. Even with the more recent techniques of robotic prostatectomy, there exists little evidence based information on return to potency compared with the other previous surgical techniques that we have at our service.

Strategies to promote recovery of erection:

The reluctance to choose more effective regimens of treatment due to fear of loss of sexual function has been demonstrated. As the demanding for optimal post-treatment erectile function is increasing its importance, it is quite conceivable that pharmacological prophylaxis with oral or intracavernous drugs will be expanding its role in the future strategies for the achievement of penile rehabilitation.