ED after nerve sparing prostatectomy

Both RP and RT have downsides and upsides.

Bilateral nerve sparing RP may allow adequate erectile function.

RT may cause lifelong bowel and bladder issues.

Either one may eradicate the bandit or fail.

Age and mental health will have an impact on erectile capability regardless of treatment and side effects.

Do your research and make an informed choice.

Accept the consequences and make the best of the dice roll.

In my just over four years (wow) on forums, i only met one person who put sexual function wholely and solely above long term survival when planning his treatment journey. Even he has come to accept living the best life you can with what you can get with the necessary treatment is better than the alternative,

Cheers

He who sits on cushions

1965,

'Nerve sparing' is an objective during RP; it is not a separate form of RP altogether.  Since doctors discovered exactly where the erectile nevers are located decades ago, most surgeons, most of the time, attempt to salvage these nerve bundles, and usually they are successful.   During residencey, they learn how to do this.   But, there are situations in which nerve sparing is not possible, such as when cancer is in the nerves themselves, which can be determined during pathology testing during the proceedure, or when perineural issues are discovered in the presurgical biopsy.    In these cases the nerves must be taken out to cure the disease.   And, if the patient were receiving radiation instead of surgery, it would still be as critical then to kill the nerves as it is in surgery; not doing so via radiation would simply ensure that the radiation eventually proved a failure.

ED following RP is not due to failure of a technique; it is due to the nature of the individual's disease.