Prostate Treatment and Erectile Function

What to expect and how to prepare

5 min read

Prostate cancer treatment saves lives, but for many men it also changes how their bodies work sexually. Understanding what’s happening, why, and what recovery actually looks like can make a stressful process like prostate treatment feel more manageable for both you and your partner.

Why prostate treatment affects erections

An erection happens when your brain sends a signal to nerve bundles that trigger blood vessels in the penis, telling them to relax and widen so blood rushes in and creates rigidity. These bundles (called the cavernous nerves) run directly along the surface of the prostate, which is why prostate cancer treatments often disrupt erectile function.¹

However, not all prostate treatment is the same, and chances of erectile disruption can vary:

• Surgery (radical prostatectomy): Up to 85% of men report at least temporary erectile dysfunction (ED).² That’s because even when using a nerve-sparing technique, the cavernous nerves can be heat-injured by cauterization or simply stretched or inflamed during the operation.
• Radiation therapy: Roughly 50% develop ED as radiation can damage nerves, blood vessels, and tissue around the prostate over time.²
• Hormone therapy: 80–90% report some stage of ED after a year.³ While hormonal therapy doesn’t injure nerves or vessels directly, it lowers testosterone, which reduces desire and can independently impair erections and orgasm.⁴

Is “penile rehabilitation” as scary as it sounds?

While admittedly it is two words you usually hope to never have to see together, “penile rehabilitation” is really a misunderstood term.

It actually refers to the scheduled, proactive use (either before or shortly after treatment) of erection-promoting therapies (like PDE5-inhibitors) with the goal of encouraging blood flow to the penis while the nerves recover.⁵

But this isn’t simply ED treatment used right before sex. It’s scheduled, regular, and meant to protect penile tissue during recovery whether or not sex is planned that day.⁶

Also, to be clear, according to the American Urological Association, penile rehabilitation does not necessarily equal restoring unassisted erectile function as current data doesn’t show that early PDE5-inhibitor use after surgery improves recovery rates at all.⁷

In short: rehabilitation is a reasonable strategy, and it’s recommended by urologists, but it’s not a guaranteed fix.

Where Eddie® can help (and where it can’t)

Eddie is an FDA Class II, non-prescription wearable device designed to help maintain an erection during sexual activity by supporting blood flow into the penis while limiting outflow.

For men who can achieve at least a partial erection — a common experience during nerve recovery after prostate treatment — Eddie helps make sexual activity more workable without medication.

But it’s important to remember that Eddie is:

• Not nerve-regeneration therapy. It doesn’t repair the cavernous nerves or speed up biological recovery.
• Not a substitute for a rehabilitation program or your urologist’s guidance. Eddie should only be used with your surgeon’s clearance, especially soon after surgery while tissue is still healing.
• Not effective without some erectile response. If you can’t achieve any erectile response — common in the first weeks or months after surgery — a mechanical aid like this may not work.
• Not diagnostic or curative. Eddie doesn’t address the underlying cause of ED — nerve injury, vascular change, or hormonal shifts.

Eddie can be a helpful tool for some men navigating erectile changes after prostate treatment, but remember — it should be used alongside, not instead of, a urologist’s recovery plan.

And speaking of…

Remember, recovery isn’t a straight line

Recovery timelines get thrown around casually, but the real data is slower and more nuanced.

Nearly all men experience some ED in the first few months after prostate cancer treatment.⁸ From there, recovery unfolds unevenly:

• Within one year, 40% to 50% of men with intact nerves regain something close to pre-treatment function.
• Within two years, it can rise to roughly 60%, depending heavily on surgical technique and how much nerve tissue could be spared.
• After that further improvement becomes less likely, and function can occasionally decline again.⁸

Recovery can also be different from day-to-day. You could see partial improvement, then plateau or even take a step backward, and then experience further gains.

The most consistent predictor of long-term outcome is your erectile function before treatment, not any single data point during recovery.⁸

Your partner is going through it too

Erectile changes after prostate treatment happen to a couple, not just a patient. In one survey of partners of prostate cancer survivors, more than three-quarters reported a decline in the quality of their sex life after treatment.⁹ Partners often experience their own psychological distress — sometimes more than the patient himself — and changes in intimacy can lead to overall relationship strain.

That’s why communication matters more than any single treatment choice. Couples who kept up open, constructive communication reported better relationship adjustment regardless of their actual level of sexual satisfaction.¹⁰ Inviting your partner into the conversation, with the urologist and at home, is one of the more evidence-backed ways to protect your relationship through this process.

Ask about erectile function before treatment, not after

Because so much of erectile outcome is tied to decisions made at diagnosis — which treatment, which surgeon, whether a nerve-sparing approach is feasible — the best time to raise sexual function is during your initial planning, not after side effects appear.

The Prostate Cancer Foundation recommends asking these questions to your doctor as directly as possible:¹¹

• How does each treatment option (surgery, radiation, hormone therapy, active surveillance) affect erectile function specifically, and how do the risks compare between them?
• Is a nerve-sparing approach possible? What does your doctor’s personal track record with erectile outcomes look like?
• What will your rehabilitation plan look like, and when should it start relative to treatment?
• What baseline erectile and urinary function do you have now, and how might that affect treatment?
• At what point should you expect to know whether your erectile function is recovering, and what should you do if it isn’t?

Asking these questions before committing to a treatment path doesn’t just set realistic expectations — it can directly shape which treatment and rehabilitation you and your urologist choose.

This article is for educational purposes and is not a substitute for personalized medical advice. Talk with your urologist about your specific diagnosis, treatment options, and recovery plan.

References

1. Chen J, Wang R, et al. Cavernous nerve injury resulted in erectile dysfunction and regeneration. NCBI Bookshelf/PMC. PMC8714392. Accessed September 2, 2026.
2. Emanu JC, Avildsen IK, Nelson CJ. Erectile dysfunction after radical prostatectomy: prevalence, medical treatments, and psychosocial interventions. Curr Opin Support Palliat Care. 2016 Mar;10(1):102-7. doi:10.1097/SPC.0000000000000195. PMID: 26808052; PMCID: PMC5005072.
3. Katz A. What happened? Sexual consequences of prostate cancer and its treatment. Can Fam Physician. 2005 Jul;51(7):977-82. PMID: 16060176; PMCID: PMC1479526.
4. Mayo Clinic Press. What to know about erectile dysfunction and prostate cancer. Published June 12, 2026. Accessed September 2, 2026.
5. American Urological Association. AUA2024 RECAPS penile rehabilitation 2024: where are we? AUANews. Published July 31, 2024. Accessed September 2, 2026.
6. Stanford Health Care. Penile rehabilitation. Accessed September 2, 2026. https://stanfordhealthcare.org/medical-treatments/p/penile-rehabilitation.html
7. Nehra A, Alterowitz R, Culkin DJ, et al. Erectile dysfunction: AUA guideline. J Urol. 2018;200(3):633-641. doi:10.1016/j.juro.2018.05.004
8. Johns Hopkins Medicine. Erectile dysfunction after prostate cancer. Accessed September 2, 2026. https://www.hopkinsmedicine.org/health/conditions-and-diseases/prostate-cancer/erectile-dysfunction-after-prostate-cancer
9. Movsas TZ, Yechieli R, Movsas B, Darwish-Yassine M. Partner’s perspective on long-term sexual dysfunction after prostate cancer treatment. Am J Clin Oncol. 2016 Jun;39(3):276-9. doi:10.1097/COC.0000000000000067. PMID: 24685887.
10. Badr H, Taylor CL. Sexual dysfunction and spousal communication in couples coping with prostate cancer. Psychooncology. 2009 Jul;18(7):735-46. doi:10.1002/pon.1449. PMID: 19061199; PMCID: PMC4476400.
11. Prostate Cancer Foundation. Questions to ask your doctor. PCF.org. Published April 17, 2025. Accessed September 2, 2026. https://www.pcf.org/questions-to-ask-your-doctor/

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