Current and future strategies for managing erectile dysfunction following nerve-sparing robot-assisted radical prostatectomy (literature review)

Erectile dysfunction (ED) is one of the most frequently developing and significantly reducing quality of life complications of radical prostatectomy (RPE). According to the number of studies, ED is diagnosed in 60-75% of patients after the RPE. The use of nerve-sparing (NS) surgical techniques has reduced the incidence of ED after RPE, but has not completely solved this problem. In addition, it is not always possible to preserve the vascular-nerve bundles for the reason of oncological radicalism. All of the above factors make the issue of restoring erectile function one of the priority areas of medical rehabilitation of patients after the radical surgery for prostate cancer (PC). The development of new strategies for the treatment of ED after NS RPE, aimed at maintaining endothelial function in the cavernous arteries until the completion of remyelination and restoration of damaged cavernous nerves, is a relevant and actively developing area of modern andrology. © 2025 Elsevier B.V., All rights reserved.