Prostate cancer is the most common cancer (representing about 25% of all new cancer diagnoses) in men in the USA. While radical prostatectomy, or surgical removal of the prostate, is the medical treatment of choice, the major urological complications of this procedure are incontinence and erectile dysfunction (ED), regardless of the surgical method used. After surgery, the risk of erectile dysfunction is as high as 90%, significantly impacting the quality of life and taking up to 3 years for the return of partial erections.

Don't wait for recovery from surgery to address sexual dysfunction. While various medical treatment options are available, including phosphodiesterase type 5 inhibitors (Viagra, etc.), penile injections or suppositories, vacuum devices, and penile prostheses, none address the psychological and emotional impact of sexual dysfunction on the patient and his relational life. There is also a 'use it or lose it' component to the erectile capacity of the penis. Therefore, waiting for recovery and subsequent sexual inactivity may actually hinder the ability to recover erectile capacity. Along with psychotherapy support for such post-surgery issues as performance anxiety, depression, and low-self esteem, sex therapy also provides relationship counseling and behavioral tools to enhance sexual expression and function.

• First and foremost, communication, communication, communication.

• Counseling and sex therapy.

• Sexual activity in the morning when an erection is more likely.

• Ample amount of tactile stimulation, manually or orally, before and during sex

• Spending more time on sexual activities other than intercourse.

• Focus on sensuality and intimacy rather than sex.

• Achieving orgasm via other techniques.

• Trying new sexual activities outside of the usual repertoire.

• Encouraging the experience sexual pleasure regardless of sexual difficulties.

• Taking turns at giving or receiving sexual pleasure.

• Consulting with a doctor about oral medications and impact of prescriptions.

• Phosphodiesterase Type 5 Inhibitors such as Viagra, Cialis, Levitra, etc.

• Injection or suppository therapies

• Genital devices for blood flow (vacuum pump).

• Over the counter supplements that impact the arousal pathway.

• Mechanical devices (vibrators) and sex toys.

• Other mediums for sexual outlets and support: self pleasure, videos, magazines, etc

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