https://www.cbh4men.com https://www.cbh4men.com/what-is-penile-rehabilitation-after-prostate-cancer-treatment-a-complete-guide Most men are never told penile rehabilitation exists. Charles Hilson explains what it is, how it works, and why starting early after surgery or radiation matters. <div data-rss-type="text"> <p> <span> Penile rehabilitation is a structured program designed to restore and maintain erectile function after prostate cancer treatment — whether that treatment was surgery, radiation, or hormone therapy. Most men who go through prostate cancer treatment are never told it exists. This guide explains what it is, why it matters, and why starting early makes all the difference. </span> </p> <p> <span> <br/> </span> </p> <h2> <span> What Penile Rehabilitation Actually Means </span> </h2> <p> <span> Penile rehabilitation — sometimes called erectile rehabilitation — is the use of physical therapy principles to maintain healthy blood flow to the penile tissue during and after prostate cancer treatment. The goal is not immediately producing an erection for intercourse. The goal is keeping the smooth muscle tissue of the penis oxygenated and healthy while the body recovers from the disruption caused by surgery, radiation, or hormone therapy. </span> </p> <p> <span> Think of it the same way you would think about physical therapy after a knee replacement. You would not skip PT and simply hope the joint healed correctly. The same logic applies here. The tissue needs consistent, daily stimulation to stay viable — and without it, a process called penile atrophy begins, in which the tissue weakens and becomes harder to treat over time. </span> </p> <p> <span> <br/> </span> </p> <h2> <span> Why Prostate Cancer Treatment Causes Erectile Dysfunction </span> </h2> <p> <span> Prostate cancer treatment affects erectile function through three main pathways depending on the type of treatment. </span> </p> <p> <strong> Surgery </strong> <span>  — specifically radical prostatectomy — disrupts the neurovascular bundles, the clusters of nerves and blood vessels that sit millimeters from the prostate and are responsible for triggering erections. Even nerve-sparing surgery causes a period of nerve disruption called neuropraxia. During this period, the nerves are not destroyed but they are temporarily offline, and the tissue needs external support to stay healthy. </span> </p> <p> <span> <br/> </span> </p> <p> <strong> Radiation therapy </strong> <span>  causes progressive vascular damage to the blood vessels supplying the erectile tissue. Unlike surgery, the effects of radiation are not felt immediately — late radiation-mediated effects on the cavernous nerve can lead to erectile dysfunction after three to five years, and vascular damage from radiation results in fibrotic changes that reduce blood flow over time. </span> </p> <p> <span> <br/> </span> </p> <p> <strong> Hormone therapy </strong> <span>  — androgen deprivation therapy (ADT) — reduces testosterone to near-zero, which eliminates the hormonal signals that normally maintain penile tissue health. Studies show that after one year of hormonal therapy, 80 to 91 percent of men have erectile dysfunction. </span> </p> <p> <span> <br/> </span> </p> <h2> <span> How Penile Rehabilitation Works </span> </h2> <p> <span> The primary tool in the CBH program is a vacuum erection device (VED) — an FDA-cleared medical device that creates gentle negative pressure around the penis, drawing oxygen-rich arterial blood into the penile tissue. Used daily for approximately ten minutes, the device cycles blood in and out of the erectile chambers, preventing the hypoxia and fibrosis that follow from it. </span> </p> <p> <span> <br/> </span> </p> <p> <span> Unlike oral medications, which depend on a functioning nerve signal to work, vacuum therapy bypasses the nerve pathway entirely — making it effective for post-surgical patients whose nerve function is temporarily absent, and for radiation patients whose vascular damage limits the effectiveness of oral medications. </span> </p> <h2> <span> <br/> </span> </h2> <h2> <span> When to Start </span> </h2> <p> <span> The answer for both surgery and radiation patients is: as early as possible, and ideally before treatment begins. Prehabilitation — beginning a structured penile rehabilitation program before surgery or radiation — produces measurably better outcomes. </span> </p> <p> <span> <br/> </span> </p> <p> <span> For surgery patients who did not prehabilitate, the first weeks after surgery are the most critical window. For radiation patients, rehabilitation should begin before radiation starts and continue throughout the entire treatment period — including throughout any hormone therapy course. </span> </p> <h2> <span> <br/> </span> </h2> <h2> <span> Frequently Asked Questions </span> </h2> <p> <strong> Does penile rehabilitation work after prostate surgery? </strong> <span> <br/> Yes. Vacuum therapy and structured rehabilitation are recognized by the American Urological Association as effective approaches to preserving tissue health and supporting functional recovery. </span> </p> <p> <strong> How long does penile rehabilitation take? </strong> <span> <br/> For surgery patients, most programs run six to twelve months of daily use. For radiation patients on hormone therapy, the program may continue two to three years or more. </span> </p> <p> <strong> Can penile rehabilitation be done at home? </strong> <span> <br/> Yes. The CBH program requires no clinic visits, no prescription, and no injections. Everything is done at home in about ten minutes per day. </span> </p> <p> <strong> Is it too late to start if surgery was months ago? </strong> <span> <br/> No. The recovery window is longer than most men are told. Starting now is always better than not starting. </span> </p> <p> <strong> Is a Spanish-language program available? </strong> <span> <br/> Yes.  </span> <a href="https://www.cbh4men.com/espanol" target="_blank"> cbh4men.com/espanol </a> </p> <p> <span> <br/> </span> </p> <p> <a href="/FREE-GUIDE-FOR-MEN-BEFORE-OR-AFTER-PROSTATE-TREATMENT"> <strong> [Download the free CBH guide → cbh4men.com] </strong> </a> </p> </div> Wed, 01 Apr 2026 18:10:32 GMT https://www.cbh4men.com/what-is-penile-rehabilitation-after-prostate-cancer-treatment-a-complete-guide thumbnail main image https://www.cbh4men.com/prehabilitation-before-prostate-surgery-or-radiation-why-starting-early-changes-everything Prehabilitation before prostate surgery or radiation helps men protect erectile function before treatment begins. Learn what it involves and why the window before your procedure may be the most important time of your recovery. <div data-rss-type="text"> <p> <span> Most men learn about penile rehabilitation after treatment — when they are already dealing with the consequences. But the men who recover the most completely tend to be the ones who started before treatment ever began. That approach has a name: prehabilitation. This post explains what it is, what it involves, and why the window before your procedure may be the most valuable time in your entire recovery journey. </span> </p> <h2> <br/> </h2> <h2> <span> <span>  </span> What Is Prehabilitation? </span> </h2> <p> <span> Prehabilitation is the practice of preparing the body for an anticipated physical challenge — in this case, prostate cancer treatment — before that challenge occurs. In the context of penile rehabilitation, prehabilitation means beginning daily vacuum therapy and pelvic floor training before surgery or radiation, so that the body enters treatment in the strongest possible state and recovery can begin from a better baseline. </span> </p> <p> <br/> </p> <p> <span> The concept mirrors what orthopedic surgeons have long recommended before major joint surgery. Tissue that is well-conditioned, well-oxygenated, and well-trained before a disruption recovers faster and more completely afterward. The application to prostate cancer treatment follows the same clinical logic. </span> </p> <h2> <br/> </h2> <h2> <span> Why It Matters for Surgery Patients </span> </h2> <p> <span> The nerves responsible for erections sit within millimeters of the prostate. During surgery, even in nerve-sparing procedures, these nerves experience trauma. This disruption temporarily interrupts the signals that normally trigger erections and maintain blood flow to the penile tissue. </span> </p> <p> <br/> </p> <p> <span> Men who begin vacuum therapy before surgery enter this disruption period with penile tissue that is already well-oxygenated and conditioned. They also begin their post-surgical rehabilitation with confidence and familiarity — they know how to use the device and have already established a daily routine. </span> </p> <h2> <br/> </h2> <h2> <span> Why It Matters Even More for Radiation Patients </span> </h2> <p> <span> For men choosing radiation, prehabilitation is arguably more critical. Radiation therapy causes progressive vascular damage with fibrotic changes in blood vessels that reduce blood flow to the erection chambers, and smooth muscle atrophy as the corpus cavernosum deteriorates similar to other muscles when they go unused. This damage does not appear immediately — it develops over months. </span> </p> <p> <br/> </p> <p> <span> Hormone therapy compounds this by suppressing testosterone and eliminating the hormonal signaling that normally keeps penile tissue healthy. A man who does not begin rehabilitation until after his radiation course and hormone therapy have concluded may have spent one to three years in a state of chronic penile tissue oxygen deprivation. The tissue deterioration during that period is the problem. Prehabilitation before radiation and continued rehabilitation throughout treatment is the solution. </span> </p> <h2> <br/> </h2> <h2> <span> What Prehabilitation Involves </span> </h2> <p> <span> A CBH prehabilitation program includes two primary elements. </span> </p> <p> <span> The first is  </span> <strong> daily vacuum therapy </strong> <span>  using an FDA-cleared device — approximately ten minutes per day — to establish consistent blood flow before any treatment-related disruption occurs. </span> </p> <p> <span> The second is  </span> <strong> pelvic floor training </strong> <span> , specifically Kegel exercises, to condition the muscles that support urinary control and erectile function before surgery or radiation affects them. </span> </p> <p> <span> Neither element requires a clinic visit, prescription, or procedure. Both are done privately at home. </span> </p> <h2> <br/> </h2> <h2> <span> Frequently Asked Questions </span> </h2> <p> <strong> How far in advance should prehabilitation begin? </strong> <span> <br/> Ideally four to six weeks before the procedure. Even two to three weeks is better than none. </span> </p> <p> <strong> Can I prehabilitate if I am having radiation, not surgery? </strong> <span> <br/> Yes — and you should. Begin before radiation starts and continue throughout the entire radiation and hormone therapy period. </span> </p> <p> <strong> Is prehabilitation FSA/HSA eligible? </strong> <span> <br/> Yes. CBH accepts FSA and HSA payment for all devices and programs. </span> </p> <p> <strong> What if my surgery is already scheduled and I have limited time? </strong> <span> <br/> Start today. Contact CBH at  </span> <a href="https://www.cbh4men.com/" target="_blank"> cbh4men.com </a> <span>  to discuss express options. </span> </p> <p> <br/> </p> <p> <a href="/FREE-GUIDE-FOR-MEN-BEFORE-OR-AFTER-PROSTATE-TREATMENT"> <strong> Download the free CBH guide at cbh4men.com </strong> </a> </p> </div> Sun, 29 Mar 2026 18:28:47 GMT https://www.cbh4men.com/prehabilitation-before-prostate-surgery-or-radiation-why-starting-early-changes-everything thumbnail main image https://www.cbh4men.com/erectile-dysfunction-after-radiation-therapy-for-prostate-cancer-what-you-need-to-know Erectile dysfunction after radiation therapy for prostate cancer develops gradually and can worsen for years. Learn how hormone therapy extends the timeline and why rehabilitation during treatment matters more than waiting. <div data-rss-type="text"> <p> <span> One of the most common misunderstandings about radiation therapy for prostate cancer is that it is easier on sexual function than surgery. In the short term, that can appear true. But the erectile dysfunction that follows radiation is not immediate — it is progressive. And for men who are also on hormone therapy, the combination creates a multi-year period of sexual dysfunction that most patients are never fully prepared for. </span> </p> <h2> <br/> </h2> <h2> <span> <span>  </span> How Radiation Affects Erectile Function </span> </h2> <p> <span> Unlike surgery, which causes immediate nerve disruption, radiation therapy causes gradual, cumulative damage to the blood vessels and nerves that supply the erectile tissue. Most men will not notice any changes at first, but erectile function can decline over the next few years. Within five years of radiation therapy, approximately 50 percent of patients could develop radiation-induced erectile dysfunction. </span> </p> <p> <br/> </p> <p> <span> The three primary mechanisms are neuronal damage, vascular damage causing fibrotic changes that reduce blood flow, and smooth muscle atrophy as the erectile chambers deteriorate from disuse. Most patients who were able to maintain baseline erectile function prior to radiation will return to that baseline within two to three years. By fifteen years after treatment, however, the rates of erectile dysfunction among radiation patients are similar to those who underwent surgery. </span> </p> <h2> <br/> </h2> <h2> <span> The Hormone Therapy Factor </span> </h2> <p> <span> Many men receiving radiation for prostate cancer are also prescribed hormone therapy — androgen deprivation therapy — either concurrently or as an adjunct treatment. ED usually starts within six weeks of hormone therapy. If you have to stay on hormone therapy long-term, ED may be permanent. If your therapy is short-term, you may see recovery of erections about six months after stopping treatment. </span> </p> <p> <br/> </p> <p> <span> Your ability to have an erection may improve several months after hormone treatment ends, but this timeline assumes the tissue has been adequately maintained during the treatment period — which it will not be without active rehabilitation. </span> </p> <h2> <br/> </h2> <h2> <span> Why Waiting Until After Hormone Therapy Is a Mistake </span> </h2> <p> <span> The most common mistake radiation patients make is waiting until hormone therapy is over before starting penile rehabilitation. By that point, the tissue has often spent one to three years in a state of chronic oxygen deprivation. The correct approach is to begin rehabilitation before radiation starts and continue it consistently throughout the entire radiation course, throughout hormone therapy, and into the recovery period after. </span> </p> <p> <span> The vacuum device bypasses the hormonal pathway entirely and delivers mechanical blood flow to the tissue regardless of what testosterone levels are doing. </span> </p> <h2> <br/> </h2> <h2> <span> What Rehabilitation Looks Like for Radiation Patients </span> </h2> <p> <span> For radiation patients, the CBH program involves daily vacuum therapy — approximately ten minutes per day. During active radiation treatment, the goal is tissue maintenance. During hormone therapy, the device serves as the primary mechanism for keeping the tissue oxygenated. In the recovery phase after treatment, the program supports the return of spontaneous function as vascular and nerve health gradually improves. </span> </p> <p> <span> The timeline for radiation patients is longer than for surgery patients — often two to three years of consistent program use. </span> </p> <h2> <br/> </h2> <h2> <span> Frequently Asked Questions </span> </h2> <p> <strong> When does ED start after radiation therapy? </strong> <span> <br/> For most men, erectile changes begin to appear six months or more after radiation. The low point in erectile function after radiation therapy typically occurs around the third year. </span> </p> <p> <strong> Should I start rehabilitation while still on hormone therapy? </strong> <span> <br/> Yes — this is one of the most important things a radiation patient can do. Waiting until after hormone therapy means losing years of tissue conditioning time. </span> </p> <p> <strong> Is the CBH program designed for radiation patients? </strong> <span> <br/> Yes. The program explicitly covers both surgery and radiation pathways, including guidance for men currently on hormone therapy. </span> </p> <p> <strong> How long does penile rehabilitation take for radiation patients? </strong> <span> <br/> Most radiation patients benefit from a rehabilitation period of two to three years, tracking alongside the hormone therapy timeline. </span> </p> <p> <br/> </p> <p> <a href="/FREE-GUIDE-FOR-MEN-BEFORE-OR-AFTER-PROSTATE-TREATMENT"> <strong> Download the free CBH guide at cbh4men.com </strong> </a> </p> </div> Wed, 25 Mar 2026 21:11:24 GMT https://www.cbh4men.com/erectile-dysfunction-after-radiation-therapy-for-prostate-cancer-what-you-need-to-know thumbnail main image https://www.cbh4men.com/vacuum-therapy-for-erectile-dysfunction-after-prostate-cancer-does-it-work Vacuum therapy for erectile dysfunction after prostate cancer is FDA-cleared and clinically supported. Learn how it works, how it differs from medication, and why it is the foundation of penile rehabilitation programs. <div data-rss-type="text"> <p> <span> Vacuum therapy — the use of an FDA-cleared vacuum erection device to draw blood into the penile tissue — has been a clinically recognized approach to erectile dysfunction since 1982. It is recommended by the American Urological Association and used in structured penile rehabilitation programs for men recovering from prostate surgery and radiation. And yet most men who go through prostate cancer treatment have never heard of it. </span> </p> <h2> <br/> </h2> <h2> <span> <span>  </span> What Is a Vacuum Erection Device? </span> </h2> <p> <span> A vacuum erection device (VED) is an external, non-invasive medical device that creates gentle negative pressure around the penis, drawing oxygen-rich arterial blood into the corpus cavernosum — the spongy erectile tissue that fills with blood during an erection. The device consists of a clear acrylic cylinder placed over the penis, connected to a manual or battery-powered pump. </span> </p> <p> <br/> </p> <p> <span> Unlike the products sold under similar names in consumer stores, FDA-cleared vacuum erection devices include a built-in vacuum safety limiter — an automatic shutoff that prevents the device from exceeding safe pressure levels. This feature is what distinguishes a medical-grade device from a consumer product. For daily therapeutic use over months and years, this safety feature is essential. CBH Medical Rehabilitation uses only FDA-cleared devices with this mechanism. </span> </p> <h2> <br/> </h2> <h2> <span> How Vacuum Therapy Supports Penile Rehabilitation </span> </h2> <p> <span> After prostate surgery or radiation, the penile tissue is deprived of the natural blood flow it normally receives from spontaneous and nocturnal erections. Without this blood flow, the smooth muscle cells of the corpus cavernosum become hypoxic and begin to deteriorate — leading to fibrosis and atrophy that progressively reduces the tissue's capacity to respond to erection signals. </span> </p> <p> <br/> </p> <p> <span> Vacuum erection device therapy preserves erectile function by alleviating tissue hypoxia, helping inhibit apoptosis and prevent cavernous tissue fibrosis, and significantly increasing both glanular and corporal oximetry. Vacuum therapy mechanically restores blood flow on a daily basis, regardless of whether the nerve signals that would normally trigger it are functioning. </span> </p> <h2> <br/> </h2> <h2> <span> Vacuum Therapy vs. Oral Medication </span> </h2> <p> <span> Oral ED medications — PDE5 inhibitors like sildenafil and tadalafil — work by enhancing blood flow in response to a nerve signal. They amplify the process; they do not initiate it. For surgery patients whose nerve function is temporarily offline, this means the medication has limited effect. For radiation patients whose vascular supply has been progressively damaged, the same limitation applies. </span> </p> <p> <br/> </p> <p> <span> The combination of PDE5 inhibitors and vacuum erection devices is considered a first-line treatment option for penile rehabilitation after prostate cancer treatment. Many programs combine both approaches — using oral medications when nerve function begins to return, and vacuum therapy throughout as the consistent daily tissue maintenance tool. </span> </p> <h2> <br/> </h2> <h2> <span> Rehabilitation vs. Intercourse Use — an Important Distinction </span> </h2> <p> <span> There are two distinct uses for a vacuum erection device: rehabilitation and intercourse. During rehabilitation, only the cylinder and pump are used — no tension ring. The goal is to cycle blood in and out of the tissue for approximately ten minutes per day. </span> </p> <p> <br/> </p> <p> <span> For intercourse use, a tension ring is placed at the base of the penis after engorgement to maintain the erection after the cylinder is removed. The tension ring should not be left in place for more than thirty minutes. The CBH program includes step-by-step guidance, video tutorials, and live coaching for both uses. </span> </p> <h2> <br/> </h2> <h2> <span> Frequently Asked Questions </span> </h2> <p> <strong> Is vacuum therapy safe after prostate surgery? </strong> <span> <br/> Yes. It can typically begin within the first weeks after surgery once basic healing has occurred. </span> </p> <p> <strong> Does vacuum therapy restore erections permanently? </strong> <span> <br/> For many men, consistent use supports the return of natural function as nerve and vascular health improves over time. </span> </p> <p> <strong> How is a medical device different from a consumer product? </strong> <span> <br/> FDA-cleared medical devices include a vacuum safety limiter. Consumer products do not. For daily rehabilitation use, a medical-grade device is essential. </span> </p> <p> <strong> Can FSA or HSA funds be used? </strong> <span> <br/> Yes. CBH accepts FSA and HSA payment for all devices and programs. </span> </p> <p> <br/> </p> <p> <a href="/FREE-GUIDE-FOR-MEN-BEFORE-OR-AFTER-PROSTATE-TREATMENT"> <strong> Download the free CBH guide at cbh4men.com </strong> </a> <span> <br/> </span> </p> </div> Tue, 17 Mar 2026 21:16:01 GMT https://www.cbh4men.com/vacuum-therapy-for-erectile-dysfunction-after-prostate-cancer-does-it-work thumbnail main image https://www.cbh4men.com/how-long-does-erectile-dysfunction-last-after-prostate-cancer-treatment-surgery-and-radiation-compared How long erectile dysfunction lasts after prostate cancer depends on your treatment type, age, and whether you start rehabilitation. Surgery and radiation have different timelines — here is what to expect. <div data-rss-type="text"> <p> <span> One of the first questions men ask after a prostate cancer diagnosis is: how long will this affect my sexual function? The honest answer depends on which treatment you choose, how old you are, how your erectile function was before treatment, and — most importantly — what you do in the months and years that follow. </span> </p> <h2> <br/> </h2> <h2> <span> <span>  </span> After Surgery: The Timeline </span> </h2> <p> <span> Erectile dysfunction after radical prostatectomy begins immediately. With radical prostatectomy, erections are at their lowest point right after surgery — sometimes this takes up to four months — and can improve over the first 18 to 24 months. </span> </p> <p> <br/> </p> <p> <span> For men who had excellent erectile function before surgery and received nerve-sparing procedures, meaningful recovery of natural function within 12 to 24 months is realistic — provided that structured rehabilitation is maintained throughout that period. The key variable most men are not told: the recovery does not happen passively. It happens in direct proportion to how consistently and how early rehabilitation is maintained. Men who start rehabilitation within the first weeks after surgery and maintain daily use consistently outperform men who wait. </span> </p> <h2> <br/> </h2> <h2> <span> After Radiation: A Different Timeline </span> </h2> <p> <span> Radiation therapy creates a fundamentally different recovery pattern. Unlike surgery, where the disruption is immediate and recovery trends upward over 12 to 24 months, radiation causes progressive damage that worsens over time. Following radiation therapy, erectile function may start to decline, with the low point occurring after the third year. </span> </p> <p> <span> Most patients who were able to maintain baseline erectile function prior to radiation treatment will return to that baseline function within two to three years. By fifteen years after treatment, however, the rates of erectile dysfunction among radiation patients are similar to those who underwent surgery. For radiation patients who also receive hormone therapy, the timeline compounds further — hormone therapy can lead to a loss of desire for sex, erectile dysfunction, and difficulty achieving orgasm, and these effects persist throughout the treatment course and into recovery. </span> </p> <h2> <br/> </h2> <h2> <span> The Factors That Affect Recovery </span> </h2> <p> <span> Several factors consistently predict outcomes across both treatment types. Age at treatment is significant — younger men with more robust baseline erectile function tend to recover more completely. Pre-treatment erectile function is the single strongest predictor of post-treatment recovery. The presence of other health conditions — cardiovascular disease, diabetes, high blood pressure, obesity, smoking — all reduce the vascular and nerve environment in which recovery is happening, compounding treatment-related effects. </span> </p> <h2> <br/> </h2> <h2> <span> What Rehabilitation Changes </span> </h2> <p> <span> The most important thing to understand is that the recovery timeline is not fixed. Structured penile rehabilitation — beginning before treatment if possible, and maintained consistently through recovery — changes outcomes in a measurable way. Daily vacuum therapy maintains penile tissue oxygenation during the period when the body cannot maintain it naturally. This prevents the fibrosis and atrophy that would otherwise accumulate, preserving the tissue's capacity to respond when nerve and vascular function gradually returns. </span> </p> <h2> <br/> </h2> <h2> <span> Frequently Asked Questions </span> </h2> <p> <strong> How long does erectile dysfunction last after prostate surgery? </strong> <span> <br/> For most men, the period of significant ED after nerve-sparing surgery lasts 12 to 24 months. Recovery is faster and more complete in men who begin structured rehabilitation early. </span> </p> <p> <strong> How long does ED last after radiation for prostate cancer? </strong> <span> <br/> Radiation-related ED develops gradually, with the low point typically around the third year post-treatment. For men on hormone therapy, the timeline extends further. Active rehabilitation throughout this period is essential. </span> </p> <p> <strong> Can erections return to normal after prostate cancer treatment? </strong> <span> <br/> For some men, especially younger patients with excellent pre-treatment function who maintain consistent rehabilitation, yes. For others, recovery is partial but meaningful. The level of recovery is directly influenced by how early and how consistently rehabilitation is maintained. </span> </p> <p> <strong> Is it too late to start rehabilitation if it has been over a year since treatment? </strong> <span> <br/> No. Improvements in tissue health and function have been observed in men beginning rehabilitation well after their treatment date. </span> </p> <p> <br/> </p> <p> <a href="/FREE-GUIDE-FOR-MEN-BEFORE-OR-AFTER-PROSTATE-TREATMENT"> <strong> Download the free CBH guide at cbh4men.com </strong> </a> </p> </div> Wed, 11 Mar 2026 21:24:48 GMT https://www.cbh4men.com/how-long-does-erectile-dysfunction-last-after-prostate-cancer-treatment-surgery-and-radiation-compared thumbnail main image