Abstract
Penile erection starts when electrical impulses from the paired cavernous nerve bundles stimulate dilation of arteries supplying blood to the penis. These nerves can be thought of as fine, spiderweb‐like on/off switches that are attached to the prostate. During prostate surgery, heat, cutting, and stretch injuries can damage (and sometimes destroy) these nerves. There can also be damage to blood vessels supplying the penis and/or development of scar tissue that limits the ability of the penis to expand normally and trap blood during erection. Radiation treatments for prostate cancer can also damage the cavernous nerves and other tissues important for erections. Having a “nerve sparing” procedure does not guarantee recovery of erections. Keep the slow recovery time of nerves (6–36 months) in mind when setting expectations about erection recovery after prostate cancer treatment.
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