ABSTRACT
Radiotherapy (RT): Generally, the basics of this schedule are usable also for the protection of erectile function after RT. Currently, radiological treatment options for men with localized PCa are external beam radiotherapy (EBRT) or high-dose interstitial brachytherapy in combination with temporary androgen ablation and, in case of low risk PCa, low-dose interstitial brachytherapy, which is probably the most common form of radiotherapy in these patients. Arguing a comparable long-term biochemical control and survival rates with radical prostatectomy (RP) in patients with low-risk disease, sexual function can be preserved in more than 50% after RT (12,13). Nevertheless, postradiation erectile function seems to worsen over time in about 50% of the patients who were potent before treatment (14), making an individualized counseling necessary to find out the best choice for the individual’s sexual quality of life expectation. Concerning the ongoing debate, whether a postintervention PDE5 inhibitor administration has to be continous or on demand, latest data provide evidence for a paradigm shift toward on-demand therapy (15). Alprostadil injections are suggested to be started three months after surgery (11) (Table 1).
