Many times subltle problems with ED may worsen after prostate surgery, particulary after a radical prostatectomy for cancer or even with a transurethral resection of the prostate for an enlarged prostate.

The first step in evaluation would be to measure the level of testosterone (male hormone) in the blood…this needs to be done early in the morning. If the level is low, testosterone replacement may be suggested…in the absence of a history of prostate cancer. Testosterone supplementation is contraindicated in patients with prostate cancer. If testosterone supplementation is ineffective or contraindicated, oral medications such as Viagra, Levitra, or Cialis may be used if there is no history of heart disease. If this is unsuccessful, intracorporal injections (ICI) may be sugggested. This involves injecting the penis with medication prior to intercourse and can be very successful. However many men may not want to inject a medication with a needle and syringe into their penis. A vacuum device may also be suggested.

The bottom line is ED needs to be evaluated and treated by a Urologist.