Medical and surgical advances in the radical prostatectomy patient

Maintaining the quality of life after surgery in the radical prostatectomy patient is of paramount importance. One of the major dilemmas in surgical m anagement of radical retropubic prostatectomy (RRP) is preservation of the neurovascular bundle and, hence, erectile function and the continence mecha nism. This manuscript addresses anatomical considerations for the surgeon a nd discusses the following issues with regard to medical and surgical thera pies: (1) incidence of erectile dysfunction solely due to complications dur ing RRP; (2) nerve damage during RRP; (3) vascular damage during RRP; (4) c urrent medical and surgical therapies for restoring or maintaining potency; and (5) new advances on the horizon for management of the prostatectomy pa tient.