Table 2.

Timelines and patient goals for erectile recovery

Timeline	Long-term penile health	Short-term erectile function
Prior to treatment	– Treatment flow post-treatment focused on the patient’s desire to maintain penile health over the long-term	– Treatment flow post-treatment focused on the patient’s desire to achieve functional erections in the short-term
	Psychosocial focus: Normalize use of pro-erectile aids, education on timeline of recovery, and success with use of pro-erectile therapies exploring patient’s goal for erectile recovery*
6 weeks post-treatment	– PDE5i first-line; dosage daily vs. PRN – Include penile stimulation in treatment flow	– Include penile stimulation in treatment flow – If immediate erection is the goal, consider ICI therapy first-line, or possibly PDE5i full-dose if responsive
	Psychosocial focus: Importance of regular sexual activity (penetrative or non-penetrative), education on timeline of recovery, manage expectations for erectile recovery and success with use of pro-erectile therapies; encourage couples to maintain sexual intimacy (penetrative or non-penetrative)
10 weeks post-treatment	– PDE5i first-line; dosage daily vs. PRN – Include penile stimulation in treatment flow	– Include penile stimulation in treatment flow – If immediate erection is the goal, consider ICI therapy first-line, or possibly PDE5i full-dose if responsive
	Psychosocial focus: Assessment and treatment of partner concerns, encouraging adherence to pro-erectile treatment plan; encourage couples to maintain sexual intimacy (penetrative or non-penetrative)
4 months post-treatment	– For patients who do not respond initially to PDE5i, introduce ICI or MUSE or VED	– Depending on response to PDE5i, consider continued use of effective PDE5i or ICI or MUSE or VED
	Psychosocial focus: Recognition of grief response to sexual losses or performance anxiety, acknowledge impact on masculinity; encourage couples to maintain sexual intimacy (penetrative or non-penetrative)
6 months post-treatment	– For patients who do not respond initially to PDE5i, introduce ICI or MUSE or VED	– Depending on response to PDE5i, consider continued use of effective PDE5i or ICI or MUSE or VED
	Psychosocial focus: Re-visit expectations and goals, and explore level of patient’s bother due to ED; sexual desire and fantasy; encourage couples to maintain sexual intimacy (penetrative or non-penetrative)
12 months post-treatment	– Re-challenge with PDE5i as needed – For patients who do not respond to PDE5i, introduce ICI or MUSE or VED	– Depending on response to PDE5i, consider continued use of effective PDE5i or ICI or MUSE or VED
	Psychosocial focus: Redefining sex life and building on success
18 months post-treatment	– Re-challenge with PDE5i as needed – For patients who do not respond to PDE5i, introduce ICI or MUSE or VED	– Depending on response to PDE5i, consider continued use of effective PDE5i or ICI or MUSE or VED
	Psychosocial focus: Confirming goals and expectations
24 months post-treatment	– Re-challenge with PDE5i as needed – For patients who do not respond to PDE5i, introduce ICI or MUSE or VED	– Depending on response to PDE5i, consider continued use of effective PDE5i or ICI or MUSE or VED
	Psychosocial focus: Long-term goal setting and management; adaptation and acceptance; satisfaction with pro-erectile therapy

Consider time since treatment an expectation management.

^*Patient goals should be continually evaluated.

ICI: intracavernous injection; PDE5i: phosphodiesterase type 5 inhibitors; VED: vacuum erection devices.