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Intracavernous Injection Therapy as Second-Line Treatment for ED After Radical Prostatectomy: A Literature Review

Vlaicu AG, Mirvald C, Najjar S, Garaz R, Tsaur I, Sinescu I, Surcel C

Medicina (Kaunas, Lithuania), 2026

Abstract

Erectile dysfunction (ED) is a frequent and significant complication of radical prostatectomy that impacts patients' quality of life. Intracavernous injection treatment has become an important approach to post-prostatectomy ED, providing an immediate and proven means of regaining erectile function in men who are unresponsive to oral phosphodiesterase type 5 inhibitors. The scope of this article is to discuss the mechanisms, efficacy, and safety of ICI treatments using vasoactive compounds as a second-line treatment for ED after radical prostatectomy. We consider clinical results, satisfaction, and compliance, as well as predictors of success, like nerve-sparing procedures. Through our interpretation of evidence and clinical experience, ICI therapy is a cornerstone of penile rehabilitation and ED management following radical prostatectomy. Also, the prospects for further treatment optimization and patient outcomes are discussed.

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