Patient D is a 58-year-old white male who had his prostate removed 8 months earlier.   His sexual function was normal prior to the surgery, but since the surgery he has no function at all.  

This is a common situation with prostate surgery.    This is an anatomic problem.   There are nerves that go to penis that actually run beside the prostate.   Without these nerves being intact, there is no erection.   So, when the surgeon removes the prostate by regular surgery or robotic surgery, it is very easy to damage these nerves.    With robotic surgery there is frequently less injury to these nerves, but it still happens.   Radiation can cause the same problem by damaging the same nerves.   Most urologists will say there are a significant number of people who will regain function after the nerve heals, but not everyone.  

This man was easily treated with ICI and he has resumed his normal function.    He is very happy to have his sex life back.