How to cite: Colella KM, and Newman DK. Proactive Management of Post-Prostatectomy Incontinence and Erectile Dysfunction. Grand Rounds in Urology. December 16, 2025. Accessed Oct 2026. https://grandroundsinurology.com/proactive-management-of-post-prostatectomy-incontinence-and-erectile-dysfunction/
Summary
Diane K. Newman, DNP, ANP-BC, FAAN, FAUNA, BCB-PMD, Urology and Pelvic Floor Nurse Specialist, University of Pennsylvania; Adjunct Professor of Surgery, Perelman School of Medicine, Emerita, University of Pennsylvania, Philadelphia, Pennsylvania, welcomes Kathleen M. Colella, APN-CNP, Advanced Practice Clinician, Endeavor Health Urology Center, Glenbrook Hospital, Glenview, Illinois. They share a structured, proactive approach to managing urinary incontinence and erectile dysfunction in men undergoing radical prostatectomy.
Patients are evaluated one to two weeks prior to surgery to receive education about expected postoperative side effects. Pelvic floor muscle exercises are taught and demonstrated, and phosphodiesterase type 5 inhibitors are initiated preoperatively, paused during surgery, and resumed after catheter removal.
Postoperative follow-up occurs every three months during the first year. Penile rehabilitation includes vacuum erection device use for “penile conditioning,” involving repeated cycles of erection and detumescence to promote blood flow. Penile stretched length is measured before surgery and monitored after surgery to address perceived shortening and recovery progress.
Treatment escalation options, including intracavernosal injections, are discussed based on patient preference and recovery trajectory. In-office pelvic floor muscle isolation is verified, with referral to physical therapy when needed.
This discussion highlights the critical role of advanced practice providers in survivorship care and in optimizing quality of life following prostate cancer surgery.
ABOUT THE AUTHOR
Kathleen M. Colella, MSN, APN-CNP, FAUNA, is an advanced practice clinician with Endeavor Health’s Urology Center at Glenbrook Hospital in Glenview, Illinois. Her clinical specialty is urology with a focus on sexual health and prostate cancer care. She specializes in the support of patients preparing for and recovering from prostate cancer treatment and the management of side effects throughout their treatment process.
Dr. Diane K. Newman is an Adjunct Professor of Surgery at the Perelman School of Medicine at the University of Pennsylvania. She is the former Co-Director of the Penn Center for Continence and Pelvic Health, Division of Urology, Penn Medicine, in Philadelphia. She is a Fellow of the American Academy of Nursing and the Academy of Urologic Nurses and Associates. She is certified as an adult nurse practitioner by the American Nurses Credentialing Center and Board Certified in Biofeedback for Pelvic Muscle Dysfunction by the Biofeedback Certification Institute of America.
Dr. Newman has 35+ years of experience practicing as a urology advanced practice provider and continence nurse specialist. Her clinical expertise involves the evaluation, treatment, and management of urinary incontinence, bladder dysfunction, and related problems, including the use of catheters and other devices in the management of bladder and pelvic floor conditions. Throughout her career, she has evaluated and treated men and women with urologic disorders in multiple settings: acute care, long-term, and home care, with 23 years in an ambulatory practice at the Division of Urology at the University of Pennsylvania.
