This "erectile issue" is very complex. The Few, The Proud -(maybe ex-jarheads?) who don't have ANY issue are indeed the Few and the Fortunate. I've gotten almost all of my erectile ability back after 7 month post-op, but I worked hard at it. I'm so tired of that stupid pump! The O-ring seals have worn, but that's OK, a small amount of vacuum does the job now.
Looking back I realize that there was a lot of psychological baggage involved. Desire to please my wife created performance anxiety. The harder I tried, the softer the erection. The ED meds and the pump get in the way of natural spontaneity. Sex becomes planned, like a trip to the dentist. There was a certain amount of anger - I had never had a problem before. Butthead Cancer! All of this short circuits the brain's response to what should be a pretty focused effort -and normally is! Most guys think about sex when they are having sex, right? (A lot of guys think about sex ALL the time). Your significant other can think of anything she wants (the ironing?) and get away with it. Not us. We have to PERFORM. Anything less suggests ... well ... we all know what it suggests.
The pump was the biggest help of all.
It created a very useable erection right from the beginning, coupled with ED meds. It eliminated the fear and anxiety. With a dependable erection I could focus on the business at hand. Anger became annoyance, a much less distracting emotion. Initially, my reaction to the pump was "This is so GAY!" It was an insult to my masculinity, another insult on top of the insult of the PCa. And, whether it contributed to my positive outcome, along with the meds, or the nerves just healed naturally, I will never know. I used to try without it, still do and it's much better, but finally resigned myself to the inevitable.
I would go the same route again, why take a chance with something so important? At the very least, it must accelerate the healing process, and it does provide a temporary band-aid.
My urologist/surgeon pushed the use of ED meds immediately after surgery, and also recommended that I get a pump and begin using it at three weeks post-op. 3X a week. I still do. At our last meeting, he said: "OK, now remove the ring and see if you can maintain a sustained erection once it's there". Ouch.
My wife has become addicted to the pump (it IS impressive what it accomplishes, limited only by the internal diameter of the pump cylinder), and now I live for the day when she says: "Honey, we don't need that thing anymore" . That will be the acknowledgement that I have finally beat the cancer, and life has returned to normal. Besides, who wants to carry that thing with them when they travel? "Bag Check!"