Just weighing in. I'm a wife of a young, and healthy 46 year old husband (diagnosed at 45) who opted for surgery. Like many here, our goal was 1. cancer, 2. continance. 3. ED. We are doing well on on fronts. Numbers, 1 and 2, especially 2, were easy to overcome. We've been diligently working on number 3, and everyday it gets better. Like you and your wife, we too have a very active sex life. What has worked for us during past 6 months is our attitude around ED. Hubby never allowed it to get him down. Yes, the first several times of trying were very awkward, but we didn't stay stuck there, dwell, or make a big deal about it. We kept trying, and made the most of where we were at in the process, recognizing that it was different, BUT expecting it to slowly improve.
Hubby had 1 nerve spared, and pretty severe ED following surgery this past February. Our URO made sure we had the tools: levirtra, trimix, and a pump to keep at it, and we've used them all at different times :) His Physican's Assistant made an excellent point, however, during our trimix visit when she said, "you can use trimix, but sex starts in the mind", and isn't that the truth.
I don't know the numbers, but I'd imagine ED is pretty high following surgery, but for us, that was secondary (even though we were very sexually active). I don't want to say I'd expect it, BUT if you do go with surgery and ED happens, work through the process of sexual rehab with a positive attitude, knowing yes, different, even awkward, but headed towards better. You are young, healthy, and determined, so you can definitely make it work. We went into surgery knowing that ED was a real possibility, even though hubby was young. We never held onto nor questioned "will it happen", we accepted that it probably would, BUT we wouldn't let it slow us down (we're persistant like that).
Hubby went back to Levitra this weekend and had 100% percent sucess, 6 months post-op! I call that SUCCESS!
PS I'm not pushing nor endorsing surgery, just sharing the experience of a young, healthy, sexually active couple. Good luck...
~walkbyfaith~ Hubby, age 45, DX 12/23/11, PSA 17.2
Biopsy, Gleason: RIGHT SIDE: 3+3, (10 or less volume) LEFT SIDE: 3+3, 3+3 (both approx 10% volume or less) 4+3, 4+3 (30% volume)T1C, Bone - Neg, CT - Neg
RALP: 2/2/2012 POST-OP: ORGAN CONFINED: Primary Pattern, Grade 4, Secondary Pattern: Grade 3 = 7 (19% prostate tissue involved) PNI/present, SVI/neg, MARGINS/clear, LN/neg, t2C
PSA, <0.1, 4/2012