Prostate cancer and sexual function have been closely intertwined since the beginning of the twentieth century, when radical perineal prostatectomy was first developed by Hugh Hampton Young as an effective therapy for localized prostate cancer. It was immediately recognized that treatment for prostate cancer came at the cost of erectile function.With the pioneering discovery by Huggins and Hodges in 1941 that prostate cancer would respond to castration or the administration of estrogens, loss of sexual function became indelibly impressed in the minds of both physicians and the public as an inevitable consequence of therapy for prostate cancer. As radiation therapy began to grow as an attractive form of treatment for prostate cancer, the relationship of treatment to sexual dysfunction became murkier.