Background & Objective: Radical prostatectomy (RP) is associated with erectile dysfunction and despite nerve-sparing (ns) surgery fewer than 50% of patients regain satisfactory erectile function (EF) within two years. Optimal multimodal rehabilitation strategies remain unclear. This prospective feasibility study evaluated whether an intensive program combining daily sildenafil and vacuum erection device (VED) therapy could be implemented and tolerated. Methods: Between May 2021 and October 2022, patients with satisfactory preoperative EF and unsatisfactory EF after nsRP, without contraindications for sildenafil, In this single-centre study. The protocol included early initiation (?4 mo) of daily sildenafil (75/100mg) and regular VED use (5 times a week), with 18 mo follow-up. EF was assessed using clinical reports and patient-reported outcomes (Erection Hardness Score and International Index of Erectile Function). Key findings and Limitations: Of 66 eligible patients, 51 were enrolled; nerve sparing was full bilateral in 31%, partial bilateral in 43%, and unilateral in 26%. Twenty percent discontinued, mainly due to sildenafil side effects. Among 41 completing follow-up, 59% were fully adherent. At 18 mo, 80% achieved satisfactory EF, including 51% without erectile aids. Limitations include the single-centre, one-arm design, small sample size, and missing data affecting adherence estimates. Conclusions and clinical implications: Early multimodal penile rehabilitation after nsRP is implementable, associated with high adherence and promising EF recovery. Multicentre randomized trials are needed to confirm efficacy and generalizability