I too traveled to UCLA to see Dr Marks team in the fall of '21 after my 3+4 diagnosis and again in January of '22 before I made my final decision. After reading all of the research papers on the various procedure options, reviewing the MRIs with Marks and a few other specialists I decided my best opportunity for the ideal outcome was with RP. My decision tree came down to two key outcomes in order of priority, the best opportunity to remain on this side of the dirt with the lowest possibility for cancer recurrence and sexual health. My surgery was in March of '22 so I'm coming up on 3 years with PSAs at zero. Now to your real Q, yes I still have an active and regular sex life with zero need for ED drugs or any other support. How I reached this point involved a serious commitment to the process and surely some luck. During RP they took out the prostate and one nerve bundle. Surprisingly after the catheter was removed(8 days post op) I had zero problems gaining an erection so at 30 days post op sexual activity began. Two weeks in my erection became less frequent so I went on Trimix as the ED drugs didn't help me evidently due to my low resting rate(47-50bpm). In laymen's terms, Trimix supported the retraining of my erection so after about 5 months of periodically using it I'm now two years with zero need for any support in that area at age 61. GOOD LUCK!!!