Multimodal Prehabilitation and Rehabilitation for Men Undergoing Robot-Assisted Radical Prostatectomy

Inclusion Criteria: 1. Adults aged ≥18 years undergoing elective robot-assisted radical prostatectomy (RARP) with curative intent for confirmed prostate cancer. 2. Consulting a urological surgeon with an appointment at participating sites at least 4 weeks prior to scheduled surgery. 3. Willingness to engage in prescribed self-directed interventions. 4. Expected to have 100% unilateral OR \>50% bilateral nerve sparing at prostatectomy Exclusion Criteria: 1. Cognitive impairment such that they lack capacity to provide informed consent. 2. Currently taking intracavernosal injection therapy. 3. Severe or complete erectile dysfunction at baseline, defined as an IIEF-5 score ≤7 or self-reported absence of erectile function. 4. Prescribed nitrates or guanylate cyclase stimulators (e.g., riociguat) - pharmacological contraindication to PDE5 inhibitor use. 5. Impaired renal function (GFR \<50 mL/min and/or creatinine clearance \<30 mL/min). 6. Severe hepatic impairment or concurrent prescription of medications that inhibit CYP3A4. 7. Loss of vision in one eye due to non-arteritic anterior ischaemic optic neuropathy (NAION). 8. Myocardial infarction within the last 90 days. 9. Stroke within the last 6 months. 10. Unstable angina or angina occurring during sexual intercourse. 11. New York Heart Association (NYHA) Class II or greater heart failure in the last 6 months. 12. Uncontrolled arrhythmias, hypotension (\<90/50 mmHg), or uncontrolled hypertension. 13. Contraindications to participating in the prescribed exercise program. 14. No access to a device with internet connectivity.