Total mesorectal excision with pelvic autonomic nerve preservation (TME-ANP)  has been reported to be an optimal surgery for rectal cancer. It minimizes local recurrence and sexual and urinary dysfunction. There is a device (CaverMapÆ Device) that has the potential ability to enhance pelvic autonomic nerve identification and preservation during rectal surgery. Erectile dysfunction after rectal excision for rectal cancer is completely reversed or satisfactorily improved in 79 percent of patients after use of sildenafil. This means that these patients have an  excellent  chance  of  improvement  in  their  erectile  function  with  sildenafil.