Others take a different view but in my mind, it seems that the decision making process should be:
1. which treatment or combination of treatments gives me the best chance of remission without needing salvage treatment
2. can I live with the potential side effects of that treatment
3. for the treatment that is most acceptable to me in terms of risk of side effects, how high is the risk of needing salvage treatment
You know that surgery is going to leave you with ED which some ED treatments won't be able to help with. But if surgery is the most likely to get you to remission, that might be something you can live with on the basis that there probably wouldn't be much sex going on with HT either. Plus ED treatments for non nerve sparing men are improving.