If you join this study, you will be placed into one of two groups by chance. One group will get pelvic floor physical therapy, which helps with bladder control and sexual function. The other group will get the same therapy plus sex therapy, which includes up to ten video sessions over six months with a trained therapist. These sessions will be audio recorded to make sure the program is being done the right way. Everyone in the study will receive a vacuum erection device and learn how to use it safely. You will fill out surveys about your health and sexual function when you start the study and again at 3, 6, 9, 12, 18, and 24 months. These surveys will ask about sexual function, urinary symptoms, physical health, activity, and mood. You will also take part in short recorded interviews at 6 and 12 months to talk about your experience.