Hi Graham,
Thank you for your post. I was about to raise a similar question, although I am now on the other side. I had a robotic ‘non nerve sparing’ radical prostatectomy in October 2015. I asked (it wasn’t routine) for an ED appointment soon after my operation, and the ED nurse wished that everyone booked to see her even before the operation, so my advice would be get there as soon as you can.
So after the operation, I made a very good recovery, but there was absolutely no erectile function whatsoever. My penis had shrunk, and for a few weeks, it felt uncomfortably cold. The ED nurse prescribed me a vacuum pump for penile rehabilitation, which I have been using regularly. It is not an erotic experience for me at all, but apparently it keeps the blood flowing, and prevents it shrinking even more. I was able to achieve orgasm with my flaccid penis, but it took a great deal of stimulation, and frankly was hardly worth it. The treatments offered (pumps and injections) are geared towards achieving an erection, whereas I think my problem is that the arousal just doesn’t build. Sexual touching is still arousing, but the arousal subsides very quickly and at any point in the proceedings, my body would be quite happy to stop and go and finish the washing up, but my brain is feeling frustrated. It wasn't like this 6 months ago!
I was then put on hormone withdrawal therapy, and my libido has nose dived. I am still trying to use the vacuum pump, but my testicles have shrunk so they get sucked into the pump, and they are still just large enough for that to be very painful. So what with everything, it does almost feel like the end of sex, which is a great sadness.
So not much comfort for you from my experience, except that before I went on the hormone therapy, I can honestly say that things were certainly getting better. The cold feeling went away, I was getting the hang of the pump, and even tried the constriction rings a few times. Of course, I immediately started with the largest ring (size 5), but once I got used to it all and admitted that I’m not that big and worked my way down to size 3, I had something a bit more like we were used to. It may seem obvious, but arousal is easier with an erection.
There are several posts here that say it’s worth giving up sex to stay alive, and that’s true, but the suddenness of the loss is hard, and even though I have a very understanding partner, it is going to take some further work to learn how to be intimate in different ways and how I can express my love for her. I also hope we can learn how to arouse me sexually, as I feel it will be achievable. I’ve read that men often confuse sex and love, which for me in the past worked fine, but now things are different. Be patient and explore, take Chris J’s advice above, and things will almost certainly improve as your body heals. Apologies for such a long reply, and further apologies for some of the detail, but I hope it’s useful for you.
The very best of luck next month!
Chris