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Side effects of Prostatectomy

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User
Posted 20 Jan 2024 at 20:33

Hi,

I am 47 and got diagnosed with prostate cancer in December. 

I have been advised to have the op due to my age and risk of it coming back or other cancer in the pelvic area. 

I have read a lot about ED and it seems this is very different for each person. 

My consultant said he should be able to do 100% nerve sparing on the right side and 50% on the left. 

He also said there is a 30% risk of never getting an erection or having an orgasm again.

I know there is lots of things you can do to help ED but has anyone experienced not having an orgasm.

This is really troubling me and the thought of this is stopping me moving forward. 

Thank you in advance 

User
Posted 21 Jan 2024 at 12:52

Originally Posted by: Online Community Member

Remind me to never again read your posts when eating my breakfast!!

:)

Did it put you off your yoghurt Steve?

User
Posted 20 Jan 2024 at 20:33

Hi,

I am 47 and got diagnosed with prostate cancer in December. 

I have been advised to have the op due to my age and risk of it coming back or other cancer in the pelvic area. 

I have read a lot about ED and it seems this is very different for each person. 

My consultant said he should be able to do 100% nerve sparing on the right side and 50% on the left. 

He also said there is a 30% risk of never getting an erection or having an orgasm again.

I know there is lots of things you can do to help ED but has anyone experienced not having an orgasm.

This is really troubling me and the thought of this is stopping me moving forward. 

Thank you in advance 

User
Posted 21 Jan 2024 at 10:33

Remind me to never again read your posts when eating my breakfast!!

:)

User
Posted 21 Jan 2024 at 20:23

Darren , I describe my self as supposedly non nerve sparing , because my surgeon said he wouldn't be sparing any nerves. I did make some recovery after surgery but I will never fully recover. Now nearly ten years since surgery and still get the odd surprise. I describe my dry orgasms as out of this world. The main this is never give up and have fun finding a solution. 

You don't need an erection for vaginal intercourse,we mastered the technique of flaccid insertion.

Thanks Chris 

User
Posted 28 Jan 2024 at 09:13
Hi Darren

I hope you are finding all these replies as helpful to you prior to surgery as I am after. I’m 61 and mrs and I have not been sexually active. So I barrelled on ahead with the surgery not really considering the impact on my sexual functioning. Though I should emphasise I was given full information and plenty of it. My surgeon was unclear about how much nerve sparing was possible although he suggested that one side was certainly more possible than the other. I’m still awaiting some clarification post op on how that went (surgery went ok).

I am only 12 days post op and 5 post catheter removal. A couple of things have become apparent to me. I have quite an absence of sensation and certainly can’t get erect or even off the starting block. It shouldn’t have, but it’s coming as a bit of a shock and it is taking some processing. I think my point here is no matter how prepared you are for changes in that department, it’s important not to underestimate the psychological impact and at least be aware of the likelihood of change in your sexual life.

Despite all this, I also like others here have discovered the possibility of dry orgasm - in my case in a completely limp state. Exhausting but satisfying. Different yes, and again may get you to question your understanding of potency but I can see an enjoyable future! It is also very early days here post op, so I don’t know if or when things might change. I am on tadalafil so that might help though no impact so far.

The last thing I want to draw your attention to is the possibility of losing length and girth. This the surgeon did not prepare me for and again is having psychological impact. There are other very good threads on this site discussing it. It does not affect everyone but handy to prepare for the possibility.

I hope my own experience is helpful and not coming across negatively. For myself I think no matter how much info I had before the op it still comes somewhat as a surprise as all the feelings are new. All part of the journey of recovery.

I wish you well with surgery and hope all goes optimally!

Cheers

Richard

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User
Posted 21 Jan 2024 at 02:56
Is it possible that you misheard or that the urologist made a simple mistake when he was talking to you? While the odds of 30% risk of never having an erection seem fairly realistic (it might not actually be as bad as that - more like 20%) having nerves removed or damage should not affect your ability to have an orgasm. It can be more difficult to achieve an orgasm without an orgasm but oral sex and / or masturbation (with a lot of lube) don't need an erection, just patience and a sense of humour.

My husband had 100% nerve-sparing on one side and 50% nerve-sparing on the other and had his first non-erect orgasm the night his catheter was removed although he didn't really recover erectile function until a couple of years post-op and still has to use tablets and injections 14 years later.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 21 Jan 2024 at 08:03

Hi Darren, 

After surgery, having no prostate means that you won't be able to produce semen so your orgasms will be 'dry'. 

For me.. orgasms aren't as good as before, not just because they're dry, but there is no longer that pumping sensation. I just don't find them as intense as before. There's a plus side to dry orgasms though, as there's no mess.

Others on here will probably disagree as some are lucky and can have really good orgasms.

Hope this helps. 

Kev.

Edited by member 21 Jan 2024 at 08:06  | Reason: Typo

User
Posted 21 Jan 2024 at 08:46
That's an interesting observation Kev T as pre-op I never produced large volumes of semen - a couple of quick spurts and a dribble - hence I have found that the dry orgasms are much better than before, certainly during masturbation.

So I never really experienced the 'pumping sensation' that you refer to and maybe that is one of the differences in the new quality of orgasm reported by different post-op men.

Interesting.

User
Posted 21 Jan 2024 at 09:21

Hi Darren.

Sorry to see you here, but welcome to the club.

I had a prostatectomy, non nerve sparing and was told I would never get a natural erection again. Thus far, that seems to be the case. However, 7 months post op, I was able to get an 80% one, good enough for penetrative sex, by using Invicorp injections

I can orgasm with or without an erection, and they're as toe curling good for me, (not so sure about the wife) as they were before the op.

Flaccid masturbation is an art form you have to learn. Not being able to ejaculate is a bit wierd, as Kev says you miss the pumping climax, but on the other hand you save a fortune in tissues and there's no fighting about who has to sleep on the wet patch.

I've had prostate problems for years and my ejaculate was always more like lumpy snot than single cream. So I don't really miss ejaculations.

On the downside, I do desperately miss the spontaneity of natural erections. 

Adrian

Edited by member 22 Jan 2024 at 05:51  | Reason: Typo

User
Posted 21 Jan 2024 at 10:33

Remind me to never again read your posts when eating my breakfast!!

:)

User
Posted 21 Jan 2024 at 12:52

Originally Posted by: Online Community Member

Remind me to never again read your posts when eating my breakfast!!

:)

Did it put you off your yoghurt Steve?

User
Posted 21 Jan 2024 at 13:38

Originally Posted by: Online Community Member

Did it put you off your yoghurt Steve?

Or his very soft boiled egg. 😄

User
Posted 21 Jan 2024 at 20:11

Hi Darren,

Sorry that you find yourself here.

I had a prostatectomy 18 months ago.  It was said to have been nerve-sparing on both sides, but later, the Surgeon told me that, even so, I still only had a 50% chance of recovery of the nerves due to trauma.  This possibility was never mentioned to me prior to the surgery.  I had naively assumed that nerves that were 'spared' were nerves that would (eventually) recover.  I still have no natural erections, but am using a pump, Cialis tablets and Alprostadil injections.  Even so, they only provide a semi-erection, which is not suitable for penetration, but I can achieve (a dry) orgasm, sometimes quite intensely.

Best wishes in your journey.

JedSee.

User
Posted 21 Jan 2024 at 20:23

Darren , I describe my self as supposedly non nerve sparing , because my surgeon said he wouldn't be sparing any nerves. I did make some recovery after surgery but I will never fully recover. Now nearly ten years since surgery and still get the odd surprise. I describe my dry orgasms as out of this world. The main this is never give up and have fun finding a solution. 

You don't need an erection for vaginal intercourse,we mastered the technique of flaccid insertion.

Thanks Chris 

User
Posted 21 Jan 2024 at 22:30

Hi,

I was 52 and had a nerve sparring RP. I could orgasm quite soon after the catheter was removed. However it's been a long road to achieve a decent enough erection for penetrative sex. I started to get some semi erections with a few months of the op but it really improved after 12 months. I would say 16 months on I am 75% to 80% of where I was pre-op. I am not convinced it will get much better after this much time. Unfortunately there are no guarantees when it comes to this op even with nerve sparring.

User
Posted 22 Jan 2024 at 18:09

I had prostatectomy at the age of 72, 12 years ago and lucky enough to think I am 'cured'. I think!. You are only 47, so your chance of a cure are very high, particularly if the cancer is well contained with negative margins. As for ED, in the hands of an experienced surgeon he/she should be able to save your nerves so you can expect to maintain your erectile function, but be aware that many men who undergo prostatectomy  find that their erectile function is not as good as pre-surgery level, but you are young so you can expect to re-establish your sex life; if necessary there is a lot of options to help you. Your consultant is wrong in saying that you can't orgasm after surgery; you can masturbate even with a flaccid penis. Most men don't have the problem of incontinence. All you need is some luck, so good luck and I hope all goes well for you, 

 'Physics is like sex: sure, it may give some practical results, but that’s not why we do it.'                    Richard Feynman (1918-1988) Nobel Prize laureate

 

 

User
Posted 28 Jan 2024 at 09:13
Hi Darren

I hope you are finding all these replies as helpful to you prior to surgery as I am after. I’m 61 and mrs and I have not been sexually active. So I barrelled on ahead with the surgery not really considering the impact on my sexual functioning. Though I should emphasise I was given full information and plenty of it. My surgeon was unclear about how much nerve sparing was possible although he suggested that one side was certainly more possible than the other. I’m still awaiting some clarification post op on how that went (surgery went ok).

I am only 12 days post op and 5 post catheter removal. A couple of things have become apparent to me. I have quite an absence of sensation and certainly can’t get erect or even off the starting block. It shouldn’t have, but it’s coming as a bit of a shock and it is taking some processing. I think my point here is no matter how prepared you are for changes in that department, it’s important not to underestimate the psychological impact and at least be aware of the likelihood of change in your sexual life.

Despite all this, I also like others here have discovered the possibility of dry orgasm - in my case in a completely limp state. Exhausting but satisfying. Different yes, and again may get you to question your understanding of potency but I can see an enjoyable future! It is also very early days here post op, so I don’t know if or when things might change. I am on tadalafil so that might help though no impact so far.

The last thing I want to draw your attention to is the possibility of losing length and girth. This the surgeon did not prepare me for and again is having psychological impact. There are other very good threads on this site discussing it. It does not affect everyone but handy to prepare for the possibility.

I hope my own experience is helpful and not coming across negatively. For myself I think no matter how much info I had before the op it still comes somewhat as a surprise as all the feelings are new. All part of the journey of recovery.

I wish you well with surgery and hope all goes optimally!

Cheers

Richard

User
Posted 28 Jan 2024 at 10:49

Thank you to everyone for all of your replies, it was very helpful. 

 
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