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How long before nocturnal erections

User
Posted 04 May 2020 at 13:06

My husband has been on the low dose of Cialis since December of 2019.  We saw stirrings of hope when stimulated (we thought) a few times but I am not sure now if it was really a stirring or false hope.  I am wondering how long it takes in general before the nocturnal erections start happening.  Will my husband know?  How do we know when it is happening?  Now that we are doing injections and they are unsuccessful for the most part too I am searching for any glimmer of hope of guidance of when we should start to worry that his recovery may not happen.  He had the nerve sparing surgery on October 17, 2019 with no complications (said his doctor) and his incotenince lasted about a month to 6 weeks.

User
Posted 04 May 2020 at 16:11

Carlos 


It will vary from person to person. My own experience, out of this world and we have to keep the windows shut. 


Adora 


Early days as already said, six years post op things can still improve.


Thanks Chris

User
Posted 04 May 2020 at 16:51
Carlos - there is no ejaculate following RP because a) the fluid you ejaculate is mostly produced in the prostate and b) as part of RP you will also have a vasectomy - the tubes from your testicles are cut so the sperm can't find their way out. Some men find they leak urine during sex and / or at the point of orgasm but not all. There are also recorded cases of men ejecting small amounts of fluid after RP and thinking it is ejaculate although in reality it is a secretion from the Cowper's gland which in normal sex acts as a bit of lubrication.

Some men find dry orgasm very painful while others find it is much more euphoric than they have experienced before. It is also quite common for men to find they can have multiple dry orgasms post-RP even though this was not happening before the op.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 04 May 2020 at 18:24
Carlos my orgasms were absolutely tiny and dry post op. It took a long time before they were even anywhere near to normal. I’m five years on now and they are as good as ever with the full pumping / squeezing sensation but obviously dry. I still produce loads of Pre cum which is apparent way after orgasm also. Not sure about multiple. I’d need more input I guess ;-))

If life gives you lemons , then make lemonade
User
Posted 05 May 2020 at 16:49

Adora,


The surgeon said pre-op it could recover but it would never be as solid.  He also asked how it was at the time because that has some bearing.   He was going to take the nerves on one side.


There was a constant slow improvement and if I was asked without looking or feeling sometimes it felt like it had recovered, there is something that stirs and gives a throb.    I rejected treatment after taking Cialis a couple of times and not liking the aching shoulder feeling, I was wary of it anyway and didn't want to inject myself.


It kept getting better but only when I stood up or near stood.  It never responds if I'm lying down.   I bought a pump and it had an almost immediate effect of making it bigger and better shaped but hasn't helped spontaneous reaction.   Admittedly I stopped using it fairly quickly.


In retrospect it's possible if I'd put a lot of work into it with different treatments it could be better.   Also experimenting with different positions as gravity has a strong effect.   To be honest I'm not hugely bothered and nor is my wife, I don't think.


I also got a urine leak but only when first stimulated although it's got a lot better.  It seemed a bit of a black joke, show me a picture of an attractive lady and I'd wet my trousers, not much but more than you'd want.  As I said it doesn't happen much now.


Regards

User
Posted 05 May 2020 at 22:50
No, it's psychological not physical. As I have written on the ED thread previously, we may now be starting to see an increase in ED as a late RT effect - hence trying the injections again - but if the opportunity is unexpected and there is no pre-thinking, he can get a solid erection. He can't maintain it for more than a few minutes, though. If it is planned (i.e. we know we are going to have an empty house or he has taken a tablet) there may be an erection but rarely sufficient for penetration and again, it can't be maintained.

I have made this point on the 'one wife's story' thread a number of times. Although toolkits and leaflets and web pages focus on the physical causes of ED it isn't just about the permanent or temporary damage of radical treatment to the nerves; it is also about how a cancer diagnosis messes with the head or how the loss of a prostate and / or ejaculate can affect the sense of manhood. Breasts are not essential to sex but many women find that mastectomy ends any desire and I guess it is the same thing - a feeling of being undesirable or that your body has let you down.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 05 May 2020 at 23:58
Hope you have tried a cock ring Lyn, makes all the difference for us. I find I can often get it really hard but it has no staying power without the ring.

I don't get nocturnal erections either now but I did on the daily Cialis, still had no staying power without a ring though and made me feel sh1t!

Length of time to orgasm is the big difference for me, used to be wham bam thankyou mam! Now it's a performance of porn star proportions!, Without the enormous woody unfortunately!

Actual orgasm sensation varies from hardly notice it's happened to wow something just exploded.

Thank goodness for empathetic spouses!
User
Posted 18 May 2020 at 22:40
Brilliant descriptive effort! I think psychological / emotional ED is underplayed by urologists and others.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
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User
Posted 04 May 2020 at 13:29
Adora I still think you are both being way too impatient ok. In all honesty , nerve sparing or not , you are only 6 months post surgery and it can take ages for the majority of men to regain enough function for penetration. As soon as I started taking low dose Cialis I saw improvements daily. Much better looking all round and waking up every day with a proper lazy lob. But then I had to wait a WHOLE YEAR before I got the Cialis after my op , so I was further down the line. In the meantime we used the pump , internet tablets , injections , the lot. Not all at the same time though. We resorted to toys and oral sex etc Like you the injections were hit and miss until I got Invicorp 25 which was sensational. Just give it some more time and take some of the pressure off. I’m a heavy drinker too and suffer badly with depression and anxiety but I got fixed in the end. And from other chats with you get him back on that pump daily. It’s not wimpy or something to be ashamed of. It s saving Mr Wriggly and keeping him in form till he’s ready.
Good luck x

If life gives you lemons , then make lemonade
User
Posted 04 May 2020 at 15:28

Hi whilst we are on the subject of the behaviour of said todger post op, I was wondering what exactly does the dry orgasm feel like, I can’t imagine what it can feel like. I’ve not had my Da Vinci surgery yet still waiting due to covid 19, had pre op assessment 8 weeks ago and it’s been mentioned a few time about not ejaculating post op. Do you still get the same sensation but with out the mesh shall we say......


Interested to hear reply 👍


Carl

User
Posted 04 May 2020 at 16:11

Carlos 


It will vary from person to person. My own experience, out of this world and we have to keep the windows shut. 


Adora 


Early days as already said, six years post op things can still improve.


Thanks Chris

User
Posted 04 May 2020 at 16:41

So is the nurse correct in saying that after the operation there is no ejaculation at ? 


Carl.

User
Posted 04 May 2020 at 16:46
Yes definitely no ejeculation. Orgasm far more intense and prolonged for me.

Good luck

Cheers Bill
User
Posted 04 May 2020 at 16:47

Sounds good to me 👍👍👍👍


Every cloud......


Carl.

User
Posted 04 May 2020 at 16:51
Carlos - there is no ejaculate following RP because a) the fluid you ejaculate is mostly produced in the prostate and b) as part of RP you will also have a vasectomy - the tubes from your testicles are cut so the sperm can't find their way out. Some men find they leak urine during sex and / or at the point of orgasm but not all. There are also recorded cases of men ejecting small amounts of fluid after RP and thinking it is ejaculate although in reality it is a secretion from the Cowper's gland which in normal sex acts as a bit of lubrication.

Some men find dry orgasm very painful while others find it is much more euphoric than they have experienced before. It is also quite common for men to find they can have multiple dry orgasms post-RP even though this was not happening before the op.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 04 May 2020 at 17:01

Adora - for a very large proportion of men, nocturnal erections will never happen again after RP. We are 10 years post-op and although he doesn't technically have ED anymore (there is no mechanical reason for him not to have erections) John has rarely had an erection without trying, has possibly woken up with a morning erection a handful of times and is not aware of ever having had a nocturnal erection.


There will be some men who recover natural erections quickly, fully and completely post-op and who do have nocturnal erections but I suspect they are a minority. Certainly, you would see evidence of erectile recovery at effort or desire long, long before there was any recovery of involuntary erections.


 

Edited by member 04 May 2020 at 17:02  | Reason: Not specified

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 04 May 2020 at 17:41
Never.

Cheers, John.
User
Posted 04 May 2020 at 17:44

Originally Posted by: Online Community Member
Adora - for a very large proportion of men, nocturnal erections will never happen again after RP.


I would question this. For a few of the men I've counseled through recovery after prostatectomy, nocturnal erections were the first sign they had of recovery. I don't have enough data to know how widespread it is though. For sure, some level of ED will usually impact nocturnal erections too.


Morning wood is a nocturnal erection you still have when you wake.


 


Originally Posted by: Online Community Member
Some men find dry orgasm very painful ...


I've only come across this temporarily during healing after a procedure, and not permanently. As a permanent condition, I'd suggest it's extremely rare.

Edited by member 04 May 2020 at 18:00  | Reason: Not specified

User
Posted 04 May 2020 at 18:24
Carlos my orgasms were absolutely tiny and dry post op. It took a long time before they were even anywhere near to normal. I’m five years on now and they are as good as ever with the full pumping / squeezing sensation but obviously dry. I still produce loads of Pre cum which is apparent way after orgasm also. Not sure about multiple. I’d need more input I guess ;-))

If life gives you lemons , then make lemonade
User
Posted 04 May 2020 at 19:32

Adora. I totally agree with Chris, you are getting ahead of yourself. I am 5 months ahead of you guys. RALP May 2019 with 50% nerve sparing. I only started on the Cialis 2 months ago after not much luck with 100mg Viagra for sex. I think the 5mg daily Cialis is much better and I feel the stirings daily and especially in the mornings. Morning/ Nocturnal Erections - Not sure, but definite improvement. Proper Lazy Lob.


Use that pump daily as well as others have said & explained. This is all work in progress.


Carlos. My first Dry Orgasm blew my mind. One of the strangest sensations ever. I tell (scare) all my friends about it. The women love it (no mess), Men not so sure about the whole thing !!!!!!!!. 


I can also say that my sex life has improved due to the hard work that has been put in since May 2019. Fo this I have to say that my Wife has been so supportive and patient. She would say that she loves our new life as well. It is different and you do have to really put the effort in.


Carlos - hope you get your surgery slot soon, I know how I felt at your stage with all the s*** going on in the head.


Wishing both of you all the best 

User
Posted 04 May 2020 at 21:26

"I've only come across this temporarily during healing after a procedure, and not permanently. As a permanent condition, I'd suggest it's extremely rare"


You haven't been a member here for 10 years - we have had a number of members who find it too painful to put themselves through. It is certainly yet another psychological contributor to ED :-(

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 05 May 2020 at 16:49

Adora,


The surgeon said pre-op it could recover but it would never be as solid.  He also asked how it was at the time because that has some bearing.   He was going to take the nerves on one side.


There was a constant slow improvement and if I was asked without looking or feeling sometimes it felt like it had recovered, there is something that stirs and gives a throb.    I rejected treatment after taking Cialis a couple of times and not liking the aching shoulder feeling, I was wary of it anyway and didn't want to inject myself.


It kept getting better but only when I stood up or near stood.  It never responds if I'm lying down.   I bought a pump and it had an almost immediate effect of making it bigger and better shaped but hasn't helped spontaneous reaction.   Admittedly I stopped using it fairly quickly.


In retrospect it's possible if I'd put a lot of work into it with different treatments it could be better.   Also experimenting with different positions as gravity has a strong effect.   To be honest I'm not hugely bothered and nor is my wife, I don't think.


I also got a urine leak but only when first stimulated although it's got a lot better.  It seemed a bit of a black joke, show me a picture of an attractive lady and I'd wet my trousers, not much but more than you'd want.  As I said it doesn't happen much now.


Regards

User
Posted 05 May 2020 at 20:29

Lyn, surely if John had RP and then SRT there is every reason that he has ED still ?? Even if he recovered from RP nerve damage then he could now be suffering from the nerve-frying of RT which is often delayed  ?


If life gives you lemons , then make lemonade
User
Posted 05 May 2020 at 22:50
No, it's psychological not physical. As I have written on the ED thread previously, we may now be starting to see an increase in ED as a late RT effect - hence trying the injections again - but if the opportunity is unexpected and there is no pre-thinking, he can get a solid erection. He can't maintain it for more than a few minutes, though. If it is planned (i.e. we know we are going to have an empty house or he has taken a tablet) there may be an erection but rarely sufficient for penetration and again, it can't be maintained.

I have made this point on the 'one wife's story' thread a number of times. Although toolkits and leaflets and web pages focus on the physical causes of ED it isn't just about the permanent or temporary damage of radical treatment to the nerves; it is also about how a cancer diagnosis messes with the head or how the loss of a prostate and / or ejaculate can affect the sense of manhood. Breasts are not essential to sex but many women find that mastectomy ends any desire and I guess it is the same thing - a feeling of being undesirable or that your body has let you down.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 05 May 2020 at 23:08

Originally Posted by: Online Community Member
I rejected treatment after taking Cialis a couple of times and not liking the aching shoulder feeling, I was wary of it anyway and didn't want to inject myself.


Just to say, you could try a different PDE5 inhibitor, or even a lower dose of Cialis/Tadalafil.


The aching is because Tadalafil is also a PDE11 inhibitor, which can cause muscle pain, not in everyone, but it does for a few people (usually in the back).


Viagra/Sildenafil is not a PDE11 inhibitor, so shouldn't give you that side effect. It is a PDE1 inhibitor, which does give some people a headache and/or a stuffed nose sensation. It's also a PDE6 inhibitor which can cause temporary blue colour shift in vision.


Levitra/Vardenafil is not a PDE11 inhibitor either (and don't know about PDE1 off top of my head), but it tends to have fewer side effects than Viagra/Sildenafil or Cialis/Tadalafil.

User
Posted 05 May 2020 at 23:58
Hope you have tried a cock ring Lyn, makes all the difference for us. I find I can often get it really hard but it has no staying power without the ring.

I don't get nocturnal erections either now but I did on the daily Cialis, still had no staying power without a ring though and made me feel sh1t!

Length of time to orgasm is the big difference for me, used to be wham bam thankyou mam! Now it's a performance of porn star proportions!, Without the enormous woody unfortunately!

Actual orgasm sensation varies from hardly notice it's happened to wow something just exploded.

Thank goodness for empathetic spouses!
User
Posted 18 May 2020 at 22:04

Originally Posted by: Online Community Member


Adora - for a very large proportion of men, nocturnal erections will never happen again after RP.


This kind of suggests to me it’s all in my head. I’ve woken up face down in agony over a nocturnal stiffy hard enough to drill a second channel tunnel yet literally any attempt when awake leads to a visit from Mr. Softy apart from one time I was worried it would never go away when it came up. The moment any thought about the activity enter my head, boom it’s gone. Well actually pfttt it’s gone.


 

User
Posted 18 May 2020 at 22:40
Brilliant descriptive effort! I think psychological / emotional ED is underplayed by urologists and others.
"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard
User
Posted 18 May 2020 at 23:18

One of the tests to find out if ED is psychological or physiological is to check for nocturnal erections. One method was to make a close fitting ring of thin paper and put it on the flaccid penis when you go to bed, and see if an erection overnight has broken it by morning. If you did get an erection overnight, there's nothing wrong with the mechanical side of your erections.

User
Posted 04 Jun 2020 at 22:50

I didn't have surgery, mine was hormone for 6 months, HDR Brachy and EBRT for 23 doses. It took 3 years but nocturnal erections are definitely back, in fact over last 6 months they are harder than when I was a teenager I think. They certainly wake me up and stay for half an hour or longer. I had dry orgasms for 1st year after erection returned but now I ejaculate quite a lot of clear fluid that turns very sticky quite quickly but my orgasms nearly blow my head off. Wife finds it funny as it goes on for several seconds, more like hers did.


It has taken me 4 years, but now have great sex life with my wife, maybe not as acrobatic as we were when we met in our teens, but probably just as much fun. So don't ever give up or let it beat you.


Mike

User
Posted 05 Jun 2020 at 12:20

Hi - had RP in sept 18. On 5 mg Ciallis. Lost left side Nerves, some nerve sparing right side. After one year started seeing first signs of life with what I call 60% erection but not good enough for penetrative sex. I have been experiencing general improvements in hardness. Last week I had penetrative sex and dry organism. Excellent result for wife and I!!!


Lesson learnt - my consultant said it would come back, I trusted him and it did. Tried pump, useful but it hurt. I went back to the century’s old technique of masterbation (regularly) and It worked. I lost a good inch in length, irritating but couldn’t be helped. My wife was getting frustrated and annoyed - but all good now. Just be patient.

 
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