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Sex can be great after surgery!

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User
Posted 03 Mar 2022 at 19:47

There’s a lot of very worried people on here who are scared about the impact on their sex life after treatment for prostate cancer. So I’m here to tell you - as the partner of a man who had radical robotic prostatectomy - it can be great!

my partner was diagnosed in 2019, just a few months after we got together. It was devastating news as sex was (still is) a very big part of our relationship. 
he was convinced it was all over and I would better off without him. 
He was so wrong but it’s only now with hindsight that he can appreciate that. 
He was very fortunate to have an excellent NHS surgeon who was able to spare some nerve on one side and what we’ve found is that the body learns to compensate. 
a bit like when you lose one of your senses, others step in to help you!

Not only is he able to get an keep an erection (usually with the help of little blue pills and a well-placed ring but he can do it without) he can even ejaculate!

Yes it’s true. We don’t really understand it but we know that ejaculate is made up of several fluids from different parts of the body. We reckon that the bits that are left are making up for the bits that are gone! (He had a vasectomy years ago so no sperm either.)

the key is a combination of patience, willingness to try things, trust between partners and no shame or embarrassment. 
it works for us - in some ways better than ever - and it can work for you too. 
stay positive. It really isn’t all bad news :)

User
Posted 03 Mar 2022 at 19:47

There’s a lot of very worried people on here who are scared about the impact on their sex life after treatment for prostate cancer. So I’m here to tell you - as the partner of a man who had radical robotic prostatectomy - it can be great!

my partner was diagnosed in 2019, just a few months after we got together. It was devastating news as sex was (still is) a very big part of our relationship. 
he was convinced it was all over and I would better off without him. 
He was so wrong but it’s only now with hindsight that he can appreciate that. 
He was very fortunate to have an excellent NHS surgeon who was able to spare some nerve on one side and what we’ve found is that the body learns to compensate. 
a bit like when you lose one of your senses, others step in to help you!

Not only is he able to get an keep an erection (usually with the help of little blue pills and a well-placed ring but he can do it without) he can even ejaculate!

Yes it’s true. We don’t really understand it but we know that ejaculate is made up of several fluids from different parts of the body. We reckon that the bits that are left are making up for the bits that are gone! (He had a vasectomy years ago so no sperm either.)

the key is a combination of patience, willingness to try things, trust between partners and no shame or embarrassment. 
it works for us - in some ways better than ever - and it can work for you too. 
stay positive. It really isn’t all bad news :)

User
Posted 04 Mar 2022 at 12:32

I had RT so I do have a prostate. I certainly don't squirt any more but sometimes a small amount of fluid comes out even if it is a couple of minutes after orgasm. However the orgasms are excellent and last longer than before, so I'm happy. Bad news for the Kleenex Corporation though.

Dave

User
Posted 22 May 2022 at 09:23

What I can add to this lovely list of positive outcomes is that the time scale varies a lot from one person to the next. I know one man who never missed a beat after RP, and others who only began to recover after 3 or 4 years. For me there was some good recovery up to one year, then a plateau, and now some further improvement after 26 months.

So there can be a dearth of erections for anything from 2 months to several years, and what matters most is to keep up your spirits and your intimacy. It has helped a lot for us to remain inventive about our love making and not depend on erections. Ask any lesbian - erections are not required to have satisfying sex. 

Perhaps more important, for the person with the prostate cancer, we need to have a lot of resilience about our bodies and minds and do everything we can to adapt to new possibilities. Remember that manhood is much more than libido, libido is much more than sex, and sex is much more than erections.

User
Posted 22 May 2022 at 09:39

That last paragraph was very profound Mish and very true.  Well said.

User
Posted 03 Mar 2022 at 23:04
"but is it right to say that there is more chance of saving some nerves with surgery as compared to radiotherapy?"

It doesn't work like that. ED tends to be an immediate side effect of RP which, if you are lucky, gets better over time. Radiotherapy doesn't cause ED for most men or, if it does, it tends to develop over the next 5 / 10 years. It is the hormone treatment that usually accompanies RT which causes the problem - chemical castration leads to a complete loss of libido (for almost all) not ED ... and if there isn't a sound approach to maintaining penile health, the lack of use during the HT can mean that the penis is permanently damaged.

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

User
Posted 04 Mar 2022 at 08:04

Aiden, I’m no doctor but I think Lyn is right. From what I read at the time the impact from radiotherapy can be worse. But it’s all a balance. 
For my partner we felt that the hormone therapy would really mess with his sense of himself. 
Plus for him he was pretty far gone and so it was surgery to save his life. 

User
Posted 04 Mar 2022 at 08:55

Originally Posted by: Online Community Member

Not so. I know what piss is like. And this is not that. It comes from a separate gland that usually only produces a tiny amount. 
edit: possibly from seminal vesicles or bulborethal glands, look it up :)

It comes from the Cowper's gland and is released during sexual activity not at orgasm

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

User
Posted 04 Mar 2022 at 22:32

I am pretty much identical Dave.  The RT was the easy bit but the Hormone treatment really was difficult with a mix of hot flushes (which i still get even after 18 months of finishing HT), loss of sex drive, and a great pair of man boobs that nobody wants and that nobody can do anything about.  We chose the RT treatment as it looked like we would be able keep erections and a sex life together.  The sex life has returned for me at last for me but the 3 years of monk life finished off my wife's interest in it sadly.

So to answer the Aidan's post, for some patients, RT and HT are a good choice IF IT SUITS your condition as you don't immediately lose the ability to get an erection. Plus, with nearly always dry orgasms, it saves money on kleenex!

Overall, we made the correct decision and have been extremely lucky - I hope you both are too.

 

Edited by member 04 Mar 2022 at 22:36  | Reason: Not specified

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User
Posted 03 Mar 2022 at 22:10

Thank you Zoe, I got my diagnosis today with the options of either robotic surgery or radiotherapy and honestly this is my biggest concern being just over a year into a wonderful new relationship. I'm somewhat terrified that sex is all over arrgh!! I have no cancer on the left and hope that surgery could save some of the nerves and leave me with some ability.  There's an awful lot to take in but is it right to say that there is more chance of saving some nerves with surgery as compared to radiotherapy?

 

Many thanks, Aidan

User
Posted 03 Mar 2022 at 23:04
"but is it right to say that there is more chance of saving some nerves with surgery as compared to radiotherapy?"

It doesn't work like that. ED tends to be an immediate side effect of RP which, if you are lucky, gets better over time. Radiotherapy doesn't cause ED for most men or, if it does, it tends to develop over the next 5 / 10 years. It is the hormone treatment that usually accompanies RT which causes the problem - chemical castration leads to a complete loss of libido (for almost all) not ED ... and if there isn't a sound approach to maintaining penile health, the lack of use during the HT can mean that the penis is permanently damaged.

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

User
Posted 04 Mar 2022 at 01:00
Zoe Re ejaculation returning, I think you are taking the piss - literally!!

User
Posted 04 Mar 2022 at 05:46

Thank you Zoe for the good news - cheered my husband (and me) up no end to know that the possibility of being able to have sex afterwards exists.  

User
Posted 04 Mar 2022 at 07:27
Great post Zoe, thank you. Gives us hope - my hubby goes in for RP on 22nd March 🤞
User
Posted 04 Mar 2022 at 08:00

Not so. I know what piss is like. And this is not that. It comes from a separate gland that usually only produces a tiny amount. 
edit: possibly from seminal vesicles or bulborethal glands, look it up :)

Edited by member 04 Mar 2022 at 08:48  | Reason: Not specified

User
Posted 04 Mar 2022 at 08:04

Aiden, I’m no doctor but I think Lyn is right. From what I read at the time the impact from radiotherapy can be worse. But it’s all a balance. 
For my partner we felt that the hormone therapy would really mess with his sense of himself. 
Plus for him he was pretty far gone and so it was surgery to save his life. 

User
Posted 04 Mar 2022 at 08:55

Originally Posted by: Online Community Member

Not so. I know what piss is like. And this is not that. It comes from a separate gland that usually only produces a tiny amount. 
edit: possibly from seminal vesicles or bulborethal glands, look it up :)

It comes from the Cowper's gland and is released during sexual activity not at orgasm

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

User
Posted 04 Mar 2022 at 08:57

I think the general understanding is that after RP men do not ejaculate due to the fact that both the Prostate & Seminal Vesicles are removed. The Testes still produce sperm but this is absorbed into the body. My surgery was May 2019 with 50% nerve sparing. I definitely do not ejaculate although there is occasional leakage. My orgasms are far more intense than before surgery - bit like female orgasms I have heard it described.

User
Posted 04 Mar 2022 at 09:52

Yes I would describe my partners orgasms now as much more like my own. Longer lasting, more intense, more ‘whole body’ and repeatable 😉

User
Posted 04 Mar 2022 at 12:32

I had RT so I do have a prostate. I certainly don't squirt any more but sometimes a small amount of fluid comes out even if it is a couple of minutes after orgasm. However the orgasms are excellent and last longer than before, so I'm happy. Bad news for the Kleenex Corporation though.

Dave

User
Posted 04 Mar 2022 at 13:36

Are you on hormone therapy as well. Zoladex causes all my problems, I had RT as well psa nw unstected ror 6 months. 

User
Posted 04 Mar 2022 at 14:28

Thanks Zoe, your post leaves me (and my OH) with some hope for the future. Thanks also to Dave for the Kleenex humour. It nearly made me burst my staples 😂. Chris

User
Posted 04 Mar 2022 at 22:32

I am pretty much identical Dave.  The RT was the easy bit but the Hormone treatment really was difficult with a mix of hot flushes (which i still get even after 18 months of finishing HT), loss of sex drive, and a great pair of man boobs that nobody wants and that nobody can do anything about.  We chose the RT treatment as it looked like we would be able keep erections and a sex life together.  The sex life has returned for me at last for me but the 3 years of monk life finished off my wife's interest in it sadly.

So to answer the Aidan's post, for some patients, RT and HT are a good choice IF IT SUITS your condition as you don't immediately lose the ability to get an erection. Plus, with nearly always dry orgasms, it saves money on kleenex!

Overall, we made the correct decision and have been extremely lucky - I hope you both are too.

 

Edited by member 04 Mar 2022 at 22:36  | Reason: Not specified

User
Posted 06 Mar 2022 at 11:13

I would echo ProSixty comments post RARP. Orgasms better and longer lasting but no jizz. And reload time is much reduced to 4-6 hours from 48 hours. so I have many more orgasms now than before . Overall not complaining

User
Posted 25 Mar 2022 at 09:02

I agree with Jeremy’s comment as well. I’m 9 weeks post RALP and orgasm is strong. Stronger than before op oddly. I find it odd that nothing but a stream of urine comes flying out after orgasm so towels at the ready 😂 

Still no erection though but as per physio said to me, it’s all about the blood flow so got to keep it going…who am I to argue?! 😉

Just hoping in time that we can have sex again but self physio for now  

Edited by member 25 Mar 2022 at 09:36  | Reason: Addition

User
Posted 07 Apr 2022 at 07:55
In my case I had a RARP and as the majority of men they removed all my "baby making" parts. They removed my prostate, my seminal vesicles and my deferent vas. I have my erections as before but I can not ejaculate, I miss to see my semen jets but the orgasm is still very nice and the spasms are powerful. In my case I really have no drop of liquid coming out of my glans at that moment.
User
Posted 22 May 2022 at 09:23

What I can add to this lovely list of positive outcomes is that the time scale varies a lot from one person to the next. I know one man who never missed a beat after RP, and others who only began to recover after 3 or 4 years. For me there was some good recovery up to one year, then a plateau, and now some further improvement after 26 months.

So there can be a dearth of erections for anything from 2 months to several years, and what matters most is to keep up your spirits and your intimacy. It has helped a lot for us to remain inventive about our love making and not depend on erections. Ask any lesbian - erections are not required to have satisfying sex. 

Perhaps more important, for the person with the prostate cancer, we need to have a lot of resilience about our bodies and minds and do everything we can to adapt to new possibilities. Remember that manhood is much more than libido, libido is much more than sex, and sex is much more than erections.

User
Posted 22 May 2022 at 09:39

That last paragraph was very profound Mish and very true.  Well said.

User
Posted 23 May 2022 at 21:57

Thank you for your positive comments Mish. Sex is much more than erections, unfortunately I didn't realize this until it was to late and completely gave up after my op which was 14 years ago. 

This eventually cost me my marriage as my wife although understanding at first decided she needed it more than me. 

I have recently started into a new relationship with a knd, compassionate lady who understands my anxietys and we are able to be intimate with each other without the spectre of erections stopping me from enjoying it.

Currently injecting 40mgs of Viridal which although not enough for intercourse is perfectly okay for oral.

 

User
Posted 24 May 2022 at 06:48

Originally Posted by: Online Community Member

... Sex is much more than erections, unfortunately I didn't realize this until it was to late and completely gave up after my op which was 14 years ago. 

This eventually cost me my marriage ...

This is a powerful and painful story! I am so glad you have rediscovered intimacy with your new body. And sad for your earlier loss. What do you remember about those days (14 years ago) when you gave up? I see so many other men apparently in the same state now - and hear many of their partners despairing as a result. Your experience might illuminate a way forward for others.

 
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