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User
Posted 19 Apr 2024 at 13:46

Dear all,  just looking for some experience advice as I'm reflecting on my personal shock response agreeing to surgery. Obviously I am torn at the age of 51, however, my hope for seed treatment is limited if further cancer returns. I wonder if sex is even possible post operation. I look forward to hearing all your comments. Regards Mark 

User
Posted 20 Apr 2024 at 09:24

Sex is usually possible after prostatectomy, but it might require some medical assistance. This depends on things like nerve sparing - if the surgeon can spare the nerves which generate erections. You can ask beforehand if they think this is going to be possible, as it depends where the cancer is inside your prostate. However, they can never be sure until they are actually doing the procedure, and sometimes when the nerves are spared, they don't recover. In the case of non-working erection nerves, there are medications which can be used. Prostatectomy very rarely impacts sensation in the penis or the ability to orgasm, but very occasionally it does.

It is necessary to be proactive with penile rehabilitation after the procedure. This is because very few men can get natural erections immediately afterwards - this takes time to recover, but it is necessary to have regular erections to maintain health and size of penis. You will probably need to be proactive with this, asking for a pump and PDE5 medications (Viagra, Cialis, etc). While this should ideally happen automatically, it usually doesn't or takes way too long.

User
Posted 20 Apr 2024 at 10:58

I was Gleason 9 at the age of 46.  Had a prostatectomy, radiotherapy and hormone therapy.  A fulfilling sex life is achievable.  My advice:

 

Ask about nerve sparing but concentrate on your upcoming surgery and get prepared for that.

Accept that there's not going to be much sex for quite a while.

Do some research into erectile dysfunction post prostatectomy and be very demanding with your doctors once the time is right.  You may find they aren't as concerned about your issues as you are.  I had to push doctors evert step of the way but I always got what I asked for.

 

In short,  concentrate on the prostatectomy for the time being.  But a good sex life can still be achieved.

User
Posted 20 Apr 2024 at 11:37

I had nerve sparing prostatectomy many years ago. My consultant had told me that my erectile function may not return to the pre-surgery level and he was right. In spite of all the rehabilitation effort I had to consider various options to re-establish our sex life. Also, while some men regain their continence immediately, for others it may take weeks to months. Some like me are unlucky not to achieve full continence; I am 99.9% continent and tend to leak when sexually excited and when I orgasm. In spite of all this we have managed to re-establish our intimate life. Did I make the right choice of treatment? Yes, hindsight is a wonderful skill! You can expect to continue having sex and orgasms after surgery provided you take the process of rehabilitation seriously.  Your young age will work in your favour; I would expect your outcome will be much better than my experience. There is sex life after prostatectomy - I have a thread running on this site which you make like to read for encouragement:

https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life

 

 '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 23 Apr 2024 at 16:12

Hello Mark,

I'm sorry to hear about your situation, but I'm glad you've found this forum. Like you, I've discovered a wealth of helpful advice and reassurance here that has been incredibly beneficial.

I'm 55 years old and two weeks post-op from a nerve-sparing procedure. My catheter was removed just a week ago. I'm nearly fully continent—using a pad as a precaution, especially when I sneeze or cough, which might cause a slight leak. Overall, I'm quite happy with how well I'm recovering in this area. As for erectile function, it's about 45-50% back, and interestingly, orgasms are surprisingly intense and more satisfying than before. It’s an adjustment, but it's reassuring to see that sexual satisfaction can be achievable even in the early stages of recovery.

The care I've received has been outstanding, particularly at the Royal Marsden in Chelsea. The staff there has been nothing short of amazing, and I am extremely grateful for their support.

Looking ahead, my next milestone is a PSA test scheduled for the end of May.

My advice is to try not to overthink too much. If surgery is your chosen path, preparing physically can make a significant difference. I focused on losing weight, eating well, and staying active with weight training. I even took a holiday before surgery to mentally and physically prepare, which I believe contributed to my relatively swift recovery.

Best of luck to you, and take care.

User
Posted 23 Apr 2024 at 17:02

Mark I was 52 at the time of my RP. It was nerve sparring but it's taken 1.5 years to get my erections back to 80% of what they were. There are no guarantees with this op given that until the surgeon gets in there they never know what they might find. Chances are though with imagination you will be able to continue your sex life albeit it may be a bit different.  

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User
Posted 19 Apr 2024 at 18:54

Hi Mark,

If you put more information in your profile you are more likely to get the help you need. It’s very difficult to comment without further information. in the meantime I have bumped you up the rankings😊

Derek

User
Posted 20 Apr 2024 at 09:24

Sex is usually possible after prostatectomy, but it might require some medical assistance. This depends on things like nerve sparing - if the surgeon can spare the nerves which generate erections. You can ask beforehand if they think this is going to be possible, as it depends where the cancer is inside your prostate. However, they can never be sure until they are actually doing the procedure, and sometimes when the nerves are spared, they don't recover. In the case of non-working erection nerves, there are medications which can be used. Prostatectomy very rarely impacts sensation in the penis or the ability to orgasm, but very occasionally it does.

It is necessary to be proactive with penile rehabilitation after the procedure. This is because very few men can get natural erections immediately afterwards - this takes time to recover, but it is necessary to have regular erections to maintain health and size of penis. You will probably need to be proactive with this, asking for a pump and PDE5 medications (Viagra, Cialis, etc). While this should ideally happen automatically, it usually doesn't or takes way too long.

User
Posted 20 Apr 2024 at 10:58

I was Gleason 9 at the age of 46.  Had a prostatectomy, radiotherapy and hormone therapy.  A fulfilling sex life is achievable.  My advice:

 

Ask about nerve sparing but concentrate on your upcoming surgery and get prepared for that.

Accept that there's not going to be much sex for quite a while.

Do some research into erectile dysfunction post prostatectomy and be very demanding with your doctors once the time is right.  You may find they aren't as concerned about your issues as you are.  I had to push doctors evert step of the way but I always got what I asked for.

 

In short,  concentrate on the prostatectomy for the time being.  But a good sex life can still be achieved.

User
Posted 20 Apr 2024 at 11:37

I had nerve sparing prostatectomy many years ago. My consultant had told me that my erectile function may not return to the pre-surgery level and he was right. In spite of all the rehabilitation effort I had to consider various options to re-establish our sex life. Also, while some men regain their continence immediately, for others it may take weeks to months. Some like me are unlucky not to achieve full continence; I am 99.9% continent and tend to leak when sexually excited and when I orgasm. In spite of all this we have managed to re-establish our intimate life. Did I make the right choice of treatment? Yes, hindsight is a wonderful skill! You can expect to continue having sex and orgasms after surgery provided you take the process of rehabilitation seriously.  Your young age will work in your favour; I would expect your outcome will be much better than my experience. There is sex life after prostatectomy - I have a thread running on this site which you make like to read for encouragement:

https://community.prostatecanceruk.org/posts/t28948-Re-establishing-Sex-Life

 

 '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 23 Apr 2024 at 16:12

Hello Mark,

I'm sorry to hear about your situation, but I'm glad you've found this forum. Like you, I've discovered a wealth of helpful advice and reassurance here that has been incredibly beneficial.

I'm 55 years old and two weeks post-op from a nerve-sparing procedure. My catheter was removed just a week ago. I'm nearly fully continent—using a pad as a precaution, especially when I sneeze or cough, which might cause a slight leak. Overall, I'm quite happy with how well I'm recovering in this area. As for erectile function, it's about 45-50% back, and interestingly, orgasms are surprisingly intense and more satisfying than before. It’s an adjustment, but it's reassuring to see that sexual satisfaction can be achievable even in the early stages of recovery.

The care I've received has been outstanding, particularly at the Royal Marsden in Chelsea. The staff there has been nothing short of amazing, and I am extremely grateful for their support.

Looking ahead, my next milestone is a PSA test scheduled for the end of May.

My advice is to try not to overthink too much. If surgery is your chosen path, preparing physically can make a significant difference. I focused on losing weight, eating well, and staying active with weight training. I even took a holiday before surgery to mentally and physically prepare, which I believe contributed to my relatively swift recovery.

Best of luck to you, and take care.

User
Posted 23 Apr 2024 at 17:02

Mark I was 52 at the time of my RP. It was nerve sparring but it's taken 1.5 years to get my erections back to 80% of what they were. There are no guarantees with this op given that until the surgeon gets in there they never know what they might find. Chances are though with imagination you will be able to continue your sex life albeit it may be a bit different.  

 
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