I had a RP more than 4 years ago. Nerve sparing and with tadalafil I can get effective erections. PSA initially 0.08 but has reduced to 0.05 over the time.
Within the first year after the op I often, but not always, experienced painful orgasms. The symptom was a sharp, sometimes agonising pain, in my rectum. The pain would subside after a few minutes to a dull ache that would remain sometimes for hours but at a manageable level (no painkillers required). If I didn’t orgasm for a while, the pain would be less the next time I did. If I was more sexually active, the pain tended to be more intense.
After the first year or so, the pain seemed to disappear. Sometimes I would get mild discomfort but nothing to demotivate me from having sex.
However, it has now returned, but seemingly worse than before. If I abstain from any sexual activity for a period (recently a month), the pain on the next orgasm tends to still be intense and almost unbearable. It recedes over time, as before, to a dull ache and eventually goes altogether although when I have a wee I can sometimes feel a very, very mild version of what I experience on orgasm.
There’s plenty on line about painful orgasm after RP, but not much on the treatment/management of it, or indeed the experiences of those who have suffered from it.
Anyone in the same/similar boat? I’d love to hear from you. Thank you.