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Intimacy after RALP

User
Posted 02 Jan 2025 at 11:05

Hi there,


In August 2023, I was diagnosed with a Gleason Score of 4+5. I was then fast tracked for a RALP at the RD&E. Prior to the op, my surgeon explained that due to the extensive and aggesive cancer, I would be undergoing a non nerve-sparing procedure. Unfortunately my PSA levels continued to rise after the procedure so in June, 2024 I was scheduled for 33 rounds of RT. Which I completed in November last year. As well as that I am on 2 years of Hormone Treatment.


I have been a widower for the past 5 years and therefore ED has not been an issue. However, I have just met someone and am now wondering what conversation I need to have with her. I'm a very open and honest person and I want to let her know as early as possible. Am I right to think that an erection is completely impossible? Any and all information would be very useful.


 

User
Posted 02 Jan 2025 at 17:15

You could get an erection with injections or a vacuum pump (even on HT).


I think the important thing is to be up front and honest with each other.

User
Posted 02 Jan 2025 at 17:40
I have a pump but have never used it as I tought it was impossible without the surrounding nerves.
User
Posted 02 Jan 2025 at 18:36
My Gleason score was 9, they quickly scheduled my radical prostatectomy and my doctor never mentioned the words "nerve-sparing" but did mention that my sex life would change. After my surgery (and for the past 16 months) my PSA was below the 0.1 threshold so they consider me "in remission" and as of today I have not had to get radiation. My thoughts are that you cant have everything...

I was on testosterone therapy (surgically implanted pellets) prior to my prostatectomy because I lost a testicle in 1996 and went into a deep depression and the testosterone treatments drastically reduced my depression. After my cancer diagnosis my urologist stopped my testosterone therapy and within 6 months my world turned upside down, my testosterone level was less than 1 (normal is 300 to 450). Last May I re-started testosterone therapy, this time as self injections and the quality of my life is improving, also my libido has returned. To my surprise I found that I can have an orgasm with a flaccid penis, all I had to do was convince my wife that we should try to restore that part of our life. Now that I have filled you in on my background...

I have tried the penis pump (fail, blood flows out within 1 minute) and I am now trying penile injections but so far this does not look promising, for me the ability to have penetration did not mean my wife & I cannot share intimate time. The prospect of pleasing my wife was always more important than me getting pleased and we have found that today's sex toy technology allows us both to enjoy intimate time together. After your relationship progresses you might ask her if she might read this forum.
I understand that bringing up and talking about this subject will probably be the hardest part but if you don't talk to her about it she may think you are not attracted to her or that she does not turn you on (you know how women think...) for that reason she should probably know whats really going on.
Good Luck
User
Posted 02 Jan 2025 at 19:06
That's really interesting and helpful.

As I said in my OP, I am a very honest and open guy and will have absolutely have that conversation as and when. I have watched several videos online regarding penile injections and have decided that route will not work for me. I have been able to achieve a climax with a wand type vibrator which works really well on flaccid penis. But due to the hormone therapy, the urge is hardly ever there. Sex toys are definately the intention if we ever get to that point.
User
Posted 02 Jan 2025 at 19:41

Gedward, I was supposedly non nerve sparing in 2014, followed be salvage RT in 2017 without HT. I did get some stirrings after surgery and on the odd occasion around a 70 percent swelling at best. I tried pills, muse pellets etc but resisted injections for many years. 


We mastered the technique of flaccid insertion with great results for us both. You don't need an erection for vaginal intercourse. 


My use of the pump has not been as regular as it perhaps should have been. I would start using the pump again it's never to late to try. 


I feel I wasted five years by resisting the injections, I think the injections helped my situation, I doubt I will ever regain natural erections but my flaccid penis is quite healthy. I still get the odd surprise and get that feeling in the root. Never give up,try everything on offer and have fun.


As to your current situation, no experience ,but I would think early honesty would be better than later disappointment.


Best wishes.


Thanks Chris 


 

Edited by member 02 Jan 2025 at 21:06  | Reason: Not specified

User
Posted 02 Jan 2025 at 21:17

I had robot assisted prostatectomy 3 years ago, suffer from mild incontinence and Erectile Dysfunction. Everything was tough - difficult surgery, long recovery, incontinence, erectile dysfunction - and we never thought we would  return to our pre-surgery days. But here we are still having sex, different but with unintended benefits. We had to learn to live with new normal which we managed.


A few useful comments:


Loss of nerves during surgery does not stop you enjoying sex in many forms, even if you are incontinent.


You can masturbate or someone else can masturbate you to orgasm without and erection.


There are many ways of creating an erection: Viagra or similar, injections, implant and lastly but not the least a VED (Vacuum Erection Device). 


Penetrative sex is possible, but if you use a pump you have to adapt how you make love - imagination and a sense of humour helps.


If you are on HT your libido will take a hit but hat does not mean you can't pleasure your partner and get pleasure from skin to skin contact.


With all this to think about, having a new partner will need some thought. I am no expert but I think it is important that you take your partner into your confidence as soon as you feel she is ready to chat. If there is a connection and mutual love and respect, the desire to please each other can be amazing. Trust your instincts and good luck.


 


 


 


 

Edited by member 02 Jan 2025 at 21:19  | Reason: Not specified

 '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 02 Jan 2025 at 21:22

If you private message me with your email I can send you a video to view. My nerves weren't spared.

 '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 02 Jan 2025 at 21:55

Ged only has 3 posts. He can't PM you. You can PM him with your email address,and he can read it.

Dave

User
Posted 03 Jan 2025 at 05:56

Hi Ged.


I'm about your age. I had a non nerve sparing robotic prostatectomy about two years ago. I was also Gleason 9 (4+5).


I was told that it was unlikely that  I'd ever be able to have a natural erection again and sadly, so far, that has been the case.


However, I have found Invicorp penile injections have enabled me to have erections good enough for penetrative sex. I believe that you do not have to be sexually aroused for it to work. From what I've read on here HT can vastly reduce sexual urges, so it would seem to me, that Invicorp may help in your case. I see, in one of your posts, that you have ruled out injections. Unless there is physical or mental issues for this, I'd seriously reconsider your decision.


 Invicorp was prescribed to me by my GP after I'd attended an ED clinic.


Hope this helps and best of luck mate.👍

Edited by member 03 Jan 2025 at 06:02  | Reason: Additional text

User
Posted 03 Jan 2025 at 08:11

It's very impressive to read the above thread, with men talking frankly and openly about intimacy and sexual performance during prostate treatment of all types.


As I said in another thread, prostate cancer strikes at the very heart of what it is to be male; the ability to have an erection and feel sexual pleasure.


When I was having tests, I told myself that if I had PCa the sexual side wouldn't bother me and I'd be able to cope. But as the tests got more serious and I read about ED and other problems I started to worry a lot about what life would be like without an active member.  


I read a man's experience of his penis becoming smaller because it didn't have spontaneous elections, even those while he was asleep that we all get.


I admit I became scared of a future without wanking, which I never thought I would be worried about.  But until it happens, you just don't know what feelings are going to happen for you.


I'm so lucky that I dodged a bullet and was found to have no cancer. But I still worry about the long term prospects for me and my little pal. That's why a discussion like this is in my view extremely important for men in our position. 


Men aren't usually so open about matters like this, but its heartening to see and be a part of such a conversation.  Sex is important,  no matter what level you enjoy it at, from bedroom superstar to moderate masturbator.


Hearing how ordinary guys deal with PCa and their physical sex life is very humbling and interesting. Being afraid of discussing things relating to the cock and it's environs has led to many guys missing out on early testing or diagnosis. 


Chatting about it here hasto be a useful part of the disease.


Thank you guys.


Mick 

User
Posted 03 Jan 2025 at 11:38

Thanks Dave


I keep forgetting that!

 '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 26 May 2025 at 15:40

Yes you are absolutely right. I was very depressed at the thought of losing my sexual function to


the extent that I was considering taking a chance on living out my normal span (Gleason 3+4).


In the end I had the op two weeks ago and it wasn't as horrific as I expected. Pain fairly mild


and leakage after the catheter came out was zero at night and one small pad coped with


daytime leakage.  I'm hoping this will improve in time but to date I have received zero advice


on exercises.  I was expecting my sex life to be over but was pleasantly surprised to get a semi-erection


on about day 10 and to orgasm out of the blue when fiddling around with it.  It was surprisingly normal feeling


and pleasurable and not entirely dry due to pre-ejaculate from the Cowper glands.  Not sure what my chances of


achieving a full erection are until I discuss with the surgeon. I tried a cheapo pump but it was useless and I agree


with the chap on here who said that if you are a grower not a shower then they are tricky to use.  Incidentally my penis is a bit shorter but nothing too dramatic - which was another thing I was worried about.


Not sure whether any kind of normal sex-life will be possible as my wife is very resistent to trying sex-toys or anything like that and I can't see us integrating a pump into our routine.  Viagra might work I suppose and it is early days yet.  I'll post how things go.


 

User
Posted 26 May 2025 at 17:52

I recently discovered the hollow strap on. They seem to be quite popular for serious ED issues. And I noticed that all the popular stores online stock them. Has anyone on here tried them? I think I would be willing to give it a go. Would be interested in how it feels and how your partner felt about them. And which brand did you use?

User
Posted 26 May 2025 at 23:40

Hello boys.


I don't want to sound as repetitive as a parrot, but try injections. Honestly lads, I was gutted when I could no longer get a stiffy, but Invicorp worked for me. It was like magic!


The first time I used it, after doing the bizz with the wife, I was so elated that I opened the bedroom window and let out a Tarzan call. 


I've got co-morbidities, cardilogical problems and I'm on quite a lot of heart tablets, which I suspect, would reduce the efficacy of the wonder drug, but it still works. 


Okay, it's not as good as a natural erection. I'd say about 80% as long and as hard, but it's better than nowt. In fact, the missus reckons I've got more girth than I used to have, but she's always been a bit of a sweet talker. The beauty of Invicorp, for me at any rate, is you get a stiffy within 10 minutes and it lasts for about an hour and a half. It's brill. After the lovemaking  which takes about 5 minutes, we've bought some curtain rings and play hoopla, so as not to waste it.


Please read my thread on it


https://community.prostatecanceruk.org/posts/t29845-Hooray-for-Invicorp


Give it a go, it's like being a randy teenager again!


The only downside to it is it has to be stored in the fridge. So keep it away from the butter. It's so good , it makes it too hard to spread. 🙂

Edited by member 27 May 2025 at 00:34  | Reason: Typo

 
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