Notification

Error

Sex life following surgery

User
Posted 02 Apr 2026 at 17:24

Hi guys.

can anybody tell me about sex life following surgery including ejaculation. Just trying to get as much information before I make a decision.

User
Posted 03 Apr 2026 at 08:43

Following radical prostatectomy, about 70-80% of men will have erectile dysfunction in the first 6 months. After that about 50% of men have ongoing erectile dysfunction - some will need to take Viagra, while others may need to use physical methods like a pump to achieve erection.

This can be improved a little with nerve sparing robot-assisted surgery, but even the best methods still report that 30-60% of men cannot get erections after 1-2 years. If you are younger, have a very experienced surgeon, and had good potency prior to surgery, you are more likely to retain the ability to maintain erections.

As prostatectomy removes the prostate completely, you will no longer produce the fluid that goes into the semen, therefore it is expected that you would have dry orgasms after surgery. However, assuming you can get an erection, you will still be able to have all the sensations that go with an orgasm, so it will still feel pleasurable.

Edited by member 03 Apr 2026 at 08:44  | Reason: Not specified

User
Posted 03 Apr 2026 at 10:19
I agree with the uncertainty expressed about potential side effects of Prostatectomy. The biggest thing that can affect erections is whether the nerve bundles can be saved, so may help you decide if you can ask the sugreon what are the chances of this in your case.

The other most worrying thing is that you may be incontinent for a short time with a low risk of this being extended for a very long time, therefore something else to ask the surgeon about.

Some men opt for other treatments if they are suitable, such as one of the several radiation based treatments or one of the Focal trreatments. However, these have other pros and cons. It is because of this that Consultants often leave the chioce to the patient except where in cases where there is a very strong argument for a particular treatment.

Barry
User
Posted 04 Apr 2026 at 18:46
In case its of use, I still have my prostate after HT/RT over 3 yrs for me but have dry orgasms, no problem at all, its not just prostate removal that results in this.

Peter

User
Posted 06 Apr 2026 at 21:20

Jay, I forgot to add, I was also supposedly non nerve sparing,  our experience is very much like Paul's except that we have used injections. 

Thanks Chris 

Show Most Thanked Posts
User
Posted 03 Apr 2026 at 08:43

Following radical prostatectomy, about 70-80% of men will have erectile dysfunction in the first 6 months. After that about 50% of men have ongoing erectile dysfunction - some will need to take Viagra, while others may need to use physical methods like a pump to achieve erection.

This can be improved a little with nerve sparing robot-assisted surgery, but even the best methods still report that 30-60% of men cannot get erections after 1-2 years. If you are younger, have a very experienced surgeon, and had good potency prior to surgery, you are more likely to retain the ability to maintain erections.

As prostatectomy removes the prostate completely, you will no longer produce the fluid that goes into the semen, therefore it is expected that you would have dry orgasms after surgery. However, assuming you can get an erection, you will still be able to have all the sensations that go with an orgasm, so it will still feel pleasurable.

Edited by member 03 Apr 2026 at 08:44  | Reason: Not specified

User
Posted 03 Apr 2026 at 09:34

Jay

You’ll get differing responses to this question as there isn’t a straightforward answer. From my own experiences following a RALP over three years ago, I’ve found that intercourse is possible with the use of a vacuum pump and a ring. Not a romantic way but life has to go on.

I’m also on Sildenafil (Viagra) to help with blood flow but the tablets aren’t enough on their own.

I’m expecting one or two of the regular contributors to mention injections - not a route I’ve looked at.

User
Posted 03 Apr 2026 at 09:47

Originally Posted by: Online Community Member
can anybody tell me about sex life following surgery including ejaculation.

My sex life hasn't changed. It's still very infrequent and nothing to write home about. 😁

Joking apart, this thread tells you how I've managed to cope.

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

Good luck, mate.

User
Posted 03 Apr 2026 at 09:59

Jay, you won't ejaculate as you you did before,you "may"  ejaculate a small amount fluids.  You don't need an erection to have an orgasm and mine are out of this world, far better than pre prostatectomy. You don't need an erection for vaginal intercourse, if you can master flaccid intercourse it can be a whole new experience for the man and woman. 

If the pills don't work go for the injections, I wasted years messing around with muse, the injections helped me physically and mentally, great to see a full swollen penis. I don't get a stand to attention erection but I get a full size swelling.

Thanks Chris 

 

User
Posted 03 Apr 2026 at 10:19

Hi Jay

It depends on many factors: Age, competence of your surgeon, whether you have nerve saving procedure or not, sex life before marriage, relationship with wife/partner etc. For certain, you will not ejaculate normally; you will have dry orgasms or ejaculate urine. That is enough to put anyone off prostatectomy but many choose this approach and live happily after treatment. I chose surgery and have no regrets.

I had surgery over 15 years ago and had both the side effects: ED and arousal climacturia. However my wife and I were determined to re-establish our sex life which is a very important part of our life. We had to work quite hard and the key to our success was our love of sex, good communication, determination, imagination and, of course, some luck. Adrian who responded to your post above has had great success with injections, but we use VEDs which has produced unexpected benefits and in many ways our intimate life is better than it might have been had I not had cancer, because of our advancing years! You may like to follow the following link to see how we did it. 

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 03 Apr 2026 at 10:19
I agree with the uncertainty expressed about potential side effects of Prostatectomy. The biggest thing that can affect erections is whether the nerve bundles can be saved, so may help you decide if you can ask the sugreon what are the chances of this in your case.

The other most worrying thing is that you may be incontinent for a short time with a low risk of this being extended for a very long time, therefore something else to ask the surgeon about.

Some men opt for other treatments if they are suitable, such as one of the several radiation based treatments or one of the Focal trreatments. However, these have other pros and cons. It is because of this that Consultants often leave the chioce to the patient except where in cases where there is a very strong argument for a particular treatment.

Barry
User
Posted 03 Apr 2026 at 16:29

Thanks for the reply’s guys, really helps

User
Posted 03 Apr 2026 at 16:33

Thanks Chris, really helps. 

User
Posted 03 Apr 2026 at 21:20
Jay, one of the main messages from reading the forum is that we all respond differently. You have to be aware that what happens to you won't be the "average".

However as others have said, without a prostate there isn't ejaculation. Semen mostly consists of liquid secreted by the prostate and without the prostate that doesn't happen. Nor is there the sperm from the testis or the fluid component from the spermatic vesicles, those have been disconnected (and in the case of the spermatic vesicles, usually removed).

Immediately after surgery you won't be experiencing erections - if nothing else you will have a catheter for a couple of weeks. There will almost certainly be bruising to the nerves supplying the penis, which run either side of the prostate, assuming the surgeon has been able to preserve them. If they can be spared there is a possibility that they will start working again, allowing erections, in the first few months. However it is more common for it to take six months to a year or more before anything like normality in a sex life. And if one or both nerves can't be preserved - usually because the cancer is too close to the nerves, though in some cases because issues in trying to preserve the nerves become apparent during the operation - it can be partial or not happen.

As others have described, there are people on this forum who have found ways of working round problems when erections don't return naturally. And you have to remember, if you look for experiences on the forum, that those who have the best recovery tend to get on with their life and are under-represented here.

If you are currently in the position of deciding what to go with, my best wishes because in some ways it is the hardest point in the process. The success rates in terms of cancer are all around the same, it is the side effects which are different and you don't know in advance which side effects you personally will experience. There isn't a "right" answer! In general terms younger men have a better likelihood of good recovery from surgery and older men are less likely to experience the delayed side effects from surgery during their lifetime but only you can decide which risks you are happiest with.

User
Posted 04 Apr 2026 at 18:46
In case its of use, I still have my prostate after HT/RT over 3 yrs for me but have dry orgasms, no problem at all, its not just prostate removal that results in this.

Peter

User
Posted 06 Apr 2026 at 18:24

Hi Jay,

I want to make sure you have a reply from the dark side.  I had non-nerve sparing surgery and that means I have almost no chance of ever getting an erection again.  This was a major issue for my mental health as I recovered from the op.  However, from as soon as I got home, after the op, we began to explore love making in creative ways.  It may sound totally mad, but my love life is amazing!  My orgasms are much better and longer than before the op and we have had so much fun exploring the world of toys.

We do use the pump and ring method when we simply must have penetrative sex, but a lot of the time we enjoy all kinds of foreplay.  On a more regular basis I do use a hollow dildo that straps on and I have a choice of dildos.  One is the size I used to be and the other is a fantasy size.  I did try injections but that was just not for us.

I simply refuse to let cancer win!  

User
Posted 06 Apr 2026 at 21:20

Jay, I forgot to add, I was also supposedly non nerve sparing,  our experience is very much like Paul's except that we have used injections. 

Thanks Chris 

User
Posted 07 Apr 2026 at 01:48

I wanted to chime in with a very positive story in this regard. My cancer was stage 3a with enough PNI that my surgeon had to remove roughly a third of the nerve bundle on my right side. Left side was spared.

 

Based on everything I had read before having surgery, when my surgeon told me (following my surgery) about the partial nerve bundle removal, I was certain I wouldn't be getting any erections for a very long time - if ever at all. But...

 

...No exaggeration - the day after my catheter was removed I was able to get and maintain a FULL erection. In fact, I've never had an ounce of ED since. Yep. And that's with partial nerve removal. Of note, my surgeon did mention that it's not fully understood to what degree the nerve bundle surrounding the prostate contributes to erections and continence and it may vary from person to person. 

 

As others have said, orgasms without a prostate are mostly dry but feel every bit as good as before. TBH, my wife and I both prefer it this way! I also find (as others mentioned) that orgasms seem to last a little bit longer than before surgery. 

 
Forum Jump  
©2026 Prostate Cancer UK