Dry orgasm after prostate cancer treatments

jc76, thanks for asking this question. Kishan at UCLA said that dry organism are something that take getting use to. And I was too timid to ask. They are common because the prostate produces fluid that propels sperm through the penis. Since we pretty much evicerate the prostate gland with radiation if we don't remove it, we might not have much recourse. I have read that some medications make it worse. And I read somewhere that they are having some success with stem cell implants in the prostate gland. I wanted to ask Kishan if they are painful or just not as pleasurable. I'll be looking for better responses than mine.

@gently
Thanks,
Do you know if something that is an issue medically? I can deal with it versus having prostrate cancer. I just did not hear a lot about it but I see you mention common. Can I asked if you had the same side effect or were just asking Dr. Kishan?

It was a shock and remember seeing something about it but could not remember the details. I hope to find out if this is something that improves or is a permament side effect of the radiation.

jc76, Kishan mentioned that it was definitely an issue to get accustomed to, but I'd never heard of it. We were talking about the protecting the urethra.
I read 70% with radiation but that was a 2013 study.
There is a situation called retrograde ejaculation which results from damage to the urethral valve. I think that valve has to be closed for ejaculate to traverse the penis.
Sometimes the cause is medications which can be altered. Sometimes nerve damage, but mainly I think it's lack of fluid production in the prostate.
Still on ADT. No experience, yet.

This is a common SE with most BPH surgeries. Not surprising that radiation to the prostate would cause it as well. Since there are two types/sources of fluid that make up the ejaculate it's possible that one or both of them have been affected.

The glandular tissue in the prostate itself makes 30% of the ejaculate while the seminal vesicles make the remaining 70%. Radiation could cause the ejaculatory ducts that carry fluid from the seminal vesicles to the apex of the prostate via the verumontanum to be "welded shut" on one or both sides. This could account for either 35% or 70% of the ejaculate never making it to the verumontaum and the apical end of the urethra.

Similarly, the glandular tissue that supplies the remaining 30% of the fluid could be damaged and be unable to produce and/or convey the fluid to the apical urethra.

A third potential cause of anejaculation is the muscular tissue or nerves controlling it surrounding the veru in the apical end of the prostate is damaged, causing the inability of the muscular tissue to "squeeze it out."

I think it is very unlikely you'd be able to recover that functionality of the prostate once it is lost.

It’s a common issue after radiation treatments. If you consider the anatomy - the seminal vesicles are located on top of the prostate - they’re difficult to miss. It doesn’t always happen, but enough that it should have been discussed between you and your RO.

I received 5 High dose Proton blasts and 3 hormone shots, and it will be a year in May. I still have dry orgasims. Some times I’ll get fluid, just clear and at times a drip or two, sometimes a little more, other times nothing. I attended a webinar on the subject thru the PCF and the concern is that it could be at least 12 to 18 mths, maybe to recover. I have not gotten anymore shots since last year. The shots were given to me by my surgeon and alternating visits with my oncologist. Before, during or after, not a word on the subject. They looked surprised when I brought up the subject and was told, yeah the shots are stronger than stated and it “should” fade in time.
Yes, my brothers, there is a lot they don’t tell you and should, but then how would they know when they haven’t actually experienced it. The old walk a mile in my shoes quote. I guess take faith that we aren’t alone in this and draw strength from our mutual understanding and experiences. Stay strong.

@slick64
Thanks to you and the others. I don't remember it being discussed by R/O at either Mayo or UFHPTI. It maybe in the handout information as side affects so will have to check. If it is not something of a medical problem that needs to be fixed or addressed I can live with it versus having prostrate cancer.

I thank all that responded with information as it help see it is a side affect. I agree should have been discussed with me. One of the pre questions I had from UFHPTI was on intercourse and I answered not active. Maybe that had a implact on UFHPTI but was not asked that question at Mayo.

I will say again "thank you Mayo Clinic for having such a forum to asked questions and get feedback." And again, thanks guys for that feedback.

I find this interesting in that my emulators volume had already decreased before my biopsy and after a few bloody emasculations (which the did warn me about) it pretty much stopped completely. Since I’ve really not had any treatment yet I attributed it to the cancer.

The only warning I got was from my cousin who had a RP. He made it sound like he was happy to have even that given that ED drugs didn't work for him. My main RO ran thru the side effects list at the same speed as the drug vendors on TV, a total blur of useless details. Regrettably, she did not 'net it out' and tell me those side effects that are most likely and how I should be prepared.

After my radiation and Orgovyx, I am also 'shooting blanks'. I should add that I had an unnecessary orchiectomy, right side, since my Dr. decided that I likely had testicular cancer that turned out benign, and ejaculation was weak to begin with.

I now get about 80% of a normal erection 3 months post completion of all therapies. I was offered a Cialis prescription, but, my pharmacy just sent: Price*
Tadalafil 20mg Tablets
30 $1501.09
Total: $1501.09

I don't know it that is the final price, but, I'll have to decide if it's work it or not.

At Walmart, the Good Rx price, which they automatically give me when insurance isn't better, is about $20-30 for 30 tablets, small enough that I don't remember the exact price, especially since the pills give me very unpleasant GERD. And since I've tried both sildenafil and tadalafil, I know the price is roughly in the same ballpark. I don't have that particular dosage, though.