Dry Orgasm after surgery: Does it get better with time?

After surgery, you will have dry orgasms. There is no reason they shouldn’t be just as intense as before surgery. it may just take a while for you to be adjusted to the new situation and then intensity will come back

If you are on any ADT drugs, they can interfere with the intensity, even the ability to reach climax.

I'm 70 YO and 4 months after bilateral NS RALP. I have had some orgasms and for me they've definitely improved compared to the first orgasm after surgery, which was so mild I wasn't entirely sure if it had happened or I had imagined it. Now, when I have one it's much more satisfying. I just wish my erections were improving as quickly as the orgasms, but for me progress there has been much much slower. Best wishes on your recovery.

No ADT drugs.

4 weeks after surgery and having an erection, and BBs?!?! I'd say you're very, very blessed.

I had a RALP last Dec.

My experience: I'm amazed how much of my drive is simply 'gone'. Like I've been gelded.

I suspect this may be unique to me, or played down b/c many wouldn't opt for RALP? IDK.

Life is full of compromises, appreciating what we have seems to be best.

I believe that you're quite luck and should be happy to have a 90% and have sex after your surgery. There are more of us that have ED after surgery. Yes, you're going to have dry orgasms but that isn't a issue. They are the same thing except without fluids. So, be happy!

Yes, finding discussion on this topic is difficult. Anecdotes aside, even the most authoritative treatments seem mostly...anecdotal :-). So I'll spare you mine :-).
Here are things I think I know at this point:
1) Orgasms happen in the brain, not in the erection.
2) Trauma is a big deterrent to orgasm, and perhaps surgery is more traumatic than radiation, but maybe catheters are more traumatic than surgeries? I guess only the first of these three is something I actually know or think I know.
3) Erections have a lot to do with blood flow, valves, and nerves. PC treatments all affect blood flow and nerves, somewhat unpredictably. Valves deteriorate with age.
4) Surgery is especially traumatic to the nerves, but there is often some recovery over time, maybe up to two years or even longer.
5) Radiation is progressive, so initial experience after radiation does not tell the whole story of the ultimate level of damage.
6) The brain can be retrained. (See 1.)
7) Erections can be preserved or strenthened via increased blood flow, either muscle tensioning or vacuum erection (mechanical) or sildenafil/taladafil/etc. (changes nitrous oxide levels, I think) or trimix etc. (chemically triggered erections.
8) Surgeons ultimately promote penile implants even if they are ostensibly educating about other strategies. Boston Scientific sponsors education because they are the biggest supplier of penile implants in the US.
9) Yes, it's true. Post prostatectomy erections are always dry because the tubes carrying seminal fluid have been severed.
[Feel free to disagree with any or all of these things I think I know, and I'd love to hear why.]

I am about 5 months post RRP. First orgasm was less intense but still a release. Since then they have improved overall but remain variable. All feel somewhat different than pre-op. I require more time for build up, Need to vary pace etc and trying to keep sense of fun and exploration. Just my experience.

I appreciate your frustration about the lack of information pre-surgery. As I recall, I got more info about sexual side effects from sites like Mayo Clinic than I did from my Dr. Has the situation improved at all for you?

With that said, I had a prostatectomy in June of this year. I haven’t had a natural erection since. I’ve tried low doses of trimix, without success. I’ll be trying the highest dose in the next couple of days. I have to use a pump to get an erection and a band to keep it. So I’m quite amazed that you’re having erections so soon after surgery.

As for orgasms, I haven’t been able to have sex with my partner because the whole preparation is simply off-putting. So my orgasms have been self-induced. I knew organisms would be dry, so my expectations were tempered. An erection with a band requires a lot of effort so my orgasms are quite intense.

I realize this doesn’t answer your question. When I’m finally able to have sex with my partner, I’ll let you know about the intensity.

I was on finasteride for a couple of years before RALP which causes dry orgasms as well as ED. I could get 80% at best, but not enough for penetration.

Monday will be 6 weeks post-RALP. I haven't even begun to think about an erection. I lost one side of the nerves since they had cancer involvement, so the doc said getting an erection will be difficult. He has not discussed any other methods with me although he does have a viagra prescription in for me. I haven't filled it yet.

Question: what kind of pump/band is recommended? Thanks.

Think about what happens during orgasm, and why it's happening. The primary purpose is to shoot sperm & seminal fluid out with a lot of force. Your (mental) pleasure is a secondary effect designed to make you want to do it again. That shooting out of fluid and sperm requires muscle contractions from a lot of places in the genito-urinary tract, including the urethra, prostate and base of the penis. The sensation of those contractions, the sudden changes in blood flow and muscle tension, is what we feel as an orgasm.

Those very areas are where the prostatectomy has happened, After surgery, there is a lot of swelling (inflammation), dying off and regrowth of tissue happening. That inhibits sensory nerve transmission. All of that interferes with the ability of the remaining structures to do their job during orgasm. So it's no wonder it feels weaker during the first few months after.

If you want to get a read of how things are progressing with internal healing, just look at the scars on your abdominal skin. Once they turn from red and swollen to whiter and less swollen, you'll know things inside are returning more to their normal state. That may take 3-6 months depending on your age, physical fitness, diet, etc. Things should feel better after that point.

Two tangential notes: 1. Many men experience climacturia after prostatectomy, the release of urine during sexual stimulation, excitement and orgasm. That's because the barriers between the bladder and the urethra have been weakened by the surgery. 2. The prostate is where the seminal fluid comes from, so it's no wonder the orgasms are "dry" after the surgery.

Erectile function after prostatectomy is a whole other topic I won't touch on here. Note that two separate nerve pathways control orgasm and erection; the latter is the only one which is affected by prostatectomy.