Experiences with prostate stimulation and orgasm: Surgery vs Radiaton?

If you get surgery and they can spare the nerves, then you can get an erection within a few months or maybe a little longer.

Even if you can’t get an erection, you can still climax. If you rub the right spot you can climax. Helps to have someone massage your testicles at the same time.

If you get radiation, you can usually still get an erection and reach climax.

If you have to go on ADT then you run into a roadblock. It takes away the desire and also makes it very difficult to reach climax. It could also extend your life by years. With your low Gleason score, you may not need ADT.

Were any of these things found in the biopsy intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive and make ADT a necessary addition to your treatment>

Thank you for your reply. I’m hoping to avoid ADT, which is the main reason I’d opt for surgery, as radiation will require associated ADT.
I’m specifically interested in the difference between regular penile orgasm, which I think you’re discussing, and prostate centered orgasm, more typically associated with direct prostate stimulation (massage or “milking”), sometimes described as male “G-spot” orgasm, which can be much more prolonged and “shuddering” than penis-centered orgasm. It’s often reported as an intense full-body orgasm. I can’t find any discussion of this at all with respect to interventions for prostate cancer.

@londonbill Surgery doesn't necessarily exclude you from the ADT process. Hopefully it does but not guaranteed. Personally if I had to do surgery again I would ask for wider margins. Dealing with the cancer or being sexual? I choose dealing with the cancer. I had to go back two years later for radiation as the guess was cells were left in my prostate bed resulting in a biochemical reoccurrence followed by radiation and ADT. My suggestion is keep expectations in check and best wishes for a successful treatment followed by...

Prostate stimulation after radiation is not what it was before. I'm 20 months post radiation and have a small vibrating prostate stimulator that is a narrow wand. It feels OK, but definitely doesn't do the job. Also, during solo sex, pressure on my perineum no longer helps trigger orgasm. Rectal sensitivity remains but prostate sensitivity is greatly reduced.

Additionally, if you have radiation, you have to be very careful putting anything in your rectum. Oncologists say to wait two months post radiation but IMO that is too soon. Be very careful, and start slowly after treatment.

This is an interesting question. For sure, without a prostate, stimulation to and experience of orgasm will probably be different. But will it be inferior? For most men, it's hard to separate the effects of surgery from the normal effects of aging. Surgery of course is overnight, rather than gradual. My own experience with nerve-sparing surgery was a return to orgasm-ability within 2-4 weeks, and "normal" intravaginal orgasm within 7-12 months. For me, the sensation of orgasm is "full-body" - tingles down the inner aspect of my thighs, back arching involuntarily, brain "explosion", as well as strong "penile throbbing" (more on this below).

The male body IMO has multiple G-Spots: the head of the penis (especially if uncircumcised), anal penetration/prostate stimulation, classic propulsive vaginal intercourse, massaging the testicles and the base of the penis, nipple stimulation, oral kissing, etc etc. We learn and get used to what works best for us. Without a prostate, one is not bereft of options for excitement, it's a matter of practice makes perfect.

As to the "penile throbbing" part of orgasm, that's associated with the actions involved in expelling semen/sperm. That happens through the urethra, with muscles surrounding it squeezing rhythmically and involuntarily with great force. I've learned post surgery that sensation can be enhanced by direct stimulation of the urethra on the underside of the penis at its base. Luckily, the urethra and the muscle contractions don't know there is no longer a prostate or semen, and go merrily on their way as before during climax.

Thanks for that. I’m sure it will be different, but I’m hoping that a large part of this experience is indeed related to some of those other g-spots and that it will still be good. Mainly interested in whether it’s more likely retained after surgery or radiation and there is indeed no data. A survey is needed!

My brother, at 66, had a total prostate removal.. He claims he gets the whole sensation, just no ejaculation. I had 5 rounds of radiation. I only had one complete ejaculation a week after treatment. 5 years now. I get sensation, but no ejaculation, just a bit of prelube. I'll get close to feeling completion but then it goes completely soft. In my mid 70's now, just grateful I'm still here, my mind works and most of my body parts work. I see some guys go to great lengths to retain all body functions. I can't afford most treatments. Trimex totally freaked me out. take too much, and my dick felt like I was 15. A breeze would blow, and I'd get hard. I've resigned myself to the current situation, and don't want to expend all the $$$ and energy to have something that feels artificial now. No longer have a wife, I've also crossed over to bisexuality, which gives me some excitement. But sex is not as important and demanding to me as it was when I was younger

@markstyles
Even completely soft, you can rub the right spot and reach climax. I did it a number of times with my wife’s help Before I went on ADT. It can get really intense after doing it a few times (not the same day). The problem is you ejaculate urine in many cases.

After your surgery and also after and during subsequent treatments, things will function somewhat differently and you will need to experiment and be open to change. Everyone is different and how your body reacts is unique. Just remember that any orgasm is a good one and they may change during the course of your treatment. Nine years ago I had a radical prostatectomy. I was able to have penetrating sex and orgasms that were satisfying. Several years later, the cancer came back and I had radiation. Still no problem. Several years later again the cancer showed up. Radiation and ADT were given. My testosterone went down to undetectable and I experienced ED. This continued for three years with my wife and I having what I called “lesbian sex” It was mutually enjoyable in the orgasm department, although somewhat more intense. A year ago I got an Inflatable Penile Prothesis implant and not only am I able to have erections that happen in 15 seconds and last for as long as I want and penetration, my orgasms last significantly longer and the sensation is more intense than any previous point in my life.

I was a Gleason 8 and had external beam radiation and brachytherapy followed by eighteen months of ADT. The ADT kills your sex life, period. I finally came off it this past October. I am able to get erections on my own, but nothing like I used to. I have not tried any ED meds. I am unable to ejaculate, which honestly makes me unwilling to attempt sexual relations. Prostate cancer, simply put, has ruined my sex life. I went from extremely active to nothing. It has changed my whole outlook on life and left me quite bitter. No one told me this was coming. Oncologists should at least prepare their patients for the bleakness that follows "successful" treatment.