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Did your surgeon discuss impact of prostate removal on orgasm?

Posted by gspotisprostate @gspotisprostate, Jan 12 5:47am

I’m just wondering if any of your doctors discussed the impact of removing your prostate would have on your orgasms after the procedure?

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daveandoneita | @daveandoneita | Jan 16 8:50am
In reply to @rlpostrp "I can't fathom sticking a needle in my penis...even a 24- or 26-gauge narrow bore needle...." + (show)
Profile picture for rlpostrp @rlpostrp

I can't fathom sticking a needle in my penis...even a 24- or 26-gauge narrow bore needle. Man...just typing that literally sent a chill through my body.

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@rlpostrp I had radiation 10 year ago. everything left me as far as sex goes.. tried vacuum pumps. ok but cold not much feeling, no orgasm.. 5 months ago went to the trimix, not a big deal about sticking myself. HaHa have some feeling but no orgasm. guess something is better than nothing. needles are small. sure beats the pump messing with the pump and have feeling!

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graybeard46 | @graybeard46 | Jan 16 8:55am

I would appreciate comments on the following problem. I am now 18 months post prostate surgery, 6 weeks of radiation and 2 Lupron shots. I have no luck with vacuum pumps, Viagra, and injections.despite minor erections no sensation and no chance of an orgasm. Has anyone had this experience and then after a longer period been able to to enjoy sex and have an orgasm?I feel like my sex life is done but a little hope would be helpful.

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briang1958 | @briang1958 | Jan 16 9:16am

After 12 years of no sex - Hot Octopuss Pulse works for me

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folmajt | @folmajt | Jan 16 10:42am

I had RARP in Oct 25. Surgeon went over possibility/likelihood of incontinence and ED in detail. Three months later... Continence improving daily, minor dribble and occasional squirt/leak. ED very weird. No problem getting aroused and hard enough for penetration. But poof... no orgasm; just kind of flame out. At 90 day follow-up, they said progress was good, but a little stumped at no orgasm. Prescribed low dose daily cialis and on demand viagra. Said nerves probably still healing/re-generating and increased blood flow via meds should/might help. But they (surgeon and underling resident) emphasized still only 3 months out and don't get discouraged.

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jime51 | @jime51 | Jan 16 3:47pm
In reply to @peterj116 "@tootall10 Nearly right. The prostate is removed, but the lymph nodes aren't generally removed unless there's..." + (show)
Profile picture for peterj116 @peterj116

@tootall10 Nearly right.
The prostate is removed, but the lymph nodes aren't generally removed unless there's some indication that the cancer has breached the prostate wall & towards the lymph nodes - where they can spread to hip bones, blood vessels or beyond. The seminal vesicle is removed.

Like the lymph nodes, the nerves aren't always removed & they do make an effort to preserve one (or both) bundles running alongside the prostate.
This is also dependent on if cancerous cells are found or suspected outside the prostate.

My understanding is that the urethra is pulled up to meet the new end of the bladder. This may result in shortening of the penis. (insert 'and I've still got plenty left' joke).

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@peterj116 I had tumors in prostate and adjacent iliac nodes. Hormone therapy has reduced my genitalia nearly to pre-puberty size and all but eliminated libido. If I'm able to discontinue hormone therapy in another 6 months (18 total), maybe by this time next year I'll be waking up a bit. I use a vacuum device daily after showers just to stretch tissue, because the erection lasts perhaps two minutes. I haven't found a working injection: I tried Trimix nearly 10 times with only one successful 45 min. erection. The last time I tried, I had an aching erection for five hours. Done.

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jeb0505 | @jeb0505 | Jan 16 3:48pm
In reply to @rlpostrp "The more important question would be: When, if ever, will I be able to have an..." + (show)
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The more important question would be: When, if ever, will I be able to have an erection? I asked, and my doctor said, "most men will regain their ability to have an erection between 3 - 6 months. I call "B.S." on that one. I am starting month "9", and I am still absolutely DEAD down there, DESPITE my urologist saying that he "preserved the neuromuscular bundles" that are necessary for an erection. Now at 9 months post-op he is saying, "It can take some men between 9-12 months to have erections return." I quoted the numerous accounts from this blog, of men who have never had a post-op erection, going on between 2-5 years. My urologist said, "yes, that can and does happen." I asked, "so what about me?" He just raised his eyebrows, shrugged his shoulders, and said "everyone is different...you are still recovering from the surgery...nerves are still regenerating or regaining their function." I said, "yes, but you told me that you preserved my neuromuscular bundles, so I should be having erections now right?" He again said, "everyone is different...you are still healing", and then he smiled and gave me an encouraging pat on the knee like a school boy who just did well on a quiz. Yet another example of why they say physicians "practice" medicine...there is no perfect or "always works" surgery, procedure or treatment. We're just finally part of the fortunate group or the unfortunate group, depending on the permanence of our outcome. We just don't know when to "call it"...when to say "I'm cured and restored as well as I'll be", or "I'll never be cured and restored to full function." Good luck to you.

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@rlpostrp took a while for me… I’m 1.5 years out. Trimex works, and I saw major improvement when I started getting testosterone injections… But your doc is right, everyone’s different.

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jeb0505 | @jeb0505 | Jan 16 3:49pm

Mine did… he explained from a high level (no fluid, still climax, but different)… that pretty much describes it.

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jeb0505 | @jeb0505 | Jan 16 3:53pm
In reply to @rlpostrp "I can't fathom sticking a needle in my penis...even a 24- or 26-gauge narrow bore needle...." + (show)
Profile picture for rlpostrp @rlpostrp

I can't fathom sticking a needle in my penis...even a 24- or 26-gauge narrow bore needle. Man...just typing that literally sent a chill through my body.

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@rlpostrp lol… it’s not as bad as it sounds. What kills me is when I read about men that can’t do it themselves, so they have their wife do it. If there’s one thing I want absolute control of, it’s needles to my penis.

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tootall10 | @tootall10 | Jan 16 5:06pm
In reply to @fiskadoro "Yes, I had a robust conversation with my doctor and his assistant about what to expect...." + (show)
Profile picture for fiskadoro @fiskadoro

Yes, I had a robust conversation with my doctor and his assistant about what to expect. I had my prostate removed roughly 7 months ago, and my doctor told me to expect orgasms starting about 3 to 4 months post surgery despite not being able to get a full erection, and to "use it or lose it". I bought a penis pump (wonderful device) and am now able to arouse myself, but i have not got up the courage to start dating and face having the "talk" with a woman. But I am 56 and really outgoing, so I will need to do it sooner rather than later. I do kegels often, have a great diet and luckily my spirits have not suffered too much.

I am happy that my length seems to be recovering, and though not as sensitive as before, I do feel pleasure in my penis nerve endings. It is my understanding that I am still "early" in my recovery, and I look forward to something close to a full recovery of sexual function and ability. There is hope!

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@fiskadoro I'm thinking that there are probably some women that would have no problem if you take a bit longer to achieve orgasm. Go get 'em tiger.

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robertcukor | @robertcukor | Jan 16 6:18pm
In reply to @tootall10 "It is my understanding that when surgeons perform an RP they remove the prostate including that..." + (show)
Profile picture for tootall10 @tootall10

It is my understanding that when surgeons perform an RP they remove the prostate including that portion of the urethra that it encloses along with related lymph nodes and seminal vesicle. They then have to pull up the end of the cut urethra to reattach it. (This is also where some shortening of the external portion of the penis occurs). The nerves that control the erection run along the side of the prostate and this portion of the nerves is lost when the prostate is removed. When the urethra is reattached I assume that hopefully the nerves ends are realigned and eventually regain their initial function. A poor realignment could explain why some men never regain full (or partial) function. It would probably help for a Urology surgeon to read this and confirm or correct this.

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@tootall10
Yes, you are correct. Speaking from both personal experience as well as a medical practitioner. Unfortunately the loss of length does occur as wel as the need for treatment of erectile dysfunction

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