Boys, sometimes this gets me down

Yeah, I totally get the sex part. G9, RP, RT, oligomets and triple therapy with 2 years of T< 3. Knew I should want sex but just didn't really care. This was after years of a great sex life. Penis and testicles shrunk from the treatments.

My MO started me on Testosterone Replacement Therapy 2 years after triple therapy with undetectable PSA. It was a game changer. Libido came roaring back. Wanted sex again. Complete ED with pills. Started Trimix injections. ( actually while my T was low ). My first time injecting I got an erection like I was 20 years old. Had an orgasm for the first time in years. Almost cried. Erection lasted 3 hours!

The needle is a 29 or 30 g. Very small; essentially an insulin needle. The injection wasn't really painful-just getting over the idea of sticking a needle in my penis. But worth it to me. I have read extensively that some guys elect the penile prosthesis which has a 90+ % satisfaction rating.

Bottom line: there are options that actually work for getting erections and having sex again. Even on ADT without the real desire to have sex, having sex can bring intimacy and satisfy your partner.

Good luck to you and others fighting this disease. This is one cancer where the treatments are as bad as the disease itself. But we are still alive.

I’m with you brother. After 32 years of marriage my divorce was finalized in mid-March 2025. I was looking forward to an active post-op, post-divorce sex life…”not.” I had the DaVinci Robotic-assisted RP one month later in mid-April 2025. I was a virile, completely capable 70-year old. I haven’t had an erection since that April surgical date, even with the surgical sparing of my neurovascular bundles to enable erections. I am so depressed that I haven’t even attempted to meet anyone: “I know we’re really attracted to each other and see this going for the long term, but oh by the way…I can’t have penetrating sex…I have post-RP erectile death.”

I am (humbly) a very younger, good looking 70 years old. I routinely engage in/with very interested 40-60 year old women who seem not to care when I tell them I am not the “50-55” years old that they think I am. But…it doesn’t matter…I don’t even feel like a man. I now appreciate how women feel when they’ve had a mastectomy. That is sadly even worse because of what is horrific scarring prior to any reconstructive surgery, if they have it.

Just out of college I used to have a friend that would say: “Life sucks, then you die.” I kind of feel like that’s true. We are all only in the present moment, and the older we get and lived, the more painful all of the good memories are, because they are over…never to be relived or recreated. I think insurance companies should be required to automatically pay for 7 sessions (more?) of post-RP counseling/therapy so we can find a way to handle the grief of never again being who you were, and what you have to accept as the new you going forward.

@rlpostrp Sorry to hear that you feel that way. Are you on active ED therapy (daily Cialis plus booster, VED, injections, stimulation)?

Injections do work. I am still trying to find the right dose. Right now, it’s just enough for penetration but lasts 3-4 hours (i.e. higher dose not recommended because of priapism risk). As has been mentioned, implants to get good reviews.

I guess I could experiment with the injections, pumps, etc., but as I offered...I am not dating anyone...not looking...until and if I can get a natural erection. I can't fathom sticking a needle into my penis. My doctor said it is on the underside and in an area that is not so sensitive compared to elsewhere on the penis. Still gives me the chills, and I drew blood from literally thousands of patients very early in my career, prior to becoming the Director of Clinical and Anatomical Pathology ("The Lab"). I am not familiar what "booster" you take on top of Cialis. I started on 5 mg Cialis immediately post-op as part of its known aid in "healing things." Then I went on 20 mg every other day, but it does absolutely nothing. I don't know if I am supposed to be able to get spontaneous erections, but I have had absolutely "zero" erections..."semi"/partial or complete. I wish I drank or took drugs to go numb to all of this.

@rlpostrp The 20mg 2-3 times each week is what I meant by booster. Have you tried to wait for two hours before stimulating? I think Cialis does not cause spontaneous erections, stimulation is necessary.

So, everyone is talking about this now here. What do your partners do / say when you piss on / in them. Do you use a condom after you do some crazy shit like putting a needle in your.
It sucks

@briang1958 The key to not peeing on them is to make sure that you go to the toilet at least twice in 30 minutes beforehand. And don't drink anything for an hour. Empty the bladder as much as possible.
Sounds obvious, but it works.

@briang1958 Ionly have that problem often when flaccid. It seems to go away with an injection-induced erection.

If persistent, I have read that sling (placed somewhat differently than for incontinence) can help.

@rooroo were you getting PSAs every 6 months before you got metastasis?

@rlpostrp Please know you are not alone. There are many of us waiting for signs we may be able to get back to what was normal at one time. Remember life itself is the top priority and everything else is a bonus, right? But it doesn't help us deal with something that is very devastating for each of us.