Sex After Surgery: What can I expect?

@jim1961 - This hit the nail on the head for me. I am 56 years old (diagnosed at 54) and now 14 months post RARP. My surgery was partially nerve-sparing. ED has been a huge factor, both psychologically and emotionally since the surgery. I immediately started on 5mg of Cialis after the surgery and continue it daily. I was recently prescribed an additional 20mg as needed for sex, but it has only had minimal results. The pump really did nothing for me. With the 20mg of Cialis I can get an erection about 90% of pre-surgery. I have climacturia every now and again with masturbation, but not every time. During masturbation, I can get an orgasm but it takes a lot of extra effort. The lack of ejaculation has had a bigger negative emotional effect on both me and my wife to the point I often wish I never had the RAPR. Other than the ED, I maintain a very healthy and normal life again, but sex is no longer a priority in my life.

@jim1961 -

“does anyone else want to share comments about the psychological and emotional challenges of ED post RARP?”

Sure, I don’t mind, and I think it fits squarely with the topic.

I’m fine with sharing, because I think, after reading ED-related posts here and other forums for the past four months, I must be some kind of oddball or outlier, because I don’t have any psychological or emotional fallout from ED. To me, it’s simply that it’s an expected side effect of the surgery, I knew that going in, so when it happened, it didn’t bother me in my mind or in my self-perception or general outlook on life. I feel like I’m pretty much the same person I was before Mr. Happy became Mr. Floppy.

Thing is, I’ve never gotten caught up in any kind of gender norms for masculine or feminine behavior. The idea that this thing is “manly” and that thing is “girly” just doesn’t register with me, nor does it my wife. We line up really well that way.

That follows through right to our sexual relationship - we’ve always just tried to make sure each other had a pleasurable, satisfied experience and that was that - I’m not even sure how to word it, because I guess I see the mechanics of sex as one thing and the emotionality of intimacy as something else. I’ve lost the ability for penetrative P-in-V sex for simple physiological reasons - something I can’t really help - but my ability for intimacy (as well as my libido) are still quite intact, so I guess it’s a matter of choosing intimacy over a purely physical act (like in some bizzaro world where I have the ability to achieve an erection, but no libido - sure, I could have sex, but would I want to? Would my wife want to have sex with me if there were no intimacy attached?).

Someone asked me, right after my surgery (and I mean just a couple of days after) if I felt like less of a man with my prostate plucked out, and I honestly thought to myself, “What a ridiculous question, of course not! Why would I?”

I doubt if that made any sense, but maybe all I’m saying is my identity and our marriage isn’t built around sex, sex is just a single component of many.

@kmc1372
Thanks for the reply. It does sound like a very similar experience. I got a shipment of Trimix, and the first dose resulted in a trip to the ER! I think the dosage is now worked out, but the whole episode did not help with the overall journey.

@jim1961 Does the Trimix help with orgasm?