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

Robert, I was only speaking of my own experience. I had exactly the same problem he did at first and after a while, the orgasms became much stronger, equal to before surgery.

Other people have confirmed the same thing with their experience

I had surgery 14 years ago and salvage radiation 3.5 years later. I have spoken of this many times in this forum. Apparently you haven’t followed my saying this many times. Hard to do that on this forum, can’t just search for some particular person’s comments.

Congratulations on having an erection that is 80 to 90% of what you had prior to surgery. If you told me that in person I would high five you. There’s a lot of reason to hope that you’re going to have a full recovery of sexual function.

There are a number of us on the forum that have not had the same good fortune to have return of natural erections but we’re all rooting for you.

I can’t speak medically to your issue, but I can tell you that I had a similar experience initially. My first erection post surgery and before I started ADT was about 70 to 75% and I felt like a stallion. Unfortunately, I recall my first orgasm post surgery was almost nonexistent. I remember commenting to my wife when I first experienced that and we were both shocked, looked at each other and said “now what?”

From my own experience, nine months after surgery things have improved to the point where orgasms are worth the effort to achieve them. Prior to starting ADT some were absolutely mind blowing and left me breathless.
Even after being on both first and 2nd generation ADT for 6 months, I think they’re still worth the effort for me.

I recently completed eight weeks of pelvic floor therapy. My therapist who is a woman had access to my medical chart and saw that I am dealing with ED. She told me that it was her belief that levels would help me not only with urinary urgency, but would aid in the quality of erections and result and stronger orgasms. She was correct.

Good luck on your journey with prostate cancer. Never give up.

Well, Jeff, here you go again.

You wrote. “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“

You’re not a doctor. You’re a cancer patient like the rest of us and to make matters worse you have no first-hand experience with recovery from surgery because you chose radiation.

Your comments aren’t constructive and helpful to those of us on this form who chose surgery and are struggling to get quality of life back.

I want to believe that your heart is in the right place, so if you want to help other men in this community, don’t tell other cancer patients who chose surgery what to expect. You can relate your experience and personal struggles any day of the week, but for the rest of it, let it go.

Do the right thing and good luck on your journey with prostate cancer.

My “dry” orgasms with a half erect penis are more intense and last longer than before. Two days ago I had the best orgasm of my life. Hang in there! Experiment!
It gets better over time. I will be having IPP and AUS surgery very soon and am excited about having full erections and no pee leakage.

The tubes carrying the ejaculate are severed, but the ejaculate is made up of fluid from the seminal vesicles (65-75%), prostate (25-30%) and sperm from the testicles (1-5%. Since the prostate and seminal vesicles are removed at surgery, even if the "tubes" were intact there would only be a slight dribble.

My Dr. recommended the Pos-T-Vac Battery System. Thinking that I needed the best, I bought the most expensive package available. Now I realize I didn’t need the most expensive one. The Pos-T-Vac Bos2000-2 Battery System has everything I need and is half the price of the most expensive.

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.

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.

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 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.