Post prostatectomy, any sexual release like nocturnal emission?

Posted by bwjb @bwjb, May 24 8:40am

I had a prostatectomy and was impotent even before the prostatectomy. I have never successfully reached orgasm by masturbation while flaccid, even before the prostatectomy. Injections don’t work for me due to venous leak. I sometimes wonder whether I could still reach orgasm from oral sex, but have never tried since I am also incontinent. As a result, I am preoccupied by sex all of the time without any release. Rightly or wrongly, I always assumed that nocturnal emissions in my youth were caused by the prostate being swollen with semen due to sexual inactivity. My radical prostatectomy removed not only my prostate but both neurovascular bundles and the right and left seminal vesicles, so of course there is no longer any buildup of semen. I have had sex dreams post prostatectomy but of course never woke up with wet underpants due to no longer ejaculating. I am wondering whether the buildup of sperm in the testicles causes any sexual release comparable to nocturnal emissions to relieve sexual tension for prostatectomy patients.

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retireddoc | @retireddoc | May 31 7:56am

In reply to @bwjb "Jeff, there has been no change to my testicles. I still produce sperm and testosterone. I..." + (show)

@bwjb
I had an RP in 2021. I have climaturia and ED. Trimix helped for years but has been getting less effective so I am scheduled for a penile implant in June.

The ejaculate/semen is 95% fluid from the prostate and seminal vesicles. The sperm from your testicles makes up a small amount. The physical tubular connection that carries the sperm to the prostate where it is mixed with the fluid from the prostate/seminal vesicles has been disrupted/resected. So, unfortunately, no more ejaculation. The pleasurable muscular contractions of orgasm are unchanged.

I ejaculate urine during orgassm. It feels very similar and pleasurable to ejeculating semen. Fortunately, my partner has no issue whatsoever with it and doesn't require me to wear a condom. It was a problem in my previous relationship (wife) which caused sex issues.

Read up on penile implants. They are covered by Medicare (and probably commercial insurance as well). Good luck!!

bwjb | @bwjb | May 31 8:35am

Retireddoc, You have answered my question. That makes sense that if 95% of ejaculate is from the prostate and seminal vesicles (my prostatectomy removed both seminal vesicles as well as the neurovascular bundles) that there is no overflow mechanism like a nocturnal emission due to a buildup of sperm. Trimix doesn't work for me due to a venous leak that a doctor diagnosed.

Good luck with the penile implant.

chippydoo | @chippydoo | Jun 1 7:37am

Not from my experience as my seminal vessels were removed. No way to get from one to the other is my understanding.

clevelandguy | @clevelandguy | Jun 1 7:54am

Hi,
Your internal plumbing is gone between your Prostate and your balls. No more semen release…….

Dave 3+4

bwjb | @bwjb | Jun 1 8:44am

chippydoo and clevelandguy,
I agree that there is no sexual release like a nocturnal emission of semen following the removal of the prostate and seminal vesicles. I was hoping that there was some type of similar release of sexual tension from the epididymus becoming filled with sperm, but I am understanding that that is not the case. As outlined in my original question, my libido is strong but there is no longer any way to get sexual satisfaction.