Prostate orgasm after surgery or radiation?

Posted by londonbill @londonbill, 2 days ago

New diagnosis prostate cancer Gleason 7 Group 2.
Deciding surgery vs. radiation.
Questions about whether any of you (gay or straight, although I suspect this is largely of interest to gay men) have experience with prostate orgasm after your treatment.
I can find no data about this other than discussion of dry ejaculation or ED. What about direct stimulation of prostate? This has been very pleasurable for me especially as I get older, and I don’t want to give it up. Logically one might anticipate that removal of the prostate would ruin the possibility of direct prostate stimulation and orgasm, however my understanding is that this sensation is mostly somatic and therefore likely preserved after prostatectomy.
Does anyone know what I’m talking about and can tell me your experience post treatment? At the moment I’m leaning toward surgery, but will have to commit in the next two weeks.

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jeff Marchi | @jeffmarc | 2 days ago

If you get surgery and they can spare the nerves, then you can get an erection within a few months or maybe a little longer.

Even if you can’t get an erection, you can still climax. If you rub the right spot you can climax. Helps to have someone massage your testicles at the same time.

If you get radiation, you can usually still get an erection and reach climax.

If you have to go on ADT then you run into a roadblock. It takes away the desire and also makes it very difficult to reach climax. It could also extend your life by years. With your low Gleason score, you may not need ADT.

Were any of these things found in the biopsy intraductal, cribriform, Seminal vesicle invasion, EPE or ECE. (Extraprostatic extensions extra capsular extensions). They can make the cancer much more aggressive and make ADT a necessary addition to your treatment>

londonbill | @londonbill | 1 day ago

Thank you for your reply. I’m hoping to avoid ADT, which is the main reason I’d opt for surgery, as radiation will require associated ADT.
I’m specifically interested in the difference between regular penile orgasm, which I think you’re discussing, and prostate centered orgasm, more typically associated with direct prostate stimulation (massage or “milking”), sometimes described as male “G-spot” orgasm, which can be much more prolonged and “shuddering” than penis-centered orgasm. It’s often reported as an intense full-body orgasm. I can’t find any discussion of this at all with respect to interventions for prostate cancer.

chippydoo | @chippydoo | 20 hours ago

In reply to @londonbill "Thank you for your reply. I’m hoping to avoid ADT, which is the main reason I’d..." + (show)

@londonbill Surgery doesn't necessarily exclude you from the ADT process. Hopefully it does but not guaranteed. Personally if I had to do surgery again I would ask for wider margins. Dealing with the cancer or being sexual? I choose dealing with the cancer. I had to go back two years later for radiation as the guess was cells were left in my prostate bed resulting in a biochemical reoccurrence followed by radiation and ADT. My suggestion is keep expectations in check and best wishes for a successful treatment followed by...

scottbeammeup | @scottbeammeup | 20 hours ago

Prostate stimulation after radiation is not what it was before. I'm 20 months post radiation and have a small vibrating prostate stimulator that is a narrow wand. It feels OK, but definitely doesn't do the job. Also, during solo sex, pressure on my perineum no longer helps trigger orgasm. Rectal sensitivity remains but prostate sensitivity is greatly reduced.

Additionally, if you have radiation, you have to be very careful putting anything in your rectum. Oncologists say to wait two months post radiation but IMO that is too soon. Be very careful, and start slowly after treatment.

trusam1 | @trusam1 | 9 hours ago

This is an interesting question. For sure, without a prostate, stimulation to and experience of orgasm will probably be different. But will it be inferior? For most men, it's hard to separate the effects of surgery from the normal effects of aging. Surgery of course is overnight, rather than gradual. My own experience with nerve-sparing surgery was a return to orgasm-ability within 2-4 weeks, and "normal" intravaginal orgasm within 7-12 months. For me, the sensation of orgasm is "full-body" - tingles down the inner aspect of my thighs, back arching involuntarily, brain "explosion", as well as strong "penile throbbing" (more on this below).

The male body IMO has multiple G-Spots: the head of the penis (especially if uncircumcised), anal penetration/prostate stimulation, classic propulsive vaginal intercourse, massaging the testicles and the base of the penis, nipple stimulation, oral kissing, etc etc. We learn and get used to what works best for us. Without a prostate, one is not bereft of options for excitement, it's a matter of practice makes perfect.

As to the "penile throbbing" part of orgasm, that's associated with the actions involved in expelling semen/sperm. That happens through the urethra, with muscles surrounding it squeezing rhythmically and involuntarily with great force. I've learned post surgery that sensation can be enhanced by direct stimulation of the urethra on the underside of the penis at its base. Luckily, the urethra and the muscle contractions don't know there is no longer a prostate or semen, and go merrily on their way as before during climax.

londonbill | @londonbill | 8 hours ago

Thanks for that. I’m sure it will be different, but I’m hoping that a large part of this experience is indeed related to some of those other g-spots and that it will still be good. Mainly interested in whether it’s more likely retained after surgery or radiation and there is indeed no data. A survey is needed!