Experiences with prostate stimulation and orgasm: Surgery vs Radiaton?

@mouser26
Get your testosterone level checked in the next PSA test. Once it gets past about 250 you probably can start having relations again and being able to climax. Don’t expect ejaculation, In some cases, it could be urine, The radiation has eliminated the Ability to produce sperm.

What other drugs are you taking besides ADT? That could be a factor in the inability to climax.

Some of the drugs people take for Mood issues can affect the ability to climax.

Thanks I'm done with "relations".

@mouser26 How does the lack of ejaculation turn you off to having relations? Buddy, I’d trade places with you in a heartbeat if I could get it up…the money shot is only important in porn!
Phil

Follow-up:
Had the laporoscopic prostatectomy in March. Six months out there is little natural erection, but the trimix works well.
I elected for surgery mainly because I already had difficulty urinating and needed Flomax. Surgeon said high risk of incontinence if a TURP was done either before or after radiation.
Good news is that there has been virtually no incontinence. I suspect that my pelvic floor had been well exercised by my experience with prostate-centered orgasm.
Is it still present after surgery? Not really. The rhythmic pulsing is gone and it just feels like nothing. Yes, there’s a bit of residual pleasure around the anus and just inside, but the lengthy prostate-centred experience is missing. Having dry orgasm which is pleasurable (and realistically it had been dry for years because of retrograde ejaculation cause by the Flomax), but do I miss my previous pleasure center?
Yes.

@londonbill I wonder where the success stories are?
My RP scheduled!!!

@solar4ever
https://connect.mayoclinic.org/discussion/big-post-rarp-milestone-for-me-possible-trigger-warning/
Read all threads by this member - you can not find a better success than this one ; ) !

My husband had good results after RARP (though not this fast ) but unfortunately he had BCR 8 mos later. So, my humble advice is to concentrate on good result in cancer eradication - all the rest is easily fixed this or that way and in many cases no "fixing" is necessary ; )

Wishing you the best of luck with your upcoming surgery 🍀✨

Solar4ever,
I imagine many of the success stories aren't posting here precisely because they have experienced success. I consider myself a success story, at least so far. I come back here out of gratitude for this community that provided me support and advice during my decision making process and after my surgery.
After years of steadily rising PSA, a couple of biopsies that found nothing, and then leveling out at a PSA around 12, my urologist said it was time for a new MRI. The MRI done in July 2025 found a larger PI-RADS 5 tumor, and a smaller PI-RADS 3 tumor, followed by a biopsy in August, which found that the larger tumor was a 3 + 4 = 7 with perineural invasion, and the smaller one was a 3 + 3 = 6. I had a high risk decipher score also. I had surgery in January this year at age 67. Now, 8 months out, my PSA is undetectable, I'm fully continent and my erections are coming back. I can enjoy orgasms, but as others have said, they are dry with a bit of urine some of the times. My abdomen is completely healed and I'm good for all the activities that I did before.
So, good luck. I hope you'll be one of the success stories!

@quaddick 🙏
My fingers are crossed!

As you can see, this is a complicated question, because it tries to separate the regular, typically ejaculatory (though dry after surgery), orgasm from a prostate-centered orgasm which is entirely different, experienced by only a subset of men, and typically through direct stimulation of the prostate via the rectum.
As it stands, there is very little data about prostate orgasm in any case, and to my knowledge this is not being tracked in any of the prostate cancer studies.
Understood that cancer treatment, and continence, probably outweigh any consideration about orgasm.
Nonetheless, it would be extremely helpful if one could know the pro-con with respect to prostate orgasm, comparing surgery vs radiation.
How hard would it be to add to treatment surveys? It would require knowledge of individual experience, questions about rectal stimulation, and sexual orientation. At this point that doesn’t seem to pique scientific interest.
Surgery: well, your prostate is missing. Does the sensation of prostate orgasm still occur? Part of this is probably related to pelvic floor contractions, which are still present. I understood from previous writers that their prostate orgasm was still partially present, although not the same. In my personal experience, that prostate contraction component is pretty much gone, which is indeed a loss.
However, radiation: Does a radiated prostate still experience prostate orgasm? (Again, I’m not talking about the ejaculatiory penile orgasm). Does the collateral damage to the rectum preclude direct prostate stimulation?
Answer: zero data, zero research.