Sex After Surgery: What can I expect?

@retireditguy How did it come back? Was it gradual and steady or was there a sudden improvement?

I think those of us who no longer have the responsive body we had are grieving. I have dreams of erections like I used to have… When I finally
Decided to give Trimix a go, I was sad going to the appointment. I should have been eager to go, but I had this feeling of being broken and not ever being able to go back. Don’t get me wrong - Trimix is a lot of fun for me - but my body is not the same. And, like others have said, I’m not depressed, I have a great life. However, nothing removes the loss.

Thanks Guys, well stated. Me, all the above and PISSED OFF! I've always been "oversexed" since puberty and have been pretty much DEAD on every level for 3 years. I think I had a fighting chance until I, ALL too late, came to the informed Realization, that MY Oncologist Poisoned my Boy z UNNECESSARILY! with the LUPRON CASTRATION POISON! Yeah, total BS. Please, advise your friends and Doctors that there ARE alternatives to Permanent Castration. I do all kinds of things to try and wake them up but just isn't getting any results.
And believe me, I am not the pleasant Patient I was described in my medical notes by my Oncologist and Radiologist as I started this adventure. BTW, did I mention that I am 75 and otherwise look like I'm < 65 despite the near total depletion of my testosterone. And, that I am married 25 years to a lovely redhead of 60? I let him/them have it every time we see each other. So, out of some sick sense of guilt I assume, He recently noted my HOT flash and Sweats on a visit and decided, after a year and a half since my last Lupron injection, that just maybe he could prescribe something that might "provide some relief". ANDROGEL. The Rx instructions prescribe "2 pumps topically Twice Daily". He made me promise that I won't use it MORE THAN ONCE A WEEK. One application every 7 days! Yeah, Big Whoop for a guy with 16 'T' measurement. And after two applications thus far, still catching fire regularly. Well, that's about it. Quality of life is actually a great alternative to Quantity. Good luck to my fellow dreamers about life returning to some function of normality on this topic. Hoping you have better medical professionals than I got hooked up with. rlm

@turtbean I congratulate you on your ability to see this from a different perspective. I on the other hand lament the loss of my nerves that allowed erections. In the past, when I heard women discuss their emotional state after a double mastectomy, I was confused. I thought ridding the body of the cancer was far more important than maintaining the breasts. Now I understand. Yes, I am happy to be cancer free, and yes, I would very possibly do it all over again. But that doesn't change my memories and my life experiences. I have had erections since puberty and I miss them. My VED and/or Trimix can achieve reasonable facsimiles, but learning I will never respond to stimulation again was jolting. Notice I am not mentioning intimacy with my wife. I agree with your viewpoint. I just miss my erections. Am I in a depressed state? I don't think so, but when I'm out golfing with buddies and the juvenile jokes start up again, I have to resist the urge to vent my frustrations. They don't need Debby downer in their foursome.

@topf For me, no orgasm is worse. Until Trimix, I could have an orgasm without a decent erection. There are occasions when cranking out an orgasm isn’t happening, and that is hugely frustrating!

@topf Yeah, not much, but I found that it hit me like 6 hrs later??
Levitra is not as well advertised but I read that it sometimes worked where others failed…’sometimes’ should have been ALL CAPS!!😩

@heavyphil I tried 100mg Viagra, but to no effect. Never heard of Levitra.

@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.

Two important things:
1. “…for those able to get an erection.”
And…tied to #1…
2. This Mayo blog is a subset “club” of men who are the “Unlucky Ones.”
Considering both #1 and #2 together:
All of the men who had smooth, uncomplicated outcomes to their radical prostatectomy, are NOT on this blog. They had prostate-confined cancer with no Extraprostatic Extension (“EPE”); therefore, no surgical margins and spread to seminal vesicles or lymph nodes. They had no Cribriform tissue or other pathology that was not revealed in the biopsy.
They were likely Gleason Score 6 or maybe lower/moderate risk Gleason 3+4=7, possibly 4+3=7. They didn’t have much, if any post-surgical incontinence or erectile dysfunction.
Therefore, they aren’t in this blog space.
Hopefully, you won’t be either, but… I would keep a positive attitude and a level of hope that your surgical pathology report is “clean” without any of the above, and that your urinary incontinence will be limited and resolve quickly, and your ability to get an erection will be restored quickly.
That said, the vast majority, if not literally “all” of us here, experience all of that. We are trying to manage our fear, dissatisfaction, frustration, anger, and hopelessness as we try to envision a life when someday we won’t have be wearing Shields/pads/diapers a year later; have absolutely no erectile response, and are waiting, figuratively wringing our hands wondering “when” our cancer will return within the next 5-10 years, because we know it likely will…unless we are extraordinarily “lucky.” So…
My advice is to be patient, keep realistic…not overly optimistic…hope that you’ll be one of the “Lucky Ones” whom we will never hear from again, because everything went well.
Good luck to you. Let us all know what your surgical pathology report said once you receive a copy. Blessings to you.

@jackwester -- Thanks for the offer, but this blog already has a private email capability. Just click on someones handle and you'll see an option to send them a private message in the top left of the screen by their name. Best wishes.