Sex After Surgery: What can I expect?

I'm 7 weeks out from my RARP at Mayo in Phoenix. Unfortunately, due to the aggressiveness and stage of my cancer, the procedure was non-nerve sparing, and the maximum tissue was removed to allow for the "best cancer surgery possible." In this case, there will be no errections without implants or shots. Additionally, the incontinence makes intimacy of any kind to messy (constant dribbling) to contemplate, so I focus on my wife's needs, not mine. I think you are making a wise decision as to surgery, but make sure you understand what the planned surgery will be (NS vs. NNS) and what the likelihood of impotence and incontinence will be after surgery. I think it is much more common than most urologists communicate to patients. Good luck on your journey!

Just bought the book! I had never previously heard of it. Thank you for the suggestion. I will probably learn something.

Make sure to learn about "penile rehabilitation." Some doctors are very good about this but I've heard others are not. It basically involves taking daily low-dose Viagra or Cialis to keep bloodflow going. If your doctor doesn't offer this, you should ask (unless, of course, these meds are contraindicated for you for some reason).

There's a good book, though keep in mind that it's a bit dated, called "Saving Your Sex Life: A Guide for Men With Prostate Cancer" by John P. Mulhall, MD. He is the director of sexual medicine at Memorial Sloan Kettering, which is a top cancer center. I had radiation and am currently on androgen deprivation therapy (ADT) so can't answer any specific questions about sex after surgery but it is covered extensively in the book.

As someone whose prostate cancer reoccurred my personal opinion is that you made a good choice given your circumstances. Don’t hesitate to check back into the forum if we can answer anything regarding concerns you have regarding prepping for surgery, recovery, regaining urinary continence, etc. We’re here for you.

Thanks... my Gleason score is 7 (3+4). With moderate aggressive cancer in multiple areas of the prostate. So focal treatment wasn't an option. Going with surgery because risk of reoccurrence down the road.

First of all welcome to the forum and the club no one wants to join. You’re going to be alright and we’re here for you.

I had surgery mid January 2024. Sex is a work in progress for me but I’ll share a few comments based on my experience. Get busy as soon as you feel well enough. Be patient and kind to yourself if things take a while. It probably will but the destination is worth the journey.

Climax feels different and without seminal vesicles you will no longer ejaculate so there is no “build up” and “release” and some describe it as a “dry”:orgasm. On the positive side it’s less messy and I’ll leave figuring out the advantages of that to you. Some men say it’s less intense. Some say it’s more intense. Your mileage may vary.

What’s your Gleason score?