why has my orgasm feel less intense after my prostate surgery?

Posted by buffalo1 @buffalo1, May 12 8:07pm

Hi guys,
I had my prostatectomy 5 months ago. Initially I noticed that my orgasms were quite intense and very pleasurable, but now that intensity has decreased. I was wondering if it will come back. It sucks having a weak erection but for the orgasms to not feel great suck. Does anyone have any insight?

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That was my experience too. The first one post RP was one of the strongest I ever had. From there it was all downhill to micro orgasms. To the point of why even bother. I view it as the "new me" and accept it. I have a full life otherwise and it will be even fuller once through ADT.

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I'm 71 and just over 10 months since NS RARP. I've found that my physical sensitivity is not yet back to my pre surgery level, although it is getting slowly better. Frankly, I believe before surgery my sexual experience (including the quality of the orgasm) had a more significant physical aspect than they do now. After surgery, I've found the mental piece is much more important to the quality of the orgasm (or even if I have one) because the actual physical sensation (I assume due to the nerve trauma) I have during the sex act still isn't back to pre-surgery levels of sensitivity. So now my wife and I do a lot more foreplay and cuddling before sex and even during the sex act as I really have to have my mind in the game if I hope to get a satisfying orgasm. I can't simply "jump into sex" like I could before the surgery and let the physical side do the heavy lifting. That said, if I do get my mind in the game then the dry orgasm can be very satisfying. But I suspect this kind of advice is probably outside the scope of urology, and I probably should have sought some male sexuality kind of therapy/advice after the surgery. Unfortunately, I think this aspect of rehab is often not discussed during the routine post-surgery medical visits, but rather left up to the patient to figure out and/or to request help. Long story short, my wife and I had to adapt our sexual experience to figure out what works for us post-surgery. For us it definitely changed from pre-surgery and we're still trying to figure it out. Of course, I'm not a medical professional and maybe I'm totally wrong. But that's been my experience so far. Here's a great video on sexual function given by a doctor at Sloan Memorial which gives a lot of specific statistics including the one you asked about. Interesting, they found 10% reported better orgasms after surgery, while the numbers for "about the same" and "less intense" were 40% and 50% (although I don't remember which was which). It's a pretty good video. It has a great chart on how long it can take for the nerves to fully "wake up" (2 years) so watching it gave me hope that my recovery isn't done. Best wishes.
Save Your Sex Life After #ProstateCancer Treatment | #JohnMulhallMD #MarkMoyadMD #PCRI

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Here's another try at the video link I tried to post above:

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@retireditguy

I'm 71 and just over 10 months since NS RARP. I've found that my physical sensitivity is not yet back to my pre surgery level, although it is getting slowly better. Frankly, I believe before surgery my sexual experience (including the quality of the orgasm) had a more significant physical aspect than they do now. After surgery, I've found the mental piece is much more important to the quality of the orgasm (or even if I have one) because the actual physical sensation (I assume due to the nerve trauma) I have during the sex act still isn't back to pre-surgery levels of sensitivity. So now my wife and I do a lot more foreplay and cuddling before sex and even during the sex act as I really have to have my mind in the game if I hope to get a satisfying orgasm. I can't simply "jump into sex" like I could before the surgery and let the physical side do the heavy lifting. That said, if I do get my mind in the game then the dry orgasm can be very satisfying. But I suspect this kind of advice is probably outside the scope of urology, and I probably should have sought some male sexuality kind of therapy/advice after the surgery. Unfortunately, I think this aspect of rehab is often not discussed during the routine post-surgery medical visits, but rather left up to the patient to figure out and/or to request help. Long story short, my wife and I had to adapt our sexual experience to figure out what works for us post-surgery. For us it definitely changed from pre-surgery and we're still trying to figure it out. Of course, I'm not a medical professional and maybe I'm totally wrong. But that's been my experience so far. Here's a great video on sexual function given by a doctor at Sloan Memorial which gives a lot of specific statistics including the one you asked about. Interesting, they found 10% reported better orgasms after surgery, while the numbers for "about the same" and "less intense" were 40% and 50% (although I don't remember which was which). It's a pretty good video. It has a great chart on how long it can take for the nerves to fully "wake up" (2 years) so watching it gave me hope that my recovery isn't done. Best wishes.
Save Your Sex Life After #ProstateCancer Treatment | #JohnMulhallMD #MarkMoyadMD #PCRI

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I had radiation and ADT, not surgery, but my experience is similar to yours, in that it takes a long time and lots of stimulation to get "over the hump" and have an orgasm. I think radiation has done some nerve damage around the prostate and possibly other tissue in the way. I am still hoping my testosterone level recovers soon, because I think that is part of my problem. I had my last Elegard shot about a year and a half ago, T should have come back by now. My urologist gave me a prescription for Chlomophene to stimulate my own production, but it is working agonizingly slow. If it doesn't happen soon, I will again ask the urologist to prescribe TRT. I just turned 74, gleason 9, decipher score 0.92, two six-month shots of Elegard.

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It's been nearly four months for me and I haven't noticed a regular change in intensity; an occasional lackluster one here and there but that wasn't any different than before the dry orgasm chapter of my life. I'm fairly active sexually so it gets lots of use. I do think that, overall, the dry orgasm isn't quite as intense as before, but it's close enough that I don't worry about it - I'm just happy to be able to rise to the occasion and finish the job.

The mental part is only a bit more needed now. I'm still about 90% Johnny on the spot where I can still be spontaneous but maybe slightly less so than before (10%).

This is all to say that, at this point, the only significant difference I have noticed is lack of ejaculate.

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What is this "orgasm" you refer to?

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had prostatectomy 4/25/ 2019, 6 month Lupron depot, and 8 weeks of radiation, erections are in a non existence condition, I can orgasm while flaccid from my changed penis, but experience climicturia, ,which is ejaculating, and pulsing out urine on each throb, can be embarrassing, but its like shooting out semen, only urine

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@derf4223mc

What is this "orgasm" you refer to?

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its the same orgasm you'd experience as you would normally ejaculate when erect, but no semen ,only urine

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do your orgasms ejaculate urine ? ( climicturia )

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@retireditguy

Here's another try at the video link I tried to post above:

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Retierdguy - thanks so much for posting this video. It is so informative and on point.

It basically explains allllllll the questions about ED post RP and post RT and compares them both in detail. It also gives input about possible solutions but also gives strait answers about levels of ED and about what is possible to achieve and what not and in what age group.

It was very interesting to hear that both RP and RT have the same results regarding ED at year 3 ! I read so many people complaining about ED after radiation that I wondered if the % is actually the same but nobody is looking into that and it looks like it actually is. Both can cause ED but with RP one deals with it immediately (if it is there) until nerves and everything else heal and with RT tissue slowly becomes weaker and weaker and 3 years down the road ED can manifest. ADT effects are the whole separate story.

All in all - great find ! Thanks again : )))

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