Achieving Orgasm After Radical Prostatectomy
Men worry about erectile dysfunction after radical prostatectomy, the operation that involves removing the prostate gland as a way to treat prostate cancer. Its a legitimate concern. Men, their spouses and partners, and their surgeons should talk about erectile dysfunction before and after the surgery. Almost all men will experience erectile dysfunction for several months to a year after a radical prostatectomy, although todays nerve-sparing operation has decreased the number of cases when its permanent.
But orgasm after radical prostatectomy? Its often even not on the radar screen. Dr. Ravi Kacker thinks that should change.
Sometimes orgasm gets forgotten because everyone is so focused on erectile dysfunction, says Dr. Kacker, a urologist and fellow in male sexual medicine at Harvard-affiliated BethIsraelDeaconessMedical Center. But for somemaybe mostmen and their partners, achieving orgasm can be as important as erectionsor even more so for having a healthy sex life.
And, says Dr. Kacker, theres good news. Orgasms after radical prostatectomy may feel qualitatively different for most men, but they dont need to be any less pleasurable or satisfying.
Ask Your Doctor About Solutions
Patients should not be shy about discussing intimacy issues with their doctor. He or she may be able to prescribe medications to help. Certain medicationssuch as sildenafil , tadalafil or vardenafil are typically tried first. But these drugs may not help men achieve an erection if the nerves responsible are not healthy. In fact, the medications only work for a small percentage of men in the first few months after surgery, according to a 2017 study published in the International Journal of Sexual Health.
Besides oral medications for erectile dysfunction, there are other options available to men with ED after prostate cancer treatment, says Dr. Shelfo. These include penile injection therapy, which involves injecting a small amount of medication directly into the base of the penis. That has helped many men achieve erections. Another option is an intraurethral suppository of medication, an external vacuum erection device, or surgery may be performed to implant a penile prosthesis.
While regaining erectile function is not possible for all men treated for prostate cancer, it is important to remember that an erection is just one aspect of a satisfying sex life. Intimacy is another major component, one that may become more important as sexual relationships become more difficult after cancer treatment.
Will A Child Conceived After My Cancer Treatment Be Healthy
There is no evidence that children conceived after cancer treatment are at an increased risk for birth defects or other health problems. However, its important to use birth control during treatment to ensure you dont conceive with sperm that may have been damaged from exposure to chemotherapy or radiation. This damage might affect the health of the child. We also recommend that you use birth control for 1 year after completing chemotherapy and radiation therapy to ensure all damaged sperm have been cleared from your body.
Some cancers are hereditary, or passed down from parents to children. Ask your doctor or nurse if you have a hereditary cancer. If you do, you can meet with a genetics counselor to learn how this may affect the health of a child.
If you have a specific genetic mutation that can be passed on to a child, you may want to consider preimplantation genetic testing . PGT is a method of testing embryos that have been created by in vitro fertilization for the mutation you have. If you want, you can then choose only those embryos that dont have the genetic mutation when youre ready to attempt pregnancy.
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How Long Must I Wait After Treatment To Try To Father A Child
The length of time you need to wait depends on your diagnosis and the treatment you received. If you have had chemotherapy or radiation, we generally suggest waiting at least 1 year after treatment is finished before trying to have a child. This allows time for sperm that may have been damaged from treatment to be cleared from your body. However, some people may not need to wait this long, while others may need to wait longer. Check with your healthcare provider to find out how long they recommend you wait.
Some Medical Reasons Why Your Semen Volume May Be Low
If your present semen volume is the same as its always been, the possibility of disease need not be a major consideration.
However, if youve noticed your semen volume has dwindled and is not as voluminous as it used to be, it could a sign that something is wrong.
Several medical conditions may cause a reduction in semen volume.
The most likely suspects are:
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What You Can Do Now
Sexual side effects from prostate cancer treatment are often temporary, especially if your doctor used nerve-sparing surgery. While your body recovers, you can try a few things to maintain your sex life:
- Let your doctor know about any sexual problems youre having right away. Although it can be hard to talk about sex, being open and honest will help you get the treatment you need.
- See a therapist. Couples therapy can help you and your partner understand and deal with sexual issues.
- Take care of yourself by exercising, eating a well-balanced diet, reducing stress, and getting enough sleep. Looking and feeling your best will give your self-esteem and mood a boost.
Can I Have Sex During Treatment
There are a few factors that determine if sexual activity is safe during treatment.
- In general, sexual activity is fine during treatment as interest, energy, and comfort levels allow. While you may not feel up to sexual intimacy after surgeries or during chemotherapy and radiation hugging, kissing, holding hands, and massages may feel good and be comforting.
- If you had surgery involving the pelvic area , you may need to allow extra time for healing before having sex that involves penile stimulation or vaginal or rectal penetration . If you are being treated for oral cancer, use caution during oral sex.
- If you have a low white blood cell count or low platelet count , you may need to refrain from any sexual activity that involves vaginal or anal penetration. This is because there is an increased risk of infection or bleeding when your counts are low.
- If you have mouth sores , you should not perform oral sex.
- Do not have vaginal intercourse if you have open sores on your genitals.
- Do not have receptive anal sex if you have sores in the rectal area, rectal bleeding, or tears in the rectal tissue.
- If you received brachytherapy for prostate cancer , be sure to follow your oncology team’s guidance about limiting close physical contact to avoid exposing your partner to radiation.
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No Cure For Retrograde Ejaculation
I had CK in Sep 2010. I did not experience any ED or any other side effects and my cancer is in remission.
However, I did expereince a gradual reduction of ejaculate. The decrease in ejaculate is a normal result of radiation treatment of the prostate. What is happening is actually called “retrograde ejaculation” which is the passage of semen into the bladder instead of thru the urethra from the testes because of the damage that was done to the prostate cells following treatment. I do not believe that there is anyway to restore your ejaculate following CK or other radiation treatments.
Here’s a very succint statement of the effect of radiation treatment on the prostate:
“Many patients are apparently under the impression that radiation therapy only affects the cancerous cells in their prostates and that the normal cells will be unaffected by radiation therapy. This is simply not the case.”
Can A Man Produce Sperm After Prostate Surgery
Likewise, people ask, what happens to sperm after prostatectomy?
You no longer ejaculate semen if you have had a radical prostatectomy. This is because the prostate gland and 2 glands called the seminal vesicles are removed. The seminal vesicles make the liquid part of the sperm. Your testicles will still make sperm cells but they will be reabsorbed back into your body.
Furthermore, can you father a child after prostate removal? The prostate and seminal vesicles, which produce semen, are removed during surgery. This means you won’t ejaculate any semen after surgery, which means you won’t be able to father a child. But you might be able to store your sperm before treatment so that you can use it later for fertility treatment.
Also know, how long after prostate surgery does impotence last?
After about three years, though, men with the most severe erectile dysfunction showed almost no improvement, Schiff says. But men who had partial erections that were occasionally sufficient for intercourse continued to make progress for up to four years after surgery.
What is life like after prostate removal?
Dry orgasm and infertilityBoth the prostate and the glands responsible for semen production are removed during surgery, which is a common prostate cancer treatment. If you received this treatment, you’d still be able to have an orgasm but you’d no longer ejaculate. This means that you’ll no longer be fertile.
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Coping With Infertility After Prostate Surgery
The prostate is one of the only organs in a males body that never stops growing. This growth is slow and continual throughout your life and many doctors dont fully understand why it happens. In some instances, the prostate grows larger than your body can accommodate, and the result is benign prostatic hyperplasia or enlarged prostate. While this isnt life threatening, it can lead to an array of uncomfortable symptoms. There are treatment options for benign prostatic hyperplasia, with the most invasive being surgery. Some men will also develop prostate cancer during their lives. While prostate cancer has one of the highest curability rates, it needs to be diagnosed early so that surgery can eradicate the cancer completely. Regardless of why you need prostate surgery, certain instances can lead to problems such as infertility. In this article, well explore everything you need to know about the prostate and how to cope with infertility after prostate surgery.
Sexual Life After Prostate Removal
This post is for all the men who have prostate cancer or are worried about prostate cancer. One of the most feared side effects of therapy for prostate cancer is the impact on sexual health.
Hopefully this will give men a better idea of what to expect and take some of the fear of the unknown away.
The prostate makes the liquid in the ejaculate. This is necessary for the sperm to work and therefore to have children. Other than having children, the prostate is of little use later in life and only causes problems with urination and is a leading cause of cancer.
The nerves that go to the penis course very close to the prostate. They are only a few millimeters from the prostate and can be affected by surgery or radiation. These nerves are solely responsible for erections, or the ability of the penis to get hard.
The net effect of someone having his prostate removed is:
Factors that are responsible for the ability to get erections are:
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The Three Parts Of Male Orgasm
Kacker starts by pointing out a common misconception that erections are necessary for male orgasm. They arent. Men can have experience orgasm without an erection. The converse is also true, of course: men can have an erection without having an orgasm.
When discussing orgasm and radical prostatectomy, its useful to think of the male orgasm as having three separate parts, says Dr. Kacker.
First, secretions from the testicles, the prostate, and the seminal vesiclessmall, slender glands near the prostateflow into the urethra, the tube-like structure that carries semen through the penis and out the body. The emission of those fluids creates a feeling of fullness and a sensation of inevitability.
Second, theres ejaculation, which is accompanied by contractions of the pelvic floor muscles, the group of muscles used to hold in intestinal gas and urine.
And third is the mental componentall of the processing the brain does of incoming sensory signals from penis and pelvis that contribute to the mental experience of build up and release.
How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
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Urine Leakage During Ejaculation
Climacturia is the term used to describe the leakage of urine during orgasm. This is fairly common after prostate surgery, but it might not even be noticed. The amount of urine varies widely anywhere from a few drops to more than an ounce. It may be more common in men who also have stress incontinence.
Urine is not dangerous to the sexual partner, though it may be a bother during sex. The leakage tends to get better over time, and condoms and constriction bands can help. If you or your partner is bothered by climacturia, talk to your doctor to learn what you can do about it.
Sex After Prostatectomy: How To Have A Healthy Sex Life After Surgery
Medically reviewed by Kristin Hall, FNP
Prostate health issues such as benign prostatic hyperplasia and prostate cancer affect hundreds of thousands of men in the United States every year.
If youve been diagnosed with a serious prostate issue, your healthcare provider may suggest a prostatectomy a surgical procedure in which your part or all of your prostate gland is surgically removed from your body.
Prostate removal surgery is usually highly effective at treating cancer and prostate enlargement , but it can potentially lead to complications.
These include some sexual performance issues, such as erectile dysfunction and difficulty ejaculating normally.
Although these effects can change your sexual experience, many men are still able to enjoy a fulfilling, satisfying sex life after prostate surgery by making certain lifestyle changes and using medication.
Below, weve talked about what to expect if youre scheduled to undergo a prostatectomy and want to maintain an active sex life after surgery.
Weve also explained how you can have a healthy sex life after a partial or complete prostate removal, whether through exercises to improve sexual functioning, medications, devices or a combination of different approaches.
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How Prostate Surgery Affects Fertility
Each type of surgery has different risks, but after a full prostatectomy, you will no longer create seminal fluid and therefore, will be unable to conceive a child naturally. Most prostatectomies also remove seminal vesicles, as theyre directly connected to the prostate and therefore have no use when the prostate is gone. Since you will no longer be able to make semen, youll experience infertility after prostate surgery. This doesnt mean you will no longer be able to orgasm however, they will be what are considered dry orgasms that produce no semen. Dry orgasms still produce the same feeling of sensation of pleasure that result in an orgasm, the only difference is there will be no semen. While this can create a period of adjustment, over time many men get used to it and cant tell a difference. In some cases, men have even reported that their orgasms feel stronger or more pleasurable.
In some cases, prostate surgery can also lead to damaged nerves that interfere with the ejaculation process. This means that semen will either no longer be made or it wont be able to leave the body naturally. Retrograde ejaculation is also a possible side effect in certain prostate surgeries, so always talk to your doctor beforehand to better understand your risks and what to expect.
Changes To Orgasm And Ejaculation
After prostate cancer treatment you will still have feeling in your penis and you should still be able to have an orgasm, but this may feel different from before. Some men lose the ability to orgasm, especially if they’re on hormone therapy.
If you’ve had radical prostatectomy, you will no longer ejaculate when you orgasm. This is because the prostate and seminal vesicles, which make some of the fluid in semen, are both removed during the operation. Instead you may have a dry orgasm – where you feel the sensation of orgasm but don’t ejaculate. Occasionally, you might release a small amount of liquid from the tip of your penis during orgasm, which may be fluid from glands lining the urethra.
If you’ve had radiotherapy, brachytherapy, high intensity focused ultrasound or hormone therapy, you may produce less semen during and after treatment. With radiotherapy, brachytherapy and HIFU you may also notice a small amount of blood in the semen. This usually isn’t a problem but tell your doctor or nurse if this happens. Some men on hormone therapy say their orgasms feel less intense.
Some men leak urine when they orgasm, or feel pain. Others find they don’t last as long during sex and reach orgasm quite quickly.
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