What Determines Erection Recovery After Surgery
The most obvious determinant of postoperative erectile dysfunction is preoperative potency status. Some men may experience a decline in erectile function over time, as an age-dependent process. Furthermore, postoperative erectile dysfunction is compounded in some patients by preexisting risk factors that include older age, comorbid disease states , lifestyle factors , and the use of medications such as antihypertensive agents that have antierectile effects.
Sex When You’re Single
Being sexually active and feeling attractive can be just as important if you are a single man. All the treatments described here are available to you if you’re single – whether you want to be able to masturbate, have sex, or want to start a new relationship.
If you are starting a new relationship, sexual problems and other side effects like urinary or bowel problems could be a worry. Some men worry that having problems with erections will affect their chances of having a new relationship. Fear of rejection is natural, and everyone has their own worries, whether or not they’ve had cancer. If you’re single, you may want time to come to terms with any changes prostate cancer has caused before you start having sex or dating.
Try talking over your worries with someone you feel comfortable with, such as a friend. Counselling or sex therapy may also help if you would prefer to talk to someone you don’t know.
How Fast Will I Become Totally Continent After Prostate Surgery
During surgery for prostate cancer, the urethra is also affected and, depending on the experience of the surgeon, more or less of the continence function will be preserved. Due to the high precision of robotic surgery, the patient will have a catheter for roughly one week and the trauma to the urinary function will be minimum.
The discomfort that patients feel during this time is minimum, but you should expect the removal to make you feel uneasy. The catheter will be removed during a visit to your doctor, so do not try to do this at home, as it could cause infections. The degree of which the urinary function will be affected depends on how normal the function was before surgery, age and weight.
It is worth noting that most men will experience some degree of incontinence after prostate surgery, but control can be regained within several weeks or months to a year.
Read Also: What Can You Do To Help An Enlarged Prostate
What Is Prostate Cancer
Prostate cancer develops in the prostatea small gland that makes seminal fluid. It is the second most common type of cancer in men. Prostate cancer usually grows over time and in the beginning stays within the prostate gland, where it may not cause serious harm. While some types of prostate cancer grow slowly and may need minimal or no treatment, other types are aggressive and can spread quickly.
Prostate cancer that is caught early has a better chance of successful treatment.
Known Side Effects Of A Radical Prostatectomy
So, what happens to a man when he has his prostate removed? There is a multitude of effects that occur to men after they have had prostate removal surgery.
The procedure is major pelvic surgery, and, as such, it carries along with it many potential risks. In addition to the immediate effects of the surgery, the removal of the prostate causes long-term side effects that are generally permanent.
Until recently, these side effects about what happens to a man when he has his prostate removed have not been relatively well-classified.
Most side effects are those reported by urologists that are performing the surgery. This reporting has been, in past years, rather poorly detailed and sparse due to the surgeons not anxious to publicize the failures of a procedure, they have attached a gold standard label.
The most reported side effects are erectile dysfunction and urinary incontinence.
Unfortunately, even though doctors have filed reports, the bias of the doctors filing them is questionable.
For example, one report details one of the significant side effects, postoperative erectile dysfunction, occurs between 14 and 90 percent of patients. This is a relatively wide range.
Based on my many years of practice, it is a very optimistic estimate. And it is likely provided by urologists who either do not want to admit their procedure causes such harm or deny the side effects and results.
Read Also: Is Stage 3 Prostate Cancer Curable
Can Prostate Surgery Affect Penis Size Or Sensitivity
Prostate surgery is very unlikely to affect penis size. The only likely case this would occur if an individual underwent surgery for ED after prostate surgery. Implants will often cause a slight shortening of the penis.
Sensitivity, however, is an issue. In order to allow men to urinate, they have to operate on the prostate.
Its right next to the bundle of nerves that relay the sensation to the brain, causing a lot of the physical pleasure that men experience during sex.
It used to be the case that a prostatectomy would almost always damage those nerves, causing a permanent decrease or even loss of sensation. It would often be 8 months to a year before men reported any sense of sexual desire after the surgery.
However, nerve-sparing surgeries, particularly robotic prostatectomies, can avoid that nerve group far more effectively.
Its never a guarantee, but a majority of men who have undergone a nerve-sparing procedure can expect to regain the majority of the sexual desire and sensation they had before the operation.
For less-involved surgeries, men can expect to regain their sexual function a lot sooner. TURPs, ReZum, Aquablation or various other novel surgeries are all less likely to damage nerves and have faster recovery periods.
Other Medications And Devices
Although medications like sildenafil and tadalafil are effective for many men with post-surgery erectile dysfunction, they arent the best choice for everyone.
If your prostatectomy causes damage to the nerves near your penis, or if you take medication for hypertension, angina or other health conditions, using an oral ED medication may not be a suitable option for you.
In this case, your healthcare provider may recommend a different type of medication or a device to help you achieve an erection. Your options may include:
Penile injection therapy. This involves using injectable medications to stimulate blood flow and improve your erections. These medications are typically administered using a very small needle to minimize discomfort.Although this treatment method may sound unpleasant, its relatively simple to use and has a success rate of 70 percent to 80 percent.
Vacuum constriction devices . Also known as a penis pump, a VCD works by creating a vacuum around your penis. This draws blood into your penis and allows it to become erect.
Also Check: Cryosurgical Ablation Of The Prostate
The Morning Of Your Surgery
Instructions for drinking before your surgery
You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.
Take your medications as instructed
If your healthcare provider told you to take certain medications the morning of your surgery, take only those medications with a sip of water. Depending on what medications you take, this may be all, some, or none of your usual morning medications.
Shower with a 4% CHG solution antiseptic skin cleanser
Shower with a 4% CHG solution antiseptic skin cleanser before you leave for the hospital. Use it the same way you did the night before.
Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne after your shower.
Things to remember
- Wear something comfortable and loose-fitting.
- If you wear contact lenses, wear your glasses instead. Wearing contact lenses during surgery can damage your eyes.
- Dont wear any metal objects. Remove all jewelry, including body piercings. The equipment used during your surgery can cause burns if it touches metal.
- Dont put on any lotion, cream, deodorant, makeup, powder, perfume, or cologne.
- Leave valuable items at home.
What to bring
Once youre in the hospital
Get dressed for surgery
When its time to change for surgery, youll get a hospital gown, robe, and nonskid socks to wear.
Meet with a nurse
What Do We Know About Potency After A Robitic Prostatectomy
The return of potency is dependent on several factors:
- Previous sexual function before surgery. Unfortunately, robotic prostatectomy will at best return you to your level of sexual function pre-surgery. It will not improve upon what you already had before surgery.
- Age. Theyounger you are, the better your chances. Men under 65 have abetter chance of regaining potency, or erectile function than those over 65.
- How many nerves are spared. As discussed previously, ideally both nerves can be spared and thiswill give you the highest chance of regain erections. However,even men with no nerve sparing can regain erectile function.
Ejaculation will no longer occur in any patient. This is because the seminal vesicles and the vas deferens , are removed and cut during the surgery. This means that you will no longer be able to father children
Also Check: How To Avoid Getting Prostate Cancer
S To Recover Orgasm And Potency After Prostatectomy
The key to enjoying sex after prostate surgery is to start when youre ready. Dr. Samadi and his knowledgeable team are available to support you and your partner as you work to resume sexual activity.
Sex After Prostate Surgery Getting Started
- Masturbate:This helps you learn how your body will respond to stimulation after surgery and builds your sexual confidence.
- Kegel exercises:Try out pelvic floor exercises to improve orgasm and urinary control.
- Involve your partner:
Can You Get Erections After Prostate Cancer Treatment
If you have ever wondered whether you’ll be able to have an erection after prostate cancer treatment, you are not alone. Many men who are facing a prostate cancer diagnosis, or who have undergone prostate cancer treatment, are worried about whether or not they will be able to have an erection after prostate cancer.
Recommended Reading: Where To Go For Prostate Exam
When Can I Return To Sexual Activity
Let the surgery heal for three to four weeks before attempting anything. After one month after the robotic prostatectomy, it is recommended that you resume sexual activity. Stimulation of the nerves is thought to be a first step on the journey back to potency. Remember that you can still experience the pleasures of orgasm and other sensual stimulations without full erections. The average time to recovery for erections adequate for intercourse is 6-12 months, but in some men it is even longer. You should also be performing kegel exercises regularly to help your return to potency.
The Importance Of Quality Of Life
Its only normal to want to drive into the practicalities. Before you go any further, I want you to understand a key metric, which is particularly challenging to standardize.
Its called Quality of Life, usually shortened to QoL in the medical literature.
With Prostate Cancer, its a particularly important one, due to the high rates of survival for those with localized prostate cancer .
Thats why its so important to understand the impact that various surgeries or treatments will have on you.
Quality of Life is how they assess the suitability of any treatment.
Those sort of difficult questions is why QoL is a factor. If youre a sexually active man in your sixties or seventies and they are offering you preventative surgery after a biopsy, you need to ask yourself about the impact it will have, what alternatives are available to treat prostate cancer.
Furthermore, you should always ask what the quality of life after that surgery or treatment will be like.
Thats why we put together this quick guide to erectile function, mens health and sex after prostate surgery.
Its not exhaustive by any means, but should certainly give you a jumping off point to better make these decisions that will have a serious impact on a really key aspect of your life.
One last note before we get into it. If the cancer is malignant, surgeons will always push you for a radical prostatectomy, to prevent the cancer from spreading to your lymph nodes.
Recommended Reading: Show Me A Picture Of A Man’s Prostate
Can Erection Rehabilitation Be Applied To Improve Erection Recovery Rates
A relatively new strategy in clinical management after radical prostatectomy has arisen from the idea that early induced sexual stimulation and blood flow in the penis may facilitate the return of natural erectile function and resumption of medically unassisted sexual activity. There is an interest in using oral PDE5 inhibitors for this purpose, since this therapy is noninvasive, convenient, and highly tolerable. However, while the early, regular use of PDE5 inhibitors or other currently available, “on-demand” therapies is widely touted after surgery for purposes of erection rehabilitation, such therapy is mainly empiric. Evidence for its success remains limited.
Habits And Lifestyle Changes
Your healthcare provider may recommend making certain changes to your habits and lifestyle to promote blood flow and improve your erectile health. These may include:
Treating any underlying health issues
Changing your eating habits to maintain a healthy weight
Exercising regularly to improve your cardiovascular health
If you smoke, quitting smoking and nicotine products
Limiting your consumption of alcohol
Weve talked more about the effects of good habits and lifestyle changes on ED in our guide to naturally protecting your erection.
Although these changes are unlikely to treat prostatectomy-related erectile dysfunction on their own, they can contribute to an increase in blood flow, better overall health and improved sexual function.
Recommended Reading: Cyberknife Prostate Cancer Side Effects
Effects On Orgasm And Ejaculation
A number of factors involved with prostate cancer may change how a man feels about sex. Understanding the risks may help people deal with these consequences.
Removing a prostate gland entirely for cancer treatment means that ejaculation will no longer be possible. Instead, the man may have a dry orgasm.
Some surgical treatments may lead to a disorder called retrograde ejaculation. With this condition, the semen does not leave the body during orgasm. Instead, it goes into the bladder and leaves through urination.
Other prostate cancer treatments may result in smaller ejaculations. Hormone therapy may also reduce the intensity of orgasm sensations.
Can I Have An Orgasm Without An Erection
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.
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Your Emotions And Sex
Your prostate cancer and its treatment wonât just affect your body. Theyâll also have a serious impact on your emotions. Stress and anxiety can trigger your body to make adrenaline, which gets in the way of having sex. The more you worry, the worse the struggle. If youâre in a relationship, your partner will be going through many of the same feelings.
One of the most important things you can do is to talk to your partner. Have an honest conversation about your fears and expectations when it comes to sex. Don’t assume they know how you feel. Being open with each other will help you both feel supported and help you work together to make any adjustments that you may need to stay intimate.
Talking with a mental health professional — either one-on-one or with your partner — can be a powerful way to help manage your emotions. A therapist can also prescribe medications that may ease stress and anxiety. A professional sex therapist can help you and your partner find ways to improve your sex life. It may also be helpful to join a support group where you can talk with others who share your experience.
Prostate Cancer Foundation: “Erectile Dysfunction.”
UCLA Urology: “Prostate Cancer: Dealing with Erectile Dysfunction.”
Albaugh, J. Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. Anthony J. Jannetti, Inc., 2012.
Harvard Prostate Knowledge: “Achieving orgasm after radical prostatectomy.”
What Will I Learn By Reading This
When you have treatment for your prostate cancer, you may have erectile dysfunction also known as impotence. Erectile dysfunction is a very common side effect . Side effects from prostate cancer treatment are different from one man to the next. They may also be different from one treatment to the next. Some men have no erectile dysfunction. The good news is that there are ways to deal with erectile dysfunction. In this booklet you will learn:
- What erectile dysfunction is
- Why prostate cancer treatment can cause erectile dysfunction
- What can be done about erectile dysfunction
- How erectile dysfunction may affect your sex life
- What your partner can expect
It is important for you to learn how to deal with erectile dysfunction so that you can continue to have a satisfying intimate relationship.
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How Radical Prostatectomy Affects Orgasm
The first two parts of orgasm are affected by radical prostatectomy, explains Dr. Kacker. Removal of the seminal vesicles and prostate gland during the operation means no fluid can come in from the testicles or the prostate. With the gland or the vesicles gone, theres no fluid buildup in the urethra and the sense of fullness and inevitability, which may have been a familiar part of your orgasm prior to surgery, is now missing.
And theres no ejaculate after radical prostatectomy. Some men also report that the operation affects their pelvic floor and its contractions.
But the third part of orgasm occurs in the brain and can be just as intense as before surgery.