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 theyre on hormone therapy.
If youve 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 dont 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 youve 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 isnt 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 dont last as long during sex and reach orgasm quite quickly.
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:
Transurethral Resection Of The Prostate
This operation is more often used to treat men with non-cancerous enlargement of the prostate called benign prostatic hyperplasia . But it is also sometimes used in men with advanced prostate cancer to help relieve symptoms, such as trouble urinating.
During this operation, the surgeon removes the inner part of the prostate gland that surrounds the urethra . The skin is not cut with this surgery. An instrument called a resectoscope is passed through the tip of the penis into the urethra to the level of the prostate. Once it is in place, either electricity is passed through a wire to heat it or a laser is used to cut or vaporize the tissue. Spinal anesthesia or general anesthesia is used.
The operation usually takes about an hour. After surgery, a catheter is inserted through the penis and into the bladder. It remains in place for about a day to help urine drain while the prostate heals. You can usually leave the hospital after 1 to 2 days and return to normal activities in 1 to 2 weeks.
You will probably have some blood in your urine after surgery.
Other possible side effects from TURP include infection and any risks that come with the type of anesthesia used.
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What Are Pelvic Floor Exercises And Can Improve Erection Quality
As we age, we lose muscle tone throughout your body. That includes the muscles that men need to maintain erections. However, there are physical exercises men can do to reduce erectile dysfunction. The best ones are known as pelvic floor exercises or kegels.
Those muscles are the core of how your body maintains blood flow to the penis and therefore keeps erections strong.
They put pressure on the veins in your penis, preventing blood from flowing back into the rest of your body. If they arent strong enough then even if you can get an erection, you wont be able to keep it.
The process starts with identifying the muscles you need to activate. Thats best achieved by lying down with knees bent and feet flat on the floor. Thats when you breathe out and squeeze your pelvic floor muscles for 3 seconds.
Its important that you identify the right group, at the base of your buttocks, on either side of your perineum. It can be easy to mistake other muscles, such as the legs or stomach for the pelvic floor.
Once you are confident you have the right muscle group, then doing the exercises in a seated or standing position three times a day can firm and strengthen the muscles, with a likely improvement within four to six weeks.
Some men find that after the initial strengthening that options like Pilates become appealing as not only are there many exercises which improve the pelvic floor, but they can improve overall posture and strength.
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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.
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Newly Diagnosed With Prostate Cancer Why Choose Robotic Prostatectomy
When first diagnosed with prostate cancer, its common for men to wonder what the future will hold. Certainly, a prostate cancer cure is a top priority, but then what?
Dr. David Samadi understands that men want to know:
Will I have sex after prostate cancer?
How will sex after prostate cancer be different?
For many men, prostate cancer treatment choice determines these answers.
If you select robotic prostate surgery your chances of enjoying sex after prostate surgery are very high. Robotic prostatectomy is a minimally invasive prostate removal. It is considered one of the best treatment options for prostate cancer due to its success rate and fast recovery rate.
The da Vinci robotic prostate cancer surgery system enables the surgeon to make precise movements. This ensures cancer-removal efficiency and sparing of the nerves and muscles that are responsible for the sexual function.
However, it is absolutely critical to choose a robotic surgeon with a high case volume and extensive prostate surgery experience. The robot does not perform the surgery and technology is no guarantee of success.
Dr. Samadi explains how the preservation of sexual function is possible:
If my only responsibility was to remove the cancerous prostate, my job would be much easier, he acknowledges, But patients deserve much more than that. It was paramount that I find a way to remove the prostate gland without damaging functions critical to a comfortable and enjoyable life after recovery.
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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Life After A Radical Prostatectomy: A Real
Reposted from Greater Boston Urology.
Less cancer was localized, meaning it was contained within the prostate gland itself. He didnt need further treatment for prostate cancer after the surgery, only regular monitoring of his PSA.
Q: So lets get right to it: You were dealing with incontinence after your radical prostatectomy?Les: The thing about any kind of prostate procedure is youve got to deal with incontinence. This was a big issue for me for a while. I had purchased padded undergarmentsa whole case of them, because I didnt know how long this was going to last.
Men wonder why this particular side effect happens. The prostate gland is the primary organ for controlling urinary flow in normal physiology. When you are rising frequently during the night, and/or having difficulty starting urination, these are signs that the prostate is beginning to grow in size and interfere with this specific function. Every mans prostate gets larger with age it does not necessarily have anything to do with having cancer. It is a separate reality.
Women dont have a prostate. What do they use? Kegel muscles!
About Greater Boston Urology
Enlarged Prostate Surgical Procedures
Here is a list of enlarged prostate surgery procedures:
- TUIP widens the urethra by making a few small cuts in the bladder neck, where the urethra joins the bladder, and in the prostate gland itself.
- TURP surgery is the procedure used for 90% of all prostate surgeries for BPHit is the standard operation.
With TURP, an instrument called a resectoscope is inserted through the penis to remove the excess tissue. It is less traumatic than open forms of surgery.
It has a high risk of retrograde ejaculation, which is when semen works its way back into the bladder instead of coming out the tip of the penis when you come.
Other risks: impotence, incontinence, blood loss, and urinary tract infection. This procedure is now available using lasers.
- Simple or Partial Prostatectomy is the removal of the inner portion of the prostate through an incision in the lower abdomen. This is an invasive surgery used for very large prostate glands to remove the enlarged part of the prostate.
This BPH surgery procedure is open surgery performed while the patient is under general anesthesia.
Read more about BPH and medical procedures here:
Read these industry-funded sites that explain all the different procedures in greater depth. Buyer beware as despite the claims to being superior, many of these private state of the art procedures have not been proven over time to be superior to the standard TURP:
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What Have I Learned By Reading This
You learned about:
- 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
If you have any questions, please talk to your doctor or health care team. It is important that you understand what is going on with your prostate cancer treatment. This knowledge will help you take better care of yourself and feel more in control. It will also help you manage any side effects you may have from your treatment.
How Bad Is The Pain After Prostate Surgery
The level of pain is lower than that of open prostatectomy, due to smaller incisions. However, you will be administered pain medication both orally and intravenously, through an IV. Make sure you have someone to pick you up from the hospital, as you wont be able to drive right away. Ask your doctor to recommend some pain medication and dosages that you can take from home most common ones are Tylenol or Ibuprofen. Even though the recovery is fast, you should get plenty of rest and not force yourself with lifting weights or exercises in the first few weeks.
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Reducing The Risk Of Erectile Dysfunction
To minimise your risk of impotence following the operation, any factors that might predispose you to erection problems should be addressed beforehand. Such risk factors include:
- obesity and
Your doctor will assess your risk and offer treatment or advice if necessary. They will also make sure that you are not taking any medicines that could contribute to erectile dysfunction.
Operating By Remote Control
Many physicians recommend a robotic prostatectomy, shown here, over traditional open surgery because the recovery is less taxing. But complications can still occur.
Because many prostate cancers grow so slowly, an older man with the disease may choose active surveillance, which involves following the cancer to see if it advances and causes symptoms. If it does, or if the man prefers to have immediate treatment, radiation therapy can control the disease for years. Hormone therapy can also help.
The bottom line: If your doctor says that you are too old for surgery, dont despair. Other, less-risky treatments may hold the cancer in check. Talk with your doctor about the options.
SOURCES: Alibhai SM, Leach M, Tomlinson G, et al. Rethinking 30-Day Mortality Risk After Radical Prostatectomy. Urology 2006 68:105760. PMID: 17113897.
Thompson RH, Slezak JM, Webster WS, Lieber MM. Radical Prostatectomy for Octogenarians: How Old is Too Old? Urology 2006 68:104245. PMID: 17095073.
Originally published July 1, 2009 Last reviewed April 8, 2011
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Questions To Ask Your Doctor
- Is my grade and stage of cancer treatable or curable?
- How do I know if I need treatment?
- How do I decide what treatment is best for me, or what treatment to start with?
- Are there any clinical trials available to me?
- How long does treatment last?
- How will treatment affect my daily life? Will I still be able to do my normal activities?
- Can treatment affect my sex life or ability to have children?
- What are the long-term effects of prostate cancer treatment?
- What is my chance of cancer returning after treatment?
- What happens if I choose not to get treatment?
Pelvic Radiation Therapy Effect On Erections
Prostate, bladder, colon, and rectal cancer are sometimes treated with radiation to the pelvis. This can cause problems with erections. The higher the total dose of radiation and the wider the section of the pelvis treated, the greater the chance of erection problems later. If radiation therapy is part of your treatment plan, talk to your doctor before it starts. Ask how your arteries and nerves might be affected by radiation therapy so you know what to expect.
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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.
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Chemotherapy Drugs For Prostate Cancer
The drugs listed above are only a sample of what is available and is used to illustrate a truth. Because of the range and variety of drugs used in both these treatments the impact on sexual function can range from sever to insignificant.
Hormone replacement therapy for prostate cancer, for example, can often impact sex drive rather that create erectile dysfunction. It is important to work with your physician to explore all available treatment options. How to keep a healthy erection?
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What Changes Do I Need To Make To My Diet
Discuss your post-surgery diet with your doctor as you will probably want to avoid or at least minimize issues such as constipation. The lack of exercise, the medication, even the stress, might affect your bowel functions. Your diet will be focused on eating more vegetables, fruits, grains and avoiding meat, especially the red one, pasta, alcohol, fast-food, sugar and processed desserts.
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Can Anything Be Done For Erectile Dysfunction Caused By Prostate Cancer Treatment
Yes, there are things you can try if you have erectile dysfunction after your prostate cancer treatment. You should keep in mind that the following things will affect your ability to have an erection after your prostate cancer treatment:
- How good your erections were before your treatment
- Other medical conditions you have like high blood pressure or diabetes
- Some types of medicines you may take such as medicines for high blood pressure or antidepressants
- Things you do in your life such as drinking or smoking
- Your age
- The type of prostate cancer treatment you had
It is important that you and your partner speak with your doctor or healthcare team about what you can do. Your doctor or healthcare team will speak with you about what might work best for you if you have erectile dysfunction. It is important that you speak with them since some treatments for erectile dysfunction can affect other medical problems you may have.
Types of treatment for erectile dysfunction include:
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