What Is The Importance Of Preserved Erectile Function
In considering the impact of the various treatment approaches for prostate cancer on their quality of life, many patients place paramount importance on the possibility of retaining natural erectile function. This matter is frequently important to young men who by age status are more likely to have intact erectile function than older men however, for all men having normal preoperative erectile function irrespective of age, preservation of this function is understandably important postoperatively.
Caring For Your Incision
The incision runs from above the base of the pubic area to below the navel. It is important to keep it clean and dry. Showering once a day should be sufficient. If you notice extreme or increasing tenderness, progressive swelling, more than a small amount of drainage or any pus or redness, notify your doctor right away.
Did You Know Sexual Function Recovery After Prostate Cancer Surgery
When men are treated for prostate cancer, some may have short- or long-term sexual health problems as a result. The most common issue is erectile dysfunction . ED is when a man cant get or keep an erection thats firm enough for sex. ED may be a result of surgery. There are times when removing the neurovascular bundles that control the blood flow to the penis, is needed.
The good news is men can still be sexually active after prostate cancer treatment because there are treatments that can help with erections, despite ED. Men treated with surgery will know how much erectile function they will get back by month 24 after treatment.
Their ability to regain erectile function will depend on their age , pre-surgery erectile function and other factors.
Treatments for ED after prostate cancer surgery can involve:
Talk to your doctorand include your partnerbefore you are treated for prostate cancer to learn more about how it might affect your sexual function, and what you can do about it. A fulfilling sex life after prostate cancer treatment is likely, with time and the right treatment.
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What We Dont Know
While research is promising, thereâs still a lot scientists need to learn. Some things to consider:
- Thereâs no proof that ejaculating more actually causes lower chances of prostate cancer. For now, doctors just know theyâre connected. It may be that men who do it more tend to have other healthy habits that are lowering their odds.
- Ejaculation doesnât seem to protect against the most deadly or advanced types of prostate cancer. Experts donât know why.
- Scientists donât know if ejaculation during sex vs. masturbation has the same benefits. Some research has found that the makeup of semen is different for each. For example, semen during sex has higher levels of sperm and some chemicals. Itâs possible that these could make a difference in a manâs odds of having prostate cancer.
- Not all studies have found a benefit. The 2016 study got attention because of its size and length . But some smaller studies have not shown the same good results. A few even found that some men, specifically younger men, who masturbated more had slightly higher chances of prostate cancer. Some researchers wonder if a manâs age may affect whether more ejaculation helps.
Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery
Recent strategies have included cavernous nerve interposition grafting and neuromodulatory therapy. The former, as a surgical innovation meant to reestablish continuity of the nerve tissue to the penis may be particularly applicable when nerve tissue has been excised during prostate removal. In the modern era of commonly early diagnosed prostate cancer, nerve-sparing technique remains indicated for the majority of surgically treated patients.
Neuromodulatory therapy, represents an exciting, rapidly developing approach to revitalize intact nerves and promote nerve growth. Therapeutic prospects include neurotrophins, neuroimmunophilin ligands, neuronal cell death inhibitors, nerve guides, tissue engineering/stem cell therapy, electrical stimulation, and even gene therapy.
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Be Mindful Of Each Others Emotions
Knowing the cause of your ED can ease any fear your partner may feel, says Madelyn Esposito-Smith, a certified sex therapist and a mental health clinician with University of Wisconsin Health in Madison. âOne of the first things I recommend for the men I work with is to simply communicate with their partner that this is not a personal thing. This is not anything that theyâre doing wrong.â
Eric Garrison agrees. Heâs the chair of the certification arm of American Association of Sexuality Educators and a certified sexuality counselor in Tidewater, VA. âWhen you become the expert in your own sexual health and sexual pleasure, and you can share that with others, it really helps with the conversation,â he says.
An open conversation with your partner can be great for your relationship. But it might also make you feel uncomfortable and vulnerable, says Kristen Lilla, a certified sex therapist and licensed clinical social worker in Omaha, NE. Itâs important for your partner to try not to judge you, she says. If they only want sex with an erection, the two of you might benefit from working with a sex therapist who can help you both expand your horizons.
Who Can Have A Prostate Orgasm
There’s a problematic yet persistent notion out there that you can’t be straight and enjoy butt play. This is falsea complete myth.
Anyone who has a prostate can potentially have a prostate orgasm, regardless of their gender identity or sexual orientation, says Dr. Justin Lehmiller, a research fellow at the Kinsey Institute, host of the Sex and Psychology Podcast, and member of the Men’s Health Advisory Board.
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How May Erectile Dysfunction Affect My Sexual Relationships
Prostate cancer and its treatment can affect your desire for sex. Every man is different but the feelings caused by having cancer and the physical stress of treatment can affect the way you feel about your body and your relationships. Some men talk about feelings of a loss of their role within the partnership or family. This can sometimes affect a mans self esteem and confidence. For others, the physical effects of treatment may lead to tiredness and a lack of energy. Physical changes after some treatments can also affect the way you feel about your body and appearance . All of these things may result in a lack of interest in sex.
If you are feeling tired or under stress, tell your partner how your feel. Loss of interest in sex does not mean you lose interest in a loving and supportive relationship. There are ways to remain physically intimate without having sex. If you are used to a close physical relationship, it is important to remember that hugs, cuddles and kisses maintain intimacy, provide support, and do not have to lead to sex.
The Basics: How An Erection Occurs
At its most basic level, an erection is a matter of hydraulics. Blood fills the penis, causing it to swell and become firm. But getting to that stage requires extraordinary orchestration of body mechanisms. Blood vessels, nerves, hormones, and, of course, the psyche must work together. Problems with any one of these elements can diminish the quality of an erection or prevent it from happening altogether.
Nerves talk to each other by releasing nitric oxide and other chemical messengers. These messengers boost the production of other important chemicals, including cyclic guanosine monophosphate, prostaglandins, and vasoactive intestinal polypeptide. These chemicals initiate the erection by relaxing the smooth muscle cells lining the tiny arteries that lead to the corpora cavernosa, a pair of flexible cylinders that run the length of the penis .
Figure 1: Anatomy of the penis
The penis is made up of three cylindrical bodies, the corpus spongiosum which contains the urethra and includes the glans of the penisand two corpora cavernosa , that extend from within the body out to the end of the penis to support erection. Blood enters the corpora cavernosa through the central arteries.
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How Would You Say Prostate Orgasms Differ From Penile Ones
Fred: Theyre way more intense. Penile orgasms are quicker, and they dont feel anywhere near as good. I love both, naturally, but for me, a penile orgasm is a quick release, whereas getting a prostate orgasm is a full eyes rolled back situation.
Alan: The obvious answer for me is the different location of the sensations. Oftentimes, with prostate orgasms, I have engaged my entire body. On top of that, it doesnt have to mean an ejaculation, thus changing how we define what the climax of our sexual pleasure is. I often find, depending on the situation, that I can have sex longer with a prostate orgasm.
Evan: Prostate orgasms are a lot more full-body. I feel it more in my legs and torso, rather than just locally in my dick. Also, sometimes I cum kind of quickly from penile orgasms, and with prostate stimulation, I last longer in every way. The resulting orgasm is generally longer and “slower” than just stimulation from my dick.
Drew: In my experience, p-spot orgasms are really different from penile ones. When I cum via penile stimulation it feels like a quick and heavy punch to my pleasure center, followed by a really nice burst/release prostate orgasms are much more intense and drawn out. At some point, I usually start oozing cum , which can go on for quite a while. I liken this all to an ocean wave on the beach, undulating between crashing up the shore and receding back down to the sea, only to come back once more.
Its Complicated: Enlarged Prostate And Sex
BPH and sexual function
Prostate enlargement, also known as benign prostatic hyperplasia , and erectile dysfunction are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.
BPH happens when your prostate becomes enlarged, but cancer isnt the cause. A mans prostate continues growing throughout most of his adult life. This is why many older men are affected by the condition.
ED is the inability to get or maintain an erection. It can be caused by physical conditions such as:
It can also be caused by psychological issues.
These two conditions dont necessarily seem linked, but certain treatments that relieve BPH can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
- inability to empty the bladder
- a weak urine stream
A surgery called transurethral resection of the prostate can help relieve these symptoms. Men who have this procedure often experience sexual side effects after surgery.
Between 50 and 75 percent of men experience retrograde ejaculation after TURP, according to Harvard Medical School. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation is sometimes called dry orgasm. Its not harmful but can affect male fertility.
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How Is It Treated
Since most men will still experience pleasure when orgasming, it may not pose a problem for everyone. Theres no one way to treat dry orgasms. Treatment will depend on the underlying cause.
If, for example, youre dealing with dry orgasms because you take tamsulosin , your ability to ejaculate normally should return after you stop using the medication. If your dry orgasms are situational and related to psychological stress, counseling could help you work through your problems to restore normal function.
If your dry orgasms are caused by retrograde ejaculation, your doctor may prescribe medication to help keep the bladder neck muscle closed during climax. These include:
Going Home With A Catheter
You will be discharged from the hospital with a catheter in place to drain urine from your bladder into a bag. The doctor will remove this in the office in five to 14 days. Be sure to clean the catheter where it exits your penis twice a day with soap and water and to empty the bag frequently. The bag should always be positioned lower than your bladder.
On occasion, the catheter may irritate the bladder, causing bladder spasms that can be quite uncomfortable. If these occur, your doctor can prescribe medication that can help. Leakage of urine around where the catheter exits the penis also may occur and can be managed by wearing incontinence pads as described in the next section.
It is normal for your urine to look cloudy for a few weeks after surgery. Occasionally, bleeding may occur around the catheter or be noticed within the urine. This also is common. If you see large clots â more than an inch in length â or if the catheter becomes plugged, contact your doctor. No anesthesia is required for catheter removal, and most patients experience only a little discomfort.
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Theme : Treatment/provider Satisfaction/dissatisfaction
Some men reported dissatisfaction with the treatment they received, while others were happy with the treatment and the care they received around the treatment. The majority of men talked about being happy they were cancer free. Several men talked about their frustration with their providers sole focus on the surgery and the lack of resources or help with side effects from treatment. Men who were dissatisfied talked about the lack of support and help from their providers while men who were satisfied with their care commented on the support and help they got from the provider throughout treatment. Some men felt the provider did not really understand them in terms of their priorities and their feelings about sexual function. Some patients regretted the particular treatment they received or that they received treatment at all. The participants said the following:
Man 17: Uh, were alive, ok? I was Gleason 7. My statistical life expectancy would be about 12 years, you know, thats average. Could be less, could be more. If I did not get treatment. And, uh, my mentality– and still isI got it out, out of my body.
Man 1: I think back. Maybe I shouldnt have done it . And go with the shorter quality of life rather than a long life a longer life with the situation.
Sex After Prostate Surgery And Achieving Orgasm
Sex after prostate surgery is an important concern for most men. The total removal of the cancerous tissues is the primary goal, but the quality of life after prostate surgery is also important. Worrying about ED makes men be nervous and anxious when thinking about undergoing radical prostatectomy. Restoring the sexual function after prostate surgery is essential to enjoying life to the fullest!
However, whilst most patients focus on erectile dysfunction, orgasm is somehow under-considered. But is it possible to achieve orgasm after prostatectomy? Erections and orgasm are equally important for a healthy sex life.
First of all, bear in mind that the radical prostatectomy is the surgery performed to remove the prostate gland and sourrounding affected tissue. This is the most recommended treatment for prostate cancer. However, many men wonder if they would be able to have sex after prostate surgery as they did before.
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A Holistic And Explorative Sexual Experience
Broadening your definition of sex will help increase your ability to experience pleasure without an erection.
Mr Tilley recommends thinking about the holistic sexual experience.
“A sense of togetherness and intimacy is usually an extremely rewarding experience irrespective of the presence of an erection.”
Dr Fox says challenging the social myths around what enjoyable sex looks like forces us to try new things.
“There is more to sexuality than just than 6 inches! With the exception of penile penetration, everything we do with an erect penis we can do with a flaccid penis.”
Dr Fox encourages his clients to explore soft-penis play.
“If there is no chance of erection, it’s about playing with a flaccid penis using lubrication, and also exploring the genitals and body as a whole.
“Even the perineum and anus, the nipples and other erogenous zones around the body.”
Mr Tilley says kissing, caressing, genital play and oral stimulation can all be experienced as pleasurable whether there is an erection or not.
In relation to partnered sex, Dr Fox stresses it is something for both parties to work on together.
“The partner may not be the cause, but they may be part of the solution.”
Communication, exploration and a light-hearted approach can all help you experience pleasure together.
“Remember to have fun. Explore. The skin is the largest organ and the mind the most powerful organ,” Dr Fox says.
“Let’s use these more in sex play and enjoy our bodies and not just the penis.”
How To Maintain Your Sex Life After Prostate Surgery
Although prostate surgery can affect your sexual experience and performance, getting surgery to remove part or all of your prostate doesnt mean that you can no longer have sex or enjoy a satisfying sexual life.
However, it does mean that you may need to make some changes to how you and your partner have sex. These may include using ED medications, erection-promoting devices or engaging in penile rehabilitation exercises to keep your penis stimulated and healthy.
If youve recently had prostate surgery, its important to talk to your healthcare provider before you make any changes to your health habits. Theyll be able to inform you about what you can do to restore and improve your sexual function after surgery.
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Does Sperm Make You Look Younger
Thats right, sperm is apparently the hot tip for younger looking skin, according to celebrity facialist, Chelsee Lewis. During sex, you release a stress hormone that helps to produce collagen , and slathering sperm on your face is like, well, a high dosage of that effect straight to your chin. Yeah, okay.