Note That The Male Orgasm Has 3 Main Components:
Even though the first 2 parts of the orgasm are affected by the radical prostatectomy, the third one that involves brain stimulation and generates the sensation of pleasure still remains. That means that you will still be able to have pleasurable sex after prostate surgery.
Talking Counselling And Sex Therapy
Talking to your partner about your erection difficulties can help. Or it may help to talk to a close friend if you are not in a relationship.
Not talking to those close to you could be one of the main barriers to coping with this side effect. You might then find it easier to consider ways that could help.
Counsellors or therapists can help if youre worrying about anything to do with your sex life and sexuality. You can be referred by your GP to a counsellor or therapist within the NHS. You might need to go on a waiting list to see them.
Talk to your GP to find out what is available in your area. Your local hospital or your local Erectile Dysfunction Clinic might have this service.
The drugs used to treat erection problems include:
These belong to a group of drugs called phosphodiesterase type 5 inhibitors. They work by increasing blood flow to the penis. For the drugs to work, men need to be aroused and have some sort of sexual stimulation. In other words, the drugs wont cause an immediate erection, some foreplay is usually needed.
As drugs work best in men who have sexual desire, they might not help some men who are having hormone therapy. There is limited evidence to say these drugs work when having hormone therapy. But some specialists believe that they are still worth a try if you would like to give them a go.
Possible side effects of PDE 5 inhibitors include:
- temporary problems with vision
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.
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.
Your Thoughts And Feelings
Changes to your body and your sex life can have a big impact on you. You may feel worried, unsatisfied, angry and some men say they feel like they’ve lost a part of themselves. There are ways to tackle these issues and find solutions that work for you.
If you are stressed or down about changes to your sex life, finding some support may improve how you feel. There are lots of different ways to get support.
You are not alone. A lot of men, with and without prostate cancer have sexual problems. Talking to other men who have had similar experiences can help.
- Our sexual support service is a chance for you, or your partner, to talk to one of our Specialist Nurses with an interest in helping with sexual problems.
- Our one-to-one support service is a chance to speak to someone who’s been there. They can share their experiences and listen to yours.
- Our online community is a place to deal with prostate cancer together. You can talk about whatever’s on your mind. Anyone can ask a question or share an experience.
- Our Specialist Nurses can answer questions and explain your treatment options. You can also email or chat online with our nurses.
- Get in touch with your local prostate cancer support group.
Counsellors are trained to listen and can help you find your own ways to deal with things. Many hospitals have counsellors or psychologists who specialise in helping people with cancer – ask your doctor or nurse if this is available.
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Hormone Therapy Effects On Erections
Hormone treatment is commonly given for prostate cancer. Men given androgen deprivation therapy are at a high risk for sexual problems, including loss of sexual desire and erectile dysfunction. Erections may or may not recover when ADT is stopped. Erectile dysfunction drugs do not usually work in these cases because they don’t help with the loss of sexual desire.
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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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.
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.
How Radical Prostatectomy Affects A Relationship
A 2011 study of 63 men that had undergone a radical prostatectomy found that about 75 percent of them sought treatment for erectile dysfunction. Additionally, more than 50 percent reported having less sexual desire, and roughly an additional 40 percent were unable to have a satisfying orgasm.
The mental health effects of these symptoms were worse in highly sexually motivated participants. 52 percent reported that this had affected their self-esteem, and 36 percent said having performance anxiety.
Additionally, the last three items on the list above can be show-stoppers for a relationship. Few women can tolerate a high degree of urine leakage during sexual activity, and few men can handle the pain during intercourse.
Can You Have Sex After Prostate Removal
The good news is that sex after prostate removal is very possible and enjoyable for most men. This is due to the newest robotic technologies that are nerve-sparing and preserve the sexual function.
Dr. Samadis robotic prostate surgery, SMART Surgery, was explicitly designed to spare the tiny nerve bundles surrounding the prostate in order to preserve sexual potency.
Men who undergo Dr. Samadis robotic prostate surgery have a reasonable chance of regaining complete erectile function for sex after prostate surgery.
Even though ejaculation will cease, you will still be able to enjoy sex after prostate surgery, as it is further explained.
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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.
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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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Sexual Dysfunction After Prostate Surgery Is More Common Than Previously Reported Says Hutchinson Center Study
Media briefing: A media briefing will be held at 1 p.m. PST Tuesday, Jan. 18 at the Centers Metropolitan Park East Campus, 1730 Minor Ave., between Olive and Howell streets. A Media Relations representative will greet you in the lobby and escort you to the briefing room. Free parking is available in an underground garage entrance off Minor Ave. A map of the site is available upon request.
B-roll available: A related video news release, including sound bites and b-roll of Dr. Janet Stanford and a Seattle-area prostate-cancer survivor, will be available via satellite feed twice on Tuesday, Jan. 18: first between 6 and 6:30 a.m. PST and again between 11 and 11:30 a.m. PST .
SEATTLE Sexual dysfunction among men who undergo prostatectomy appears more prevalent than previously reported, according to a multi-center study led by an investigator from the Fred Hutchinson Cancer Research Center in Seattle.
The results will appear in the Jan. 19 issue of the Journal of the American Medical Association.
Funded by the National Cancer Institute, the Prostate Cancer Outcomes Study is the first comprehensive, population-based assessment of sexual function and urinary continence among men treated with radical prostatectomy for early stage, localized prostate cancer. It is also the first study to examine the sexual and urinary side effects of such surgery in minority populations.
Age and education also had an impact on the frequency of impotence.
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Talk About How You Feel
First off, it is essential to evaluate how you feel.
It is vital to talk about it if you want to improve.
Most men prefer not to talk about this with a professional, and they avoid the topic with their partners.
However, this position will only make things worse with your partner and cause anxiety to you.
After talking it out with a professional, you will see how easy it is.
They are trained to answer your questions and give you recommendations and a variety of options.
Sometimes men are anxious about erections after surgery because they read so much about it.
Their anxiety plays against them, turning a weaker erection function into a complete failure.
Thus, one of the first aspects to consider is your mindset, feelings, and emotions.
Therapy can help a lot if youre struggling.
It is sometimes appropriate to incorporate your partner in the talking, but it is not always required.
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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.
When Is Nerve Preservation Not Done
The term nerve preservation or nerve sparing during radical prostatectomy refers to preservation of this second set of nerves . When these nerves are not preserved it is not because they have been accidentally damaged, but because either one or part of one has been removed to ensure that the cancerous cells are fully removed. This is known as cancer control.
You can see how the location of the prostate cancer on the left side of the prostate specimen below allowed full nerve preservation on this side whereas the tumour on the right side of the prostate was invading the NVB, which meant that NVB removal on this side together with all of the tissue surrounding it was necessary for good cancer control.
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What Are The Current Expectations With Regard To Outcomes After Radical Prostatectomy
Following a series of anatomical discoveries of the prostate and its surrounding structures about 2 decades ago, changes in the surgical approach permitted the procedure to be performed with significantly improved outcomes. Now after the surgery, expectations are that physical capacity is fully recovered in most patients within several weeks, return of urinary continence is achieved by more than 95% of patients within a few months, and erection recovery with ability to engage in sexual intercourse is regained by most patients with or without oral phosphodiesterase 5 inhibitors within 2 years.
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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