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.
Are There Any Surgical Techniques That Have Been Developed To Improve Erectile Function Outcomes
At this time, there are several different surgical approaches to carry out the surgery, including retropubic or perineal approaches as well as laparoscopic procedures with freehand or robotic instrumentation. Much debate but no consensus exists about the advantages and disadvantages of the different approaches. Further study is needed before obtaining meaningful determinations of the success with different new approaches.
- You are bleeding from your rectum.
- You are urinating very little or not at all.
- You have pain from your procedure that does not get better, even after taking pain medicines.
The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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.
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Other Possible Side Effects
Anorgasmia is the inability to achieve orgasm regardless of the level of stimulation.
2) Penile shrinkage
Removal of the prostate seems to initiate a phase of penile shrinkage that varies between 2 to 3 cm. For men with large organs, this may have little effect. But a man that starts on the small side might be very dismayed about it.
3) Urine leakage or pain during intercourse
4) Urine leakage at orgasm
5) Pain or discomfort at orgasm
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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Prostate Surgery And Erectile Dysfunction
The short answer is yes prostate surgery is very likely to cause erectile dysfunction.
A prostatectomy, even though modern surgeries are nerve-sparing is likely to cause months of issues to a mans sex life.
Less invasive procedures that avoid the bundle of nerves and seminal vesicles next to the prostate will still likely cause ED, even if its a shorter-term issue.
Other surgeries are less likely to cause lasting damage, but the fact is that sexual dysfunction is a complicated issue. Men have to grapple with the mental side of it as well.
A cancer diagnosis can weigh heavily on a mans mind, which can impact both his sex drive as well as his ability to maintain an erection.
Theres also the fact that as we age, men experience a natural reduction in sex drive and are likely to be less able to get and maintain an erection.
The likelihood is that any surgery would just exacerbate the underlying issue.
Around 1 out of every 4 men over the age of sixty will experience some form of erectile dysfunction. Thats also the most likely group to undergo surgery, which is why the two are often linked, but not necessarily the sole cause.
If you have some pre-existing medical condition that impacts your floor muscles, sexual function or urine/ urinary function than you might find that the side effects of the surgery are more severe.
You should talk with your Urologist about any pre-existing medical conditions and how they might affect the treatment.
Why Is There Increasing Concern At This Time Regarding Erectile Dysfunction Issues Following Radical Prostatectomy
The reality of the recovery process after radical prostatectomy today is that erectile function recovery lags behind functional recovery in other areas. Patients are understandably concerned about this issue and, following months of erectile dysfunction, become skeptical of reassurances that their potency will return.
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Erection Concerns After Prostate Biopsy
When his doctor mentioned the prostate biopsy, Stans heart sank. What did this mean? Did he have cancer? And if so, how would his life change?
Quietly, he listened his doctor explain. Stan had high levels of prostate-specific antigen and the doctor had found an unusual lump on his prostate during his digital rectal examination. These two factors made a biopsy necessary. Stan might have cancer and catching it early was important.
Some men do develop ED for a time after a prostate biopsy. But not all do. Learn more hereâ¦
Stans expression was stoic, but inside, his body was in turmoil. He was anxious about his prognosis, of course. Also, the idea of having a needle in his private parts made him nervous. He knew the biopsy was necessary. He knew it could save his life. But he had other questions, too.
For example, what would happen to his erections? Would the biopsy procedure affect his sex life?
Lots of men share Stans concerns. The anxiety of a biopsy is enough to cope with, but wondering about your erections afterward is also difficult.
Some men do develop erectile dysfunction for a time after a prostate biopsy. But not all do. Lets look at this topic more closely.
What happens during a prostate biopsy?
Typically, a prostate biopsy is done in one of three ways:
Will I have problems with erections afterward?
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How Long Does It Take For Nerves To Heal After Prostatectomy
How long does nerve regeneration take? Recovery of potency may be very rapid in younger patients and is sometimes immediate. However, for most patients the recovery is gradual and can take up to 3 years to plateau, although typically a patient sees a return to erectile function after about 12 months .
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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.
Can You Still Have An Erection If Your Prostate Is Removed
When you have a radical prostatectomy , you have surgery to remove your prostate gland. These nerves, blood vessels, and muscles may be weakened when you have surgery for your prostate cancer. For a period of time after surgery , many men are not able to get an erection . This time is different for each man.
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On Sex After Prostate Surgery Confusing Data
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For men having prostate cancer surgery, one of the biggest fears is that they will be left impotent. Unfortunately, the research that might help address that question is likely only to confuse.
A notable study in 2005 showed that a year after surgery, 97 percent of patients were able to achieve an erection adequate for intercourse. But last month, researchers from George Washington University and New York University reviewed interim data from their own study showing that fewer than half of the men who had surgery felt their sex lives had returned to normal within a year.
So which of the studies is right? Surprisingly, they both are.
The results depend on several crucial variables the type of patient studied, sex life before surgery and, most important, the definitions doctors use to define potency.
Of the 219,000 men a year who receive diagnoses of prostate cancer, nearly half undergo surgical removal of the gland, according to the National Cancer Institute. Most top surgeons report that an overwhelming majority of their patients can achieve erections adequate for intercourse after the operation.
Under that definition, a man who had regular sex after surgery, a man who managed to have sex only once and a man who struggled mightily each time he had sex would all be considered success stories.
Although he could cite statistics to give men a more hopeful view, he said that did not help the patient.
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.
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:
Pain During Erection Or Ejaculation
Some men find that erections and ejaculating is painful after surgery, or during and after their course of radiotherapy.
Painful erections following surgery could be due to internal bruising caused by the operation. The tube which carries urine from the bladder to the outside of the body gets inflamed by the radiotherapy treatment.
This side effect should disappear a few weeks after you finish radiotherapy or as you recover from surgery. Talk to your specialist nurse for specific advice. If masturbation and sex is important to you, its important to keep stimulating the penis to keep it healthy. On the other hand, if erections are very painful, you might need to avoid ejaculation for a while and try again later.
The penile injections to stimulate an erection can cause painful erections in some men. This pain might lessen with continued treatment.
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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.”
Will Treatment Cause Erectile Dysfunction
When youre sexually excited, nerves cause tissues in your penis to relax, allowing blood to flow into the organ. The nerves that control erection are very delicate. Surgery or radiation for prostate cancer may damage them enough to cause ED. When you have ED, you cant get or keep an erection.
Radical prostatectomy is a surgery to remove the prostate gland. When your surgeon removes the gland, they may damage the nerves and blood vessels that run along it. If theyre damaged enough, you wont be able to get an erection following the procedure.
Today, doctors can do nerve-sparing surgery, which helps prevent permanent ED. Your surgeon can still touch those nerves and blood vessels, causing ED as a temporary side effect. Many men have trouble getting an erection for a few weeks, months, or even years after their procedure.
Radiation therapy also damages blood vessels and the nerves that control erection. Up to half of men who have radiation for prostate cancer experience ED afterward. In some men, this symptom will improve with time. Sometimes radiation side effects dont appear until a few months after the treatment. If ED starts late, it may not be as likely to go away.
A few treatments can help with ED until youre able to have erections on your own again.
Additional treatments include the following:
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Doctors may also make a number of assumptions about patients, including about their family support system, their sexual orientation and their sexual interests.
Your doctor might tell you youll have an erection strong enough for intercourse, but anal penetration requires 33 percent more rigidity, Rosser said. Hes heard men say their doctors neutered them. Others have said theyd rather be dead. In all, 15 percent of all men whove had a radical prostatectomy exhibit some kind of treatment regret. For gay men, so long ignored by medicine, Rosser believes those rates are much higher.
with a postmenopausal wife who doesnt want sex anyway might just accept having a low libido, he explained. But if your partner is another man, and his drive isnt diminished, it can be a real problem.
Rosser said the silence and shame surrounding the topic allows ugly myths to flourish like that gay sex somehow caused their cancer. Guys can feel guilty, Rosser said. Or, their partners may think on some level, they can catch it.
He had some of those thoughts himself: Im a cyclist did being in the saddle too much cause it? Did enjoying receptive anal sex?
Without good data, researchers cant get to the truth, Rosser stressed.