Sex After Prostate Surgery And Achieving Orgasm
Sex after prostatectomy 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.
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.
The good news is that sex after prostate surgery 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.
What Is Prostate Cancer
most common cancer in men in the United States, according to the Centers for Disease Control and Prevention .
Prostate cancer occurs when cells in the gland divide uncontrollably. This leads to a lump, or tumor, that draws nutrients and blood away from other vital functions in the area.
Acinar adenocarcinomas, or slow-growing tumors, are the most common type of prostate cancer
Thousands of men die in the U.S. every year from prostate cancer, but the CDC highlights that most men who have prostate cancer are over 65 years of age and usually die from a
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.
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Seek Care Immediately If:
- 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.
How To Get The Best Results
Most men do not find prostate biopsy excessively painful or uncomfortable, and the complications are usually not seriousbut can be. Certain steps taken before, during, and after the procedure can improve the outcome:
Take antibiotics. Taking preventive antibioticsbefore and after the procedurecuts the risk of infection substantially. Most infections are not dangerous but could become so if they get out of control. The overall chance of being hospitalized with an infection after prostate biopsy is 1% to 3%.
Review medications. Before the biopsy, your doctor may advise you to stop taking daily low-dose aspirin or an anticoagulant such as warfarin , dabigatran , edoxaban , rivaroxaban , or apixaban . These drugs reduce the blood’s ability to clot. Your doctor will weigh the chance of bleeding against the need for anticoagulants to prevent heart problems or stroke.
Expect anesthesia. Get local anesthesia for the biopsy. This means an injection of a numbing drug into the prostate gland to reduce pain during the biopsy.
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I Dont Have Erections After Surgery Am I Impotent For Life
Think of your erections as a well conditioned athlete, who has been injured. This injury is going to take time to heal. You should try to remain patient, and remember that this will be an ongoing battle for many months and even years. Rehabilitation of potency is much like a sports injury. Proper conditioning and medical treatment may potentially speed up recovery, but it is not guaranteed.
If you see any fullness in your erections in the months after your robotic prostatectomy surgery, this is a positive sign that some of the nerves are working or re-growing. You are taking the first steps down the potency recovery path. Remember though, as shown in the previous table for open prostatectomy, 25-55% of men do not regain erections.
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Large Review Study Finds Low Risk Of Erectile Dysfunction After Prostate Biopsy
- By Charlie Schmidt, Editor, Harvard Medical School Annual Report on Prostate Diseases
Having a prostate biopsy to check for cancer is unsettling, but fortunately the procedure comes with a low risk of side effects. Infections can be reduced by giving antibiotics, and the discomfort and bleeding that some men experience typically resolve soon. An ongoing question has been whether biopsies might interfere with a man’s ability to have an erection. Studies in this area have generated mixed results. But now the largest review of the evidence so far provides some encouraging news: according to the findings, men who do lose some of their sexual potency after a biopsy usually get it back within a few weeks.
Just why sexual dysfunction occurs after a biopsy isn’t always clear. A biopsy needle might damage nerves that control erectile functioning, or the psychological stress of a cancer diagnosis might contribute to the problem. Erectile dysfunction can impact significantly on quality of life, so it’s important that doctors counsel their patients accurately on what to expect from the procedure.
The King’s College investigators also set out to investigate which aspects of a biopsy might increase the risk of erectile dysfunction. During this part of the review, they looked into
Harvard Medical SchoolAnnual Report on Prostate Diseases
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How To Have A Terrific Sex Life After Prostate Cancer
When patients learn they have prostate cancer, they often fear that impotence is inevitable. In almost all cases, fear of impotence is totally unwarranted. It is true that the old surgical cure for prostate cancer left 60 to 80 percent of patients impotent since surgery damaged the vital nerve bundles that make erection possible. Today, however, the majority of men who undergo treatment for prostate cancer will still be able to enjoy an active sex life after treatment. Heres how you can have a terrific sex life after prostate cancer.
Get Diagnosed Early
The most essential aspect of ensuring the preservation of normal life expectancy and a high quality sex life is the early diagnosis and prompt treatment of the prostate cancer. Early diagnosis of prostate cancer has an extremely high success rate of restoring prostate health and sexual function. If a prostate cancer has not extended beyond the prostate, prompt, early treatment offers a high percentage of disease-free survival. If you experience any of the following symptoms, you should seek an immediate urologic consultation:
- A weak or interrupted urinary stream
- Difficulty starting the urinary stream
- The need to urinate frequently, especially throughout the night
- Blood in the urine
- Dribbling after you think you have completely emptied your bladder
- Painful or burning urination
- Persistent pain in the lower back, pelvis, or lower abdomen
Consider a Nerve-Sparing Prostatectomy
Seek Help if You Need It
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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How To Get Started
You’ve had a period of time without sex and now feel ready to rekindle your sex life, but how do you get started? Set the mood- what sparked romance for you and your partner before cancer? Music, a romantic meal or an evening out? Relax and don’t pressure yourselves to have sex the first go at it. Take your time, enjoy each other, and most of all, communicate.
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.
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Sex Life During And After Prostate Cancer Treatment
Sex after prostate cancer looms large in menâs minds, but it can be hard to bring it to attention. Shouldnât you just be thrilled that you have a chance to beat cancer? Yet our sexuality is a very important part of our being.
Will your sex life be the same? No. There will be changes. But that doesnât mean it will be worse. It could even be more pleasurable in time. It can help to break down how cancer affects a manâs sexuality into three main areas: desire, erectile dysfunction, and orgasm. Since we addressed orgasm up front, letâs check out the other two areas.
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 here…
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?
How is prostate cancer diagnosed?
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Tips For Talking With Your Partner
Feeling less of a desire to have sex or having trouble getting an erection may affect your relationship. Try to be as open with your partner as you can. Here are some tips:
- Bring your partner with you to doctors visits. Being part of the conversation may help them understand what youre experiencing.
- Listen to your partners concerns, too. Remember that this issue affects both of you.
- See a therapist or a sex therapist to help you work out any issues that are affecting your sex life.
- If sex is a problem right now, its possible to fulfill each other sexually in other ways. Cuddling, kissing, and caressing can also be pleasurable.
Chemotherapy & Hormone Therapy
- Chemotherapy does not often cause erectile dysfunction, though it may affect the desire for sexual activity. Your desire may fluctuate over the course of treatment.
- Hormone therapy for prostate cancer is designed to decrease testosterone levels or prevent your body from using testosterone. This can result in loss of desire for sex, erectile dysfunction, and difficulty achieving orgasm, which tends to develop slowly over the first few months of hormone therapy.
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Can A Man Have A Normal Sex Life After Prostate Surgery
The question is loaded what is a normal sex life anyway? Most men will experience a slowing down or drop off in their sexual activity as they get older.
That said, it is still a source of pleasure and intimacy amongst older couples, and for those for whom it is an important part of their relationship, they are keen to understand what sex after surgery will look and feel like.
The majority of men with a diagnose of localized prostate cancer will undergo a conservative approach known as active surveillance, but some of them will require surgery at some point.
The surgeons will excise the growth, or in some cases remove the entire prostate. There are also less invasive surgeries, such as the TURPs and other non-surgical therapies such as radiation therapy.
With careful intervention, most men will be able to resume a healthy sex life after the initial recovery period.
If you have had a radical prostatectomy without a nerve-sparing technique, theres a high chance you will experience a significant reduction in your sexual sensation and libido
Even then, the likelihood is that pleasure will be diminished, and men will only experience dry orgasms, as they will no longer ejaculate merely experiencing the mental side of orgasm. This is not common, and when it happens, it is temporary.
How Will Treatment Affect My Libido
Prostate cancer may dampen your sex drive. Knowing that you have cancer and going through treatment can both cause you to feel too anxious to have sex.
Hormone therapy used to treat prostate cancer can also affect your libido. This treatment slows prostate cancer growth by lowering testosterone levels in your body. You need testosterone to have a healthy sex drive. Hormone therapy can also affect your self-esteem and sex drive by making you gain weight or causing your breast tissue to enlarge. If your hormone levels are low, your doctor may be able to prescribe testosterone replacement therapy to bring them back up to normal. This depends on your overall cancer treatment plan.
2013 study , about 3 percent of participants reported that they had a reduced penis size after radical prostatectomy or radiation plus hormone therapy. The men said their smaller penis affected their relationships and their satisfaction with life.
For men who do experience this, the change in size is generally half an inch or less. This decrease in size may be due to tissues shrinking in the penis. These tissues may shrink because of nerve and blood vessel damage.
If youre concerned about this side effect, ask your doctor about taking a drug for an erectile dysfunction , such as Cialis or Viagra. The increased blood flow from these drugs may help prevent your penis from getting smaller. Theyll also help with acquiring and maintaining an erection.
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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.