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Can You Still Have Sex After Prostate Removal

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Other Cancer Treatment Effects On Ejaculation

EXTRA: Sexual Function After Prostate Cancer Surgery – Mark’s Prostate Cancer Experience

Some cancer treatments reduce the amount of semen thats produced. After radiation to the prostate, some men ejaculate less semen. Toward the end of radiation treatments, men often feel a sharp pain as they ejaculate. The pain is caused by irritation in the urethra . It should go away over time after treatment ends.

In most cases, men who have hormone therapy for prostate cancer also make less semen than before.

Chemotherapy and other drugs used to treat cancer very rarely affects ejaculation. But there are some drugs that may cause retrograde ejaculation by damaging the nerves that control emission.

Yes You Can Have Sex After Prostate Surgery

Survivorship programs offer counseling and interventions to promote sexual recovery after cancer treatment.

Theres a perception that surgery to treat prostate cancer will spell the end of a mans sex life.

And while that often used to be the case, survivorship programs, like the one at the University of Michigan Rogel Cancer Center, offer counseling and interventions to promote sexual recovery after cancer treatment.

Prostate cancer, especially if its caught early, is a highly treatable disease, says Daniela Wittmann,;an associate professor of urology and social work at U-M, and a certified sex therapist with more than 30 years of experience. But that also means that men are often living for a long time and dealing with the side effects of treatment.

U-Ms David and Jan Brandon Prostate Cancer Survivorship Program is devoted to helping menand their partnersmanage those side effects, the most disruptive of which are urinary incontinence and erectile dysfunction.

What we do is that we help men and their partners manage expectations for what the side effects of treatment are going to be like, Wittmann says. Before treatment, we tell them about the rehabilitation thats available, and then after treatment, we are there as a team to support them and to help them with rehabilitationthe physiological, emotional, relationship aspects as they relate to intimacy.

Without such support, men are far less likely to try available interventions, she notes.

What Current Options Exist To Treat Erectile Dysfunction After Radical Prostatectomy

Options include pharmacologic and nonpharmacologic interventions. Pharmacotherapies include the oral PDE-5 inhibitors , intraurethral suppositories , and intracavernous injections . Non-pharmacologic therapies, which do not rely on the biochemical reactivity of the erectile tissue, include vacuum constriction devices and penile implants .

Men who have undergone nerve-sparing technique should be offered therapies that are not expected to interfere with the potential recovery of spontaneous, natural erectile function. In this light, penile prosthesis surgery would not be considered an option in this select group, at least in the initial 2 year post-operative period, until it becomes evident in some individuals that such recovery is unlikely.

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It Wont Be The Same But There’s Reason To Be Optimistic

Once a man gets a diagnosis of prostate cancer and has to have surgery to address it, his thoughts will turn to the obviouswhat can I expect for my sex life after prostate surgery?

The good news is that if a man does elect to have prostate surgery, his chance of returning to an enjoyable sex life is very good. The first thing to know is that sexual recovery does take time so having plenty of persistence and patience goes a long way. It can also help a man to approach sex after prostate cancer treatment by going into it without any expectations, being open to experimenting, and discussing with his physician what works and what doesnt.

Knowing what to expect by talking with your physician can optimize your recovery and help you return to a satisfying, normal sex life once again. Heres what you need to know:

Impotence;is likely.;Most likely there will initially be some experience with erectile dysfunction, but for most men its temporary. While a man is recovering, he should be able to rely on medications such as Viagra or Cialis until normal sexual functioning returns.

Orgasm might not be the same.;A man should be able to achieve an orgasm after prostate surgery, but it may be different. It is possible for a man to achieve an orgasm without an erection and this should be thoroughly understood by any man after the surgery is done.

There are several things a man can do to help himself recuperate fully so that he can get back to a normal sex life:

How To Return To An Active Sex Life After Prostate Cancer Treatment

Surgery for Prostate Cancer

No matter the cancer, treatments often cause side effects that affect patients quality of life. But with prostate cancer, the potential side effects can be particularly concerning to men who are trying to decide which approach is right for them. Surgery, radiation therapy and other treatments may impact a patients sex life, causing challenges like low sex drive, loss of penis length, dry orgasm or low sperm counts. Despite the angst these issues may cause, experts say most of these side effects can be managed and many men have a good chance of returning to a full sex life after prostate cancer treatment.

Unfortunately, sexual dysfunction is a possibility for nearly all treatment options for prostate cancer, including surgery, says Scott Shelfo, MD, FACS, Medical Director of Urology at our hospital near Atlanta.;The degree of dysfunction depends on many factors, including the patients overall health, co-existing medical problems, as well as the patients level of sexual function and ability before treatment.

Read Also: Does An Enlarged Prostate Affect A Man Sexually

Sexual Potency At The Heart Of The Poten

Despite the advances weve made across the board in prostate cancer care, preserving sexual function took a back seat to eliminating the disease for many doctors and researchers until now. Because we know SAbR is effective in treating patients prostate cancer, our focus today can shift to sexual wellness.

I am leading the POTEN-C clinical trial, and it includes investigators at UT Southwestern and other top centers throughout the country. All of us will be working together to determine the effectiveness of a novel technique that involves the use of;SpaceOAR, a gel that increases the space between the prostate and rectum during radiation therapy. This extra space might give enough room to reduce the risk of sexual side effects after treatment even more than what weve seen in the current generation of SAbR.

Importantly, this study is a collaborative effort with randomization and quality controls to stringently evaluate both the ability of this novel technique to improve sexual quality of life and whether it can be standardized across multiple centers. We have used the SpaceOAR for most of our patients over the past several years and presented the initial experience at national meetings. As of April 2018, well start recruiting around 40 patients at UT Southwestern with prostate cancer to take part in the POTEN-C study, and well eventually enroll 120 participants nationwide.

The Purpose Of Prostate Surgery

Prostate cancer surgery, or radical prostatectomy, is a procedure conventional medicine praises for curing prostate cancer.

It has been performed for many years and was regarded as the gold standard of prostate cancer treatment. However, few studies compare its efficacy to other techniques.;

Most men diagnosed with prostate cancer today are typically diagnosed with Gleason 6 cancer levels. But, according to many experts, this diagnosis may not be cancer! According to Mark Scholz, MD, a board-certified oncologist and expert on prostate cancer:

Misuse of the term cancer has tragic implications. Real cancer requires action and aggressive medical intervention with the goal of saving a life. But consider the potential havoc created by telling someone they have cancer when it is untrue. This dreadful calamity is occurring to 100,000 men every year in the United States with men who undergo a needle biopsy and are told they have prostate cancer with a grade of Gleason 6.

The impact of this is quite profound. Most prostate cancer diagnosed today falls into this Gleason 6. If it is not cancer, thousands of men have had aggressive treatment for cancer they dont really have.

Aggressive treatment, usually a complete surgical removal of the prostate , is the typical result. This leaves the patient to suffer from its side effects for the rest of their life.

Read Also: Can An Mri Detect Prostate Cancer

Chemotherapy Drugs For Prostate Cancer

  • Docetaxel
  • Mitoxantrone
  • Estramustine

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?

Can Masturbation Cut Prostate Cancer Risk

Preserving sexual function after prostate cancer

In this area of interest, a study that took information from 32,000 men looked at whether regular ejaculation helps to prevent prostate cancer.

The researchers published their work in the journal European Urology and reported that more frequent ejaculation might lead to a lower risk of prostate cancer.

Among men aged 2029 years old who had 21 or more ejaculations a month, there were 2.39 fewer in every 1,000 who developed prostate cancer when the researchers compared them to those ejaculating 47 times a month.

Among men who were aged 4049 years old, there were 3.89 fewer people per 1,000 who developed prostate cancer.

The reasons for these results are unclear, but one theory refers to prostate stagnation. This means that less frequent ejaculation allows prostate secretions to build up, possibly contributing to cancer.

An earlier study threw light on other potential aspects of prostate cancer, indicating that frequent sexual activity in younger life increased the risk of prostate cancer. However, the study also indicated that this activity seemed to give protection against the disease when people were older.

While many men experience sexual issues following prostate cancer treatment, these issues are not often due to prostate cancer itself.

More active treatments for cancer, such as surgery, radiation therapy, or hormone therapy, may lead to sexual dysfunction.

Treatment options with a risk of erectile dysfunction include:

Read Also: Can You Shrink An Enlarged Prostate

If You’re A Gay Or Bisexual Man

To be the active partner during anal sex you normally need a strong erection, so erection problems can be a particular issue. You could try using a constriction ring around your penis together with another treatment like PDE5 inhibitor tablets, to help keep your erection hard enough for anal sex.

If you are receiving anal sex, a lot of the pleasure comes from the penis rubbing against the prostate. Some men who receive anal sex find that their experience of sex changes if they have their prostate removed .

If you receive anal sex, then bowel problems or sensitivity in the anus may be an issue after radiotherapy. Its best to wait until your symptoms have settled before trying anal play or sex. If youve had permanent seed brachytherapy there is a risk in the first few months that your partner might be exposed to some radiation during sex. Talk to your doctor or nurse for further advice.

With all sexual changes you may be able to find ways to work through this.

Watch Martin’s story below for one gay man’s experience.

Watch;other men’s personal stories;about sex after prostate cancer.

Masturbation After Prostate Cancer Treatment

Masturbation after prostate cancer treatment can be helpful in decreasing the risk of impotence and penile shrinkage. The radical prostatectomy removes a portion of the urethra which can shorten the length of the penis. Radiation therapy can contribute to hardening of the blood vessels in the penis. Think of the penis as people think of the muscles in their bodies: if a muscle does not exercise, it grows weak and inflexible. Masturbation or penile exercises through external stimulation forces blood to flow through the caverns of the penis which keep the organ malleable and may help decrease the chances of penile shrinkage. After brachytherapy, men who will not use condoms for sexual intercourse should masturbate the first times after treatment to avoid letting migratory seeds enter their partner.


Recommended Reading: What Is Prostate Massage Therapy

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.

The Three Parts Of Male Orgasm

Improving Your Sex Life After Prostate Cancer

Kacker starts by pointing out a common misconception that erections are necessary for male orgasm. They arent. Men can have experience orgasm without an erection. The converse is also true, of course: men can have an erection without having an orgasm.

When discussing orgasm and radical prostatectomy, its useful to think of the male orgasm as having three separate parts, says Dr. Kacker.

First, secretions from the testicles, the prostate, and the seminal vesiclessmall, slender glands near the prostateflow into the urethra, the tube-like structure that carries semen through the penis and out the body. The emission of those fluids creates a feeling of fullness and a sensation of inevitability.

Second, theres ejaculation, which is accompanied by contractions of the pelvic floor muscles, the group of muscles used to hold in intestinal gas and urine.

And third is the mental componentall of the processing the brain does of incoming sensory signals from penis and pelvis that contribute to the mental experience of build up and release.

Also Check: What Does A Cancerous Prostate Look Like

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:

What Is A Prostatectomy

A prostatectomy is a surgical procedure in which part or all of your prostate gland is surgically removed from your body. Its usually carried out to treat advanced benign prostatic hyperplasia or prostate cancer.

Your prostate is a small gland thats located between your penis and your rectum. Its roughly the same size as a ping-pong ball and plays a key role in your reproductive health by creating the semen that mixes with your sperm before you ejaculate.;

Prostatectomy surgery is generally described as simple or radical. In a simple prostatectomy, the inner part of the prostate gland is removed through an incision thats made in your lower abdomen. This type of procedure is usually performed to treat prostate enlargement.

In a radical prostatectomy, your entire prostate gland and some of the surrounding tissue may be removed. This type of procedure is usually performed to treat prostate cancer.

Read Also: How Fast Does Prostate Cancer Grow

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.

How To Maintain Your Sex Life After Prostate Surgery

Video 12 – Four Weeks After Surgery – Mark’s Prostate Cancer Experience

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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