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Can You Still Have Sex With No Prostate

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How Do You Find It

What Do You Need To Know About Sex After Prostate Cancer?

Youll need to head south along the back road to find it in a magical place called the anal region.

Although entering through the anus is the most direct way, you can also stimulate the prostate indirectly through the perineum, or taint.

This is the skin that runs underneath the scrotum to the anus.

Can You Get Erections After Prostate Cancer Treatment

If you have ever wondered whether you’ll be able to have an erection after prostate cancer treatment, you are not alone. Many men who are facing a prostate cancer diagnosis, or who have undergone prostate cancer treatment, are worried about whether or not they will be able to have an erection after prostate cancer.

Percentage Of Men Obtaining Full Erections 2 Years After Open Prostatectomy

15% 13%

As one can see, the chance of regaining potency diminishes with age and with the number of nerves damaged. Even though it is usually technically possible to spare the nerves, sometimes the nerves themselves are cancerous and must be removed since the primary goal of the surgeon is to remove the prostate cancer. If the cancer has not reached the nerves controlling erection, the da Vinci Robot has the visual capabilities and the precision necessary to spare these nerves in most cases, thus it is possible that using the robot may add to the chances of being potent after surgery. However, there is no way to guarantee this due to variability in patient anatomy and condition. It is important to realize that some men never regain the ability to maintain an erection after robotic prostatectomy.

As mentioned above, medical therapy may aid in return to erections, but this has not as of yet been fully substantiated. Usage of sildenafil and newer erectile medications may potentially increase the potency percentages in the table above but this has not been proven. A recently presented study found that daily doses of 50mg or 100mg sildenafil for 9 months increased full erections by 7 fold when compared with a group who did not receive any medication.

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Is Another Treatment Option Better For Preservation Of Erectile Function

The growing interest in pelvic radiation, including brachytherapy, as an alternative to surgery can be attributed in part to the supposition that surgery carries a higher risk of erectile dysfunction. Clearly, surgery is associated with an immediate, precipitous loss of erectile function that does not occur when radiation therapy is performed, although with surgery recovery is possible in many with appropriately extended follow-up. Radiation therapy, by contrast, often results in a steady decline in erectile function to a hardly trivial degree over time.

What Would You Tell Men Who Are Opposed To Having Things Put In Their Rear End

Can I Still Get My Period While Pregnant?

Fred: Without being too forward or rude, just grow up and give it a go. The stigma around it is so incredibly strong, mostly because it goes against the masculine trend of only putting your dick in things, but seriously itll change your life. Youll never wanna orgasm any other way again.

Alan: While its certainly valid and not everyones favorite cup of tea, the sensations offer a wider range of pleasure to bring into the bed with yourself or with your partner. If you are searching for something new to try, this is a sensation that all people with a prostate can enjoy.

Evan: I would say to men who are reticent to put things up their ass that they are probably fearful because of societal pressures/expectations. They need to look at their prostate as an important part of their body and sexuality to explore.

Drew: I would say youre really missing out! Take some time to reflect on why youre not open to exploring this amazing pleasure center. Does it rub up against your ideas of masculinity and what it means to be a man? Do you have anxiety related to the other fluids and substances that might be down there? Are you afraid of exploring this with your partner and what they might think? If any of these are coming up I would recommend starting small and solo: small size toys, or preferably your own finger. The prostate is a gift, celebrate and cherish it!

*Name has been changed to allow subject to freely on private matters.

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How Does Prostate Surgery Affect You Sexually

If you are diagnosed with prostate cancer and opt for a prostatectomy, particularly a radical prostatectomy, the surgeons will have removed your prostate.

While the prostate isnt directly responsible for your libido or sexual sensation, in some men who have had a prostatectomy, there can be damage to nerves or blood vessels.

The prostate is next to a dense group of nerves and the seminal vesicles .

There is a heightened chance of an infection such as spermatocystitis which can cause you pain or in some cases impotence.

For men who have had an open prostatectomy, they will find that they can no longer ejaculate. This is known as a dry orgasm and can still be pleasurable.

Even with less invasive surgeries, the most common complaint or side effect tends to be sexual in nature.

However, according to systematic reviews and meta-analysis of the scientific data, these cases of sexual dysfunction are often associated with psychological factors that might be present before surgery or as a result of stress related to the surgical procedure.

Radiation therapy can impact the pelvic floor muscles and nerves that control erections and provide pleasure.

According to a 2016 study, around half of Prostate Cancer patients who have any form of radiation therapy go on to develop erectile dysfunction.

For a large section of men who opt for radiation-based therapies, the first stage is usually hormone therapy.

S Men Can Take To Improve Or Recover Orgasms

This doesnt mean that some men dont have difficulty experiencing orgasm after radical prostatectomy. The missing sensation of fullness and the lack of ejaculate are big changes. But there are some things you can do to correct the problem, according to Dr. Kacker.

Men can achieve an orgasm on their own with manual stimulation or with a partner through manual or oral stimulation. Just remember that an erection is not needed. Using a vibrator on the head of penis is often helpful. Vibration can stimulate the nerves in the penis and increase the signals being sent to the brain.

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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.

Can Men Have Sex After Prostatectomy

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Most men who have normal sexual function and receive treatment for early prostate cancer regain erectile function and can have satisfying sex lives after robotic prostatectomy. However, it is a gradual process and may take up to a year. Very few of our patients experience erectile dysfunction, but we work closely with those who do.

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What Changes Can You Expect

  • Ejaculation will cease:Without a prostate gland or seminal vesicles, you will no longer experience ejaculation. Even though your orgasm may feel different, it will still be pleasurable.
  • Leaking urine during sex:This is possible but does not happen to all men. Its harmless and temporary.
  • Performance anxiety:Dont underestimate the emotional roller coaster of prostate cancer surgery and recovery. Its normal to worry about sex after prostate cancer. Being open and honest with your partner will help.

Keep in mind that your overall health, age, and present ED status are all factors in your recovery to sex after prostate surgery.

Less commonly, the prostate cancer tumor may bulge to one or both sides of the prostate gland, making nerve-sparing surgery extremely difficult or impossible.

Dr. Samadi will help you understand your exact prostate cancer status and the position and size of your tumor. In some cases, a nerve graft can be performed to regenerate the penile nerves for sex after prostate surgery.

  • Changes in mood and libido:The psychological impact of surgery can be significant this will leave you tired and irritable, not in the mood for sex so you will need to move towards intimacy slowly and your desire will return back to normal.

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Cut Back Or Change Antidepressants

Another thing to think about is any other medications youre taking, notes Dr. Kacker. Many men are, unknowingly, taking medications that suppress orgasm. By far the number one offender is the SSRI class of antidepressants, which include fluoxetine and Paxil . By reducing the dose of these drugs or eliminating them entirely, or switching to a non-SSRI like bupropion , many men see an improvement in their ability to orgasm.

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Prostatectomy And Sexual Issues

As a man, your prostate gland plays several important roles in your bodys sexual and urinary function.

During sex, your prostate gland is responsible for releasing seminal fluid, or semen, into your urethra. As you reach orgasm and ejaculate, the muscle tissue of your prostate forces semen and sperm out from your penis.

The nerves that surround your prostate also play an important role in allowing blood to flow to the erectile tissue of your penis when youre sexually aroused.

Because prostate surgery involves removing the prostate gland, its normal to lose some parts of your normal sexual function after the surgery.

For example, radical prostatectomy involves cutting the connection between your urethra and your testicles. This means that sperm is no longer able to flow down your urethra and out the tip of your penis during sex.

As a result of this, men who undergo radical prostatectomy surgery can still reach orgasm, but arent able to ejaculate.

Several different approaches are used to remove your prostate gland during surgery. Some of these approaches particularly those used to treat prostate cancer may result in damage to the nerves that surround your prostate gland, testicles and penis.

Nerve damage caused by prostatectomy surgery may affect your erectile health. If your nerves need to be cut during the procedure , you may find it difficult or impossible to get and/or maintain an erection after surgery.

Sex When You’re Single

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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.

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How Will Treatment Affect My Ability To Orgasm Or My Fertility

Surgery for prostate cancer can affect both your orgasms and your ability to have children. The prostate gland normally adds a fluid called semen to sperm to nourish and protect it. Youll no longer make semen after surgery, which means your orgasms will be dry. Radiation therapy can also reduce the amount of fluid you ejaculate. Without semen, you wont be able to father children. If youre concerned about fertility, you can bank your sperm before your surgery.

After surgery, orgasms will also feel different. You wont have that normal buildup of sensation before you have an orgasm. Youll still be able to feel pleasure, though.

If Youre The Receiving Partner

Youll want to be as relaxed and aroused as possible, because itll make the experience easier and more enjoyable.

The whole poop-comes-out-of-the-butt thing gives some people a case of the heebie-jeebies even when its their own butt.

Remedy this by taking a shower and paying a little extra attention back there to get it squeaky clean. Some people like to use an enema before engaging in butt play, but it isnt necessary.

Use the bathroom before getting started. Prostate stimulation can make you feel like you need to pee, and anal penetration can cause the sensation of needing to poop.

Even though you wont actually do either, worrying that you might can interfere with your ability to let go and enjoy yourself. Knowing your bladder and bowels are empty can help.

Getting used to the sensation of having your prostate touched can help, too. Practice with an anal sex toy, like a butt plug, or your fingers.

Be sure to set the mood so that youre turned on and primed for action. Light candles, watch porn, or engage in some good old-fashioned masturbation or foreplay to get there.

Finally, be sure to lube up real good. Applying a water-based lubricant will allow for easier penetration and make for some easy gliding if stimulating your prostate externally.

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Are These Erections Lost For Good

Theres pretty good evidence to show that men can continue to recover erectile function up to two years after prostatectomy surgery , which we believe is partly because it takes time for the bruising and scar tissue after surgery to settle down. But if spontaneous erections do not recover by this point then it is unlikely that they will do so thereafter. Conversely, there is good evidence that drugs such as Viagra can be used to enhance erections after surgery and that, even if such drugs do not work for example if the nerves have been removed to maximise cancer clearance mechanical devices such as vacuum pumps, cavaject injections into the side of the penis or MUSE therapy are effective.

Questions To Ask Your Doctor Or Nurse

When is it Safe for Sex after Prostate Cancer?
  • How could my prostate cancer treatment affect my sex life?
  • How soon after treatment can I masturbate or have sex?
  • Which treatments for erection problems would be best for me? Can I get them on the NHS?
  • Is there anything I can do to prepare myself before I start my prostate cancer treatment?
  • What happens if the treatment doesn’t work? Are there others I could try?
  • What other support is available to me?
  • Can my partner also get support?

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Treating Advanced Prostate Cancer

If the cancer has reached an advanced stage, it’s no longer possible to cure it. But it may be possible to slow its progression, prolong your life and relieve symptoms.

Treatment options include:

  • hormone treatment
  • chemotherapy

If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss.

What Is The Problem

Some 6,500 radical prostatectomies are performed every year in the UK . While approximately half of these men have pre-existing erectile dysfunction, over 50% of the other half can expect to lose natural erections after prostatectomy surgery, especially if their cancers are locally advanced and require wide clearance to ensure removal of the whole tumour.

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How Soon After Prostate Cancer Treatment Can You Be Sexually Active Again

Different Prostate Cancer treatments have various periods before one can resume sexual activity. Its also down to an individuals recovery time, which has to factor in age.

A man who has had a prostatectomy in his eighties will find that it will take him a lot longer to resume any sexual activity than a man in his fifties who has had external beam therapy.

The individuals general health and genetics all play a part in the healing process. With a prostatectomy, studies tend to show that it is at least several months before erectile function returns, but it can be up to a year.

For more limited surgery, such as TURPs, one can expect to be sexually active again within 4 6 weeks if that is the only surgery and treatment. Often it happens in conjunction with other treatments, such as hormone or radiotherapy, which have much longer recovery times.

There are still options that are open to men before that. If a man still feels sexual desire, then sexual activity is still possible.

There are three parts to orgasm, and while the sensation of fullness or ejaculate may no longer be present, the mental part of orgasm which takes place in the brain is just as possible as before surgery. Plus theres absolutely nothing stopping a man from being more focused on his partners sexual pleasure.

Are There New Strategies In The Near Future That May Be Helpful In Improving Erection Recovery After Surgery

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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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