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.
How Does Your Sex Life Affect Your Prostate Cancer Risk
Could how often you ejaculate be linked to prostate cancer? Find out what two studies and two experts say about sex and prostate cancer risk.
What if your chances of getting prostate cancer were somehow tied to how much sex you were having? Some studies have explored that very question specifically, whether theres a link between how often you ejaculate and your prostate cancer risk.
Its Complicated: Enlarged Prostate And Sex
BPH and sexual function
Prostate enlargement, also known as benign prostatic hyperplasia , and erectile dysfunction are separate problems. Both increase with age, but one causes problems in the bathroom and the other in the bedroom. However, the two are somewhat linked.
BPH happens when your prostate becomes enlarged, but cancer isnt the cause. A mans prostate continues growing throughout most of his adult life. This is why many older men are affected by the condition.
ED is the inability to get or maintain an erection. It can be caused by physical conditions such as:
It can also be caused by psychological issues.
These two conditions dont necessarily seem linked, but certain treatments that relieve BPH can cause ED and other sexual side effects. On the other hand, treating ED can improve enlarged prostate symptoms.
- inability to empty the bladder
- a weak urine stream
A surgery called transurethral resection of the prostate can help relieve these symptoms. Men who have this procedure often experience sexual side effects after surgery.
Between 50 and 75 percent of men experience retrograde ejaculation after TURP, according to Harvard Medical School. This means that semen released during orgasm enters the bladder rather than exiting the penis. Retrograde ejaculation is sometimes called dry orgasm. Its not harmful but can affect male fertility.
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Frequent Sex May Be Protective
Hence, not until very recently, the mainstream hypothesis had been too much sex might provoke the development of prostate cancer but a recently published research study thinks the direct opposite, postulating that frequent sex may be a protective factor in prostate cancer.
The findings, published in the April 7 issue of The Journal of the American Medical Association and reviewed on webmd.com, are based on data collected from nearly 30,000 predominately white men aged 46 to 81.
At the start of the study, men provided information on ejaculation frequency in their 20s, 40s, and in the previous year . Ejaculation frequency included sexual intercourse, masturbation, and nighttime ejaculations that can occur during sleep. The men were then monitored for eight years.
Ordinarily, researchers found most categories of ejaculation frequency were unrelated to prostate cancer risk. But when they looked at men in the highest category of ejaculation frequency , they found evidence of a protective effect.
According to Michael Leitzmann, MD, an investigator at the National Cancer Institute in Bethesda, USA, who conducted the research during a post-doctoral fellowship at Harvard University, when you look at the data in a little bit more detail, you do see that not only is there not an increased risk, but there is potentially even the possibility of a slight decrease in risk with high ejaculation frequency.
How Do You Find It
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.
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Questions To Ask Your Doctor Or Nurse
- 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?
How Are Prostate Cancer Stages Determined
Once all testing has been completed, your doctor will tell you the stage of your cancer, or how much it has progressed and whether it has spread beyond your prostate. The stage will help your medical team decide which treatment is best for you. The higher the stage, the more advanced your cancer. The most common way to stage prostate cancer is the TNM system, developed by the American Joint Committee on Cancer, which hinges on three important factors:
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T : How much of your prostate the tumor affects
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N : Whether the cancer has spread beyond your prostate to nearby lymph nodes
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M : Whether your cancer has metastasized, or spread far beyond your prostate to your bones, to nearby organs such as your bladder or rectum, or to more distant organs like your lungs, liver, or brain.
The TNM system also includes your PSA level and your Grade Group, based on your Gleason score. With your stage designated, which is labeled in a range of T1 to T4 , a treatment plan can be developed.
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Having Sex More Often Can Protect Your Prostate
A few studies conducted concurrently in various parts of the world have come to an interesting conclusion: frequent ejaculation is associated with lower incidence of some forms of prostate cancer.
One of these studies tracked 32,000 men from 1992, when they were in their 20s, to 2010. The researchers analyzed data from questionnaires regarding participants sexual health. They also reviewed their medical records and lab test results to double-check their prostate tumor diagnoses.
More Sex For Prostate Cancer Prevention
One study, published in the British Journal of Urology International, found that the more ejaculations a man has between the ages of 20 and 50, the less likely he is to develop prostate cancer. The findings suggest that a man in his twenties who ejaculates more than seven times a week has one-third the risk of getting an aggressive type of prostate cancer as a man who ejaculates less than three times a week.
The study, done in Australia, relied on questionnaires filled out by men younger than 70, including 1,079 men who had been diagnosed with prostate cancer and 1,259 men who did not have the disease. The authors of the study speculate that ejaculation may have a protective effect against prostate cancer, but they admit that their findings need to be supported by more research.
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Changes In Penis Size
Some men notice that their penis is shorter after;surgery;. Some men notice other changes such as a curve in their penis or a narrower area. We don’t know for certain why these changes happen, but it could be because of low oxygen levels in the penis, caused by not having erections. Other treatments such as hormone therapy with radiotherapy may also cause changes to the size of your penis.
Encouraging blood flow to the penis after surgery may help prevent this. In particular, using a vacuum pump, either on its own or with PDE5 inhibitor tablets could help maintain your penis size and improve erections.
Keeping your penis active after surgery
Although you may not be ready or recovered enough for sex, you can still start treatment for erection problems in the weeks immediately after surgery. It could be taking a low-dose PDE5 tablet once a day or using a vacuum pump, or sometimes both together. The treatment along with masturbation encourages blood flow to the penis. This can help keep your penis healthy. You may hear this called;penile rehabilitation. Think of it in the same way as having physiotherapy if you had injured your arm or leg. Starting treatment soon after surgery may help improve your chance of getting and keeping an erection. But it may not work for every man.
How Does The Prostate Work
The prostate is a gland about the size of a chestnut and weighs about 30 grams . It is part of the male reproductive system and is located inside the body. The prostates most important function is the production of a fluid that, together with sperm cells from the testicles and fluids from other glands, makes up semen. The muscles of the prostate also ensure that the semen is forcefully pressed into the urethra and then expelled outwards during ejaculation.
The prostate is located directly below the bladder and above the muscles of the pelvic floor. The rectum is behind the prostate, making it possible to feel the gland from the rectum using the finger. The ducts in the prostate gland flow into the urethra, which passes through the prostate. The word prostate is taken from the Greek expression meaning one who stands before, which describes the position of the prostate gland. Viewed from below, where the urethra leaves the gland, the prostate stands before the bladder.
The tissue of the prostate gland can be divided into three different zones, listed here from innermost to outermost, which encircle the urethra like layers of an onion:
The prostate has various functions:
Production of fluid for semen:
Hormone metabolism: In the prostate the male sex hormone testosterone is transformed to a biologically active form, DHT .
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Why Can Stimulating The Prostate Feel So Good
The anus and its surrounding area are packed with nerve endings, Hong explains. Thats precisely why anal play can feel so amazing whether or not you have a prostate. Dr. Hong also notes that the prostate has plenty of blood vessels that swell with increased blood flow. The extra blood helps make the area more sensitive, which can boost pleasure.
Even though the anus is surrounded by nerve endings, its also surrounded by stigma. The human body is amazing in that parts like the vagina and anus have natural functions but can also be sites of intense pleasure. Trying out different sex-related acts is normal, and discovering new ways to experience pleasure is always a good idea.
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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Is Sex Good For Your Prostate
Whether or not sex is good for prostate problems is a question many men wonder, and its an important one that needs answering.
The prostate plays an active role during sexual activity.
Along with other structures, the prostate is responsible for making fluid in semen, which helps transport your sperm when you ejaculate.
The effect regular ejaculations have on the prostate should become a significant talking point, especially amongst men who are experiencing prostate problems.
This article will determine whether a healthy sex life can reduce the risk of developing prostate cancer.
Additional Types Of Therapy For Prostate Cancer
A few other treatments exist for advanced prostate cancer or prostate cancer that has stopped responding well to other forms of hormone therapy. They are usually taken with one of the therapies discussed above.
Chemotherapy. For cases of very aggressive prostate cancer, or when hormone therapy isn’t effective, your doctor may recommend chemotherapy. This class of anti-cancer drug, taken by mouth or injected, fights cancers that have spread beyond the prostate to other parts of your body. The schedule of your treatment will depend on the specific drugs you require, but chemotherapy is typically given in cycles that last two to three weeks. Once you finish a cycle, the next cycle begins. The length of your treatment hinges on how well it works and whether you can cope with the side effects. Chemotherapy drugs are used to help you live longer. They rarely cure prostate cancer, according to the ACS, and can cause unpleasant side effects, including hair loss, nausea, and fatigue.
Immunotherapy. This type of treatment harnesses the power of your immune system to fight cancer. While it has been used successfully in several types of cancer, it hasnt proved as effective in prostate canceryet. Researchers are working to discover the best ways to incorporate immune therapy into prostate cancer care, particularly for men whose cancer no longer responds to hormone treatment. In 2019, more than 100 such studies were underway.
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Is It Easy To Orgasm This Way
Lets say it may take some practice and patience.
Actual clinical research on prostate-induced orgasms is seriously lacking, so we dont know how common it is or if its possible for everyone with a prostate to have this type of orgasm.
Every body is different, so some experimenting to see what feels good is in order. If you do manage to have one, reproducing it will be easy.
Clinical Relevance Prostatic Carcinoma
Prostatic carcinoma represents the most commonly diagnosed cancer in men, especially in countries with high sociodemographic index. The malignant cells commonly originate from the peripheral zone, although carcinomas may arise from the central and transition zones too. It is still debatable that the latter tumors may present with lower malignant potential.
However the proximity of the peripheral zone to the neurovascular bundle that surrounds the prostate may facilitate spread along perineural and lymphatic pathways, thus increasing the metastatic potential of these tumors. Malignant cells may invade adjacent structures and/ or lymphatic and blood vessel routes to give distant metastases. Prostate carcinoma also commonly spreads via the Batson venous plexus to the vertebral bodies and cause skeletal metastases.
A DRE may reveal a hard, irregular prostate gland. In most cases the serum PSA values will be increased. However, due to the peripherally-advancing tumor, symptoms may be minimal, as obstruction occurs usually at late stages. One should also keep in mind that the high incidence of prostate carcinoma is found in elderly men, who may already have symptoms due to BPH.
Fig 4 Prostate cancer has the potential to invade nearby structures.
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Sex And The Prostate: Overcoming Erectile Dysfunction When You Have Prostate Disease
If you are concerned about erectile function, its important to understand what erectile dysfunction really is. Failing to have an erection one night after youve had several drinks or even for a week or more during a time of intense emotional stress is not erectile dysfunction. Nor is the inability to have another erection soon after an orgasm. Nearly every man occasionally has trouble getting an erection, and most partners understand that.
Erectile dysfunction is the inability to attain and maintain an erection sufficient for sexual intercourse at least 25% of the time. The penis doesnt get hard enough, or it gets hard but softens too soon. The problem often develops gradually. One night it may take longer or require more stimulation to get an erection. On another occasion, the erection may not be as firm as usual, or it may end before orgasm. When such difficulties occur regularly, its time to talk to your doctor.
Erectile dysfunction can have many causes, including some forms of prostate disease and medications and surgery for prostate cancer. Fortunately, in many cases, this problem can often be effectively addressed. Some men find relief by taking medications to treat erectile dysfunction. If these arent effective for you, a number of other options, including injections and vacuum devices, are available. The possibility of finding the right solution is now greater than ever.