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.
After A Radical Prostatectomy: What To Expect
Answers to your questions about sex, incontinence, fertility and more
If your medical team determines that your prostate cancer has become aggressive and needs to be treated, an operation called radical prostatectomy removal of the prostate is typically the first-line treatment. This surgery removes the prostate gland and surrounding tissues such as the seminal vesicles and sometimes nearby lymph nodes.
Minimally invasive techniques and most commonly, robot-assisted surgery help speed recovery after radical prostatectomy, since they cause less blood loss, less pain and shorter hospital stays. At Roswell Park, 100% of radical prostatectomies are performed with robot assistance. Regardless of how the operation is performed, the potential for lingering side effects urinary incontinence and erectile dysfunction must be considered as you decide on your treatment.
The good news is that not all men experience these, says Roswell Park urologist James Mohler, MD, Associate Director and Senior Vice President, Translational Research. And for most of the men who do, these effects are temporary. Here are answers to some of the most common questions men have about recovering from radical prostatectomy.
Day Before Your Surgery
Follow a light diet
Follow a light diet, such as a small sandwich, eggs, toast, crackers, or soup. Limit the amount of dairy products you eat and drink, and avoid fried foods and foods with a lot of seasoning.
Note the time of your surgery
A staff member from the Admitting Office will call you after 2:00 pm the day before your surgery. If your surgery is scheduled for a Monday, theyll call you on the Friday before. If you dont get a call by 7:00 pm, call .
The staff member will tell you what time to arrive at the hospital for your surgery. Theyll also remind you where to go.
Do your bowel preparation
The night before your surgery, use a saline enema as instructed on the box.
Shower with a 4% CHG solution antiseptic skin cleanser
The night before your surgery, shower using a 4% CHG solution antiseptic skin cleanser.
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Side Effects From Hormone Therapy
Hormone therapy for prostate cancer, known as androgen deprivation therapy , suppresses production of testosterone. ADT can cause several side effects. These include fatigue, hot flashes, decreased bone density, ED, depressed mood, decreased sex drive, weight gain, heart risks, breast growth and cognitive decline.
The severity and length of side effects depend on how long treatment lasts. “If a man has only six months of treatment, their level of testosterone rises again, and they’ll go back to feeling like themselves,” Calvaresi said.
Often, mood changes in men on ADT are caused by other side effects such as weight gain and hot flashes. “If we can manage those other side effects, then often that improves mood,” she said. Following a healthy diet and exercising regularly often helps to decrease fatigue, prevent weight gain and improve overall mood. Before beginning hormone therapy, you should discuss the effects of ADT with your doctor, and talk about how you can change your exercise and eating habits to help head off side effects before they occur.
What Happens After Robotic Prostate Surgery
- Robotic prostate surgery operative time is typically 2-4 hours
- Hospital stay is typically 1-2 days
- Our team will be seeing you on a daily basis during your stay in the hospital and will give you detailed after-surgery instructions prior to your discharge home.
- Foley Catheter typically comes out on day 5 after a cystogram
- Jackson Pratt drain comes out around the time of Foley catheter removal depending on your individual circumstances
- No driving for 7 days after prostate surgery
- No other restrictions in physically activities after surgery – just do what you can tolerate
- Aspirin can be restarted when you are back to eating regular meals
- You will be given Viagra upon the removal of the foley catheter. Typically 50mg a night, increasing to 100mg if no response. This is not given to necessarily induce erections, but to help improve the blood supply to your penis. If you have any heart conditions, your internal medicine doctor needs to clear you before taking Viagra.
- The first PSA check after prostate surgery is at 1 month and then 3-6 months thereafter.
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Can I Lower The Risk Of Prostate Cancer Progressing Or Coming Back
If you have prostate cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. While there are some things you can do that might be helpful, more research is needed to know for sure.
About The Challenge Dose
- When you take the challenge dose, take the medication on an empty stomach. Take it about 2 hours before your evening meal.
- The medication takes 30 to 60 minutes to start working. It will last in your system for up to 8 hours. At any time during these 8 hours, try to become sexually aroused through contact with a partner or yourself. Write down what happened and tell your doctor during your next visit.
- If you havent had any response after trying the challenge dose for 4 weeks, call your doctors office. Your doctor can refer you to our Sexual Medicine team.
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What Are Laparoscopic And Robotic Surgery
Laparoscopic and robotic prostate surgery are minimally invasive techniques for performing surgery. Both these procedures allow surgeons to operate through small ports rather than large incisions, resulting in shorter recovery times, fewer complications and reduced hospital stays. Surgical robotics combines minimally invasive surgery with advanced robotic technology.
Getting Ready For Your Surgery
You and your care team will work together to get ready for your surgery.
Help us keep you safe during your surgery by telling us if any of the following statements apply to you, even if you arent sure.
- I take a blood thinner, such as:
About drinking alcohol
The amount of alcohol you drink can affect you during and after your surgery. Its important to talk with your healthcare providers about how much alcohol you drink. This will help us plan your care.
- If you stop drinking alcohol suddenly, it can cause seizures, delirium, and death. If we know youre at risk for these complications, we can prescribe medications to help keep them from happening.
- If you drink alcohol regularly, you may be at risk for other complications during and after your surgery. These include bleeding, infections, heart problems, and a longer hospital stay.
Here are things you can do before your surgery to keep from having problems:
If you smoke, you can have breathing problems when you have surgery. Stopping even for a few days before surgery can help. Your healthcare provider will refer you to our Tobacco Treatment Program if you smoke. You can also reach the program by calling .
About sleep apnea
Please tell us if you have sleep apnea or if you think you might have it. If you use a breathing device for sleep apnea, bring it with you the day of your surgery.
Ask about medications
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What To Expect After Radiationtreatment For Prostate Cancer
Afterreceiving brachytherapy, if you receive pellets that give off radiation overthe span of a couple months, you will need a doctors note to travel,as some detection systems will be alerted. It is also recommended to avoiddirect contact with pregnant women and small children, even though theradiation does not travel far from the prostate.
Somepatients treated with EBRT can experience lymphedema when a buildup of fluidover time in the legs or genital region causes pain and swelling. Some casesmay not go away over time, but most are treated with physical therapy. Theradiation causes damage to the lymph nodes, blocking fluid from returning tothe heart.
Both typesof radiation have several shared side effects associated with the treatmentincluding:
- Urinary frequency
- Irritated urethra in the weeks following treatment
- Burning/bleeding during urination
Ask Your Doctor For A Survivorship Care Plan
Talk with your doctor about developing a survivorship care plan for you. This plan might include:
- A summary of the treatment you received
- A suggested schedule for follow-up exams and tests
- A schedule for other tests you might need in the future, such as early detection tests for other types of cancer, or tests to look for long-term health effects from your cancer or its treatment
- A list of possible late- or long-term side effects from your treatment, including what to watch for and when you should contact your doctor
- Suggestions for things you can do that might improve your health, including possibly lowering your chances of the cancer coming back
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Risks Of Radical Prostatectomy
Radical prostatectomy has a low risk of serious complications. Death or serious disability caused by radical prostatectomy is extremely rare.
Important nerves travel through the prostate on the way to the penis. Skilled surgeons can usually protect most of these nerves during radical prostatectomy. Still, complications from inadvertent nerve damage do occur after radical prostatectomy. They include:
- Urinary incontinence: More than 95% of men younger than age 50 are continent after radical prostatectomy. Around 85% of men aged 70 or older maintain continence after the operation.
- Erectile dysfunction : Problems with erections are common after prostatectomy. Still, most men are able to have sex after prostatectomy while using medicines for ED , an external pump, or injectable medications. The younger the man, the higher the chance of maintaining potency after prostatectomy. A period of penile rehabilitation is often necessary.
Much of the skill involved in radical prostatectomy centers on sparing these nerves during the operation. A man undergoing radical prostatectomy by a surgeon at an advanced prostate cancer center has a better chance of maintaining sexual and urinary function.
Other complications of radical prostatectomy include:
- Bleeding after the operation
What To Expect After Surgery
A prostatectomy is major surgery from which your body needs time to recover. Your doctor will discuss the details of your recovery with you.
Typically patients stay in the hospital overnight after surgery and then need to recuperate at home for a month before returning to work. Most men can start to drive a few weeks after surgery. You should avoid heavy lifting for several weeks after surgery. It usually takes about six weeks for most men to feel back to normal.
This page provides general information about what you can expect in the first hours and days right after surgery. You may also want to read more about:
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Things You Should Expect After Prostate Surgery
Prostate removal is a major type of surgery and requires time for the body to recover. Even though robotic prostatectomy using the Da Vinci robot has less severe effects on the body and the patient can leave the hospital the same day, men should expect some changes in order to know how to deal with them. The surgery is performed through small incisions that are barely sensitive at the incision sites and the scar tissue is almost unnoticeable. Typically, the recovery is fast, most men are able to go home the next day and resume driving and working in two to three weeks after the surgery.
In the immediate hours after surgery:
Living As A Prostate Cancer Survivor
For most men with prostate cancer, treatment can remove or destroy the cancer. Completing treatment can be both stressful and exciting. You may be relieved to finish treatment, but find it hard not to worry about cancer growing or coming back. This is very common if youve had cancer.
For other men, the cancer may come back in other parts of the body or may never go away completely. These men may get hormone treatment or other therapies to help keep the cancer under control for as long as possible. Learning to live with cancer that does not go away can be difficult and very stressful.
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The Three Parts Of Male Orgasm
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.
Nutrition And Dietary Supplements
Some studies have suggested that eating a healthy diet that is rich in vegetables and lower in animal fats might be helpful, but more research is needed to be sure. However, we do know that a healthy diet can have positive effects on your overall health, with benefits that extend beyond your risk of prostate or other cancers.
So far, no dietary supplements have been shown to clearly help lower the risk of prostate cancer progressing or coming back. In fact, some research has suggested that some supplements, such as selenium, might even be harmful. This doesnt mean that no supplements will help, but its important to know that none have been proven to do so.
Dietary supplements are not regulated like medicines in the United States they do not have to be proven effective before being sold, although there are limits on what theyre allowed to claim they can do. If you are thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that could be harmful.
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When You’re In The Hospital
You had surgery to remove all of your prostate, some tissue near your prostate, and probably some lymph nodes. This was done to treat prostate cancer.
- Your surgeon may have made an incision either in the lower part of your belly or in the area between your scrotum and anus .
- Your surgeon may have used a robot or a laparoscope . You will have several small incisions on your belly.
Psa Recurrence Or Psa Persistence After Prostate Removal How To Interpret The Data
Although PSA should be 0 after surgery, some patients are faced with one of two scenarios: PSA recurrence or PSA persistence.PSA persistence is the detection of a PSA higher than 0 within the first three months after prostatectomy. The distinction is that the PSA has not recurred, but rather persisted after surgery. The key difference this small distinction makes is the prediction of the course the disease will take. A persistent PSA after radical prostatectomy or other forms of treatment can, unfortunately, mean cancer has progressed and metastasized. In many cases, the best course of secondary treatment is hormone therapy.
Unlike PSA persistence, PSA recurrence is characterized by a PSA of 0 postoperative and a rising in the blood test after an unspecified period of time. Traditionally, the value of 0.2 has been used as the benchmark to indicate PSA recurrence.
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What Is The Difference Between Robotic And Laparoscopic Radical Prostatectomy
Both are minimally-invasive techniques of performing radical prostatectomy for cancer. In laparoscopic radical prostatectomy, the surgeon stands by the operating table and himself manipulates the instruments. In robotic prostatectomy the surgeon is seated at a robotic console near the patient from where he drive the robotic instruments to perform the operation. The robot faithfully and accurately reproduces the surgeon’s sophisticated maneuvers.