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Sex after Prostate Cancer Surgery

Successful surgery Jan 2020. Happy to be alive and happy to have a job in this economy.

But the sex life pretty much sucks. I was warned it would be challenging. I was counting on things working a bit less well, but holy cow wasn't prepared for this much of a drop-off. Tips and tricks from any guys that have been down this path before?
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Avatar universal
Hi, OA_T -

Please understand that you are not alone - this is extremely common with almost all guys who undergo prostate cancer surgery. I’m  a prostate cancer survivor, had RALP Jul 31, 2018, so I’m a little over 2 yrs past surgery. I’ve been struggling to get sexual function back ever since, some improvement but not what I had before. The thing you need to do is get blood flowing into the erectile tissues to keep those areas ‘pliable’, otherwise they become sort of hardened & ‘fibrotic’ & then will no longer be able to expand properly.

Hopefully you were instructed on so-called ‘penile rehabilitation’ - this includes frequent stimulation to encourage blood flow, Kegel exercises, use of Viagra, Cialis, etc. to aid in erections, use of a VED (vacuum erection device or ‘penis pump’) and also possibly use of injection therapy.

ED drugs were not working much for me the 1st 6 months, so at about 7 months I started on TriMux injections into the penis, which worked quite well & produced erections within about 10 min or so. I know it sounds awful - sticking a needle into your penis ??!! But it’s not that bad - I won’t say it doesn’t hurt at all, but if done correctly, it’s not bad & the results are worth it. I feel that getting that blood flow into the tissues definitely helped my recovery, altho after about a year, the injections just stopped working. I then went back to low-dose generic Sildenafil (Viagra), and that was working better than before.  I also got a Rx for generic Cialis for daily use, 5 mg (but I take only 1/2 = 2.5 mg). The prblm for me is, the ED Meds cause bad heartburn, usually the next day, so I have to take a pretty low dose that doesn’t produce a very firm erection, altho occasionally I have had erections that were firm enuf for intercourse, even w/ the low dose, so it’s a bit encouraging.

Bottom line - if you haven’t already, please start on a penile rehab program right away - the longer those tissues go without significant blood flow (from erections), the more likely that tissue degenerates. If I had it to do over again, I would’ve started on the injections within 2-3 months after surgery if ED Meds aren’t working, which is true for most guys because the nerves that control erections were damaged (even with nerve-soaring surgery, which I had) & can take up to 2 yrs to heal.

BTW - I’m 69 (67 at time of surgery), trim & in good shape & had excellent erectile function prior, didn’t need any help from ED Meds, so I was assured I had a very good chance to regain most of my function. It hasn’t quite worked out that way - on a very good day I can get to about 80% or maybe 90%, but most days it’s more like 60-70%. Of course, as you know, you no longer ejaculate, so for me, at least, orgasms are not really as satisfying as before.

Good luck to you - hope your journey back to sexual function is a little better than mine has been..
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2 Comments
As always, great advice from Bonzo dog.  
Thx, GR - in this case, I had a whole lot of personal experience to draw on! Also, because of the cancer, surgery & rehab, I found out a lot about all this stuff, did a lot of research online, etc.

BTW - I should have mentioned to OA_T  that there are numerous Prostate Cancer support groups online - most deal with both treatments (for example, side-effects of hormone therapy for guys whose cancer continues to spread after surgery) & recovery of sexual function afterward. Many of the guys have tremendous knowledge from their own research, speaking to Urologists & Oncologists, plus their own experiences. It’s very helpful - lots of good info & also it helps to know many guys are going thru very similar struggles, always helps to know you’re not alone...

Also, look up the website for UsTOO - Prostate Cancer support, they put out a monthly newsletter & have support groups meeting in different locations, often at local hospitals & sometimes monitored by specialists in this disease. - there may be a chapter near you, OA_T...
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