I had a Robotic radical prostatectomy in August of 2012. Over time, there has been shrinkage especially when flacid. Orgasm without ejaculation is definitely different, but for some reason I have a mental picture of ejaculating even though I don't. There is some fluid which comes from the Cowper's gland. Sex for me is not the same but I think that is just my fault. I expect to much and therefore sex is pretty uneventful for me. Any similar experiences out there? Thanks.
I I had my prostatectomy in 2016 and yes sex has not been the same of course and the uneventful orgasm has been replaced with hers. I have had to use injections to achieve an erection and sometimes I simply don't use them and concentrate instead on the charge I get from achieving her orgasm. it is an amazing thing when you forget about your own physical pleasure and just concentrate on hers it quickens my heartbeat and enhances my excitement in ways I would have never experienced have I not they just need to be with went through the removal of my prostate... just a thought ..
This is why prostatectomy (or any other treatment) will be an absolute last resort for me. Were you even told what to expect in the way of genital shrinkage and dry orgasm? Many men are not told, or these life altering consequences are dismissed as minor "side effects." For most men, ejaculation is extremely important, and the vast majority of men want more, not less or no ejaculate. That's why there are all those products out there claiming to increase amount of ejaculate (most of which do not work). Same for genital size. I know you are not alone is the dissatisfaction you are experiencing, despite many in the medical community who obfuscate or minimize the significant impact these consequences can have for the vast majority of men. I, for one, view my genital size and ejaculate, and my current sexual abilities, as very important. I am not married and still have to date.
Before radical surgery it seems worldwide that most folk, me included are not told a thing about side effects and significant changes to sexual function. That said, in many cases surgery does a better job of ridding a body of the cancer, so in the end one has to consider the choice: less sex and less cancer or more sex with cancer not being treated as effectively as could be.
After extensive research, the posts expressed here are the main reasons I went with the HIFU procedure. i still have all my male functions, cancer is in check (or gone) and I have none of the bad side effects. if the cancer comes back, i still have other alternatives. men must be there own best advocate. Don't take the urologist word/recommendation. Research and determine what procedure is best for you. Every man is different and each will have different results.
Actually the urologist assistant at the time told me (in front of my wife) that I could still ejaculate after the surgery. When I researched the procedure, I realized her stupidity and wrote a lengthy letter and brought it in to the urologist and detailed what she had said and emphasized her incompetence. Shrinkage was never mentioned.
I had half my prostate (one lobe) ablated with HIFU in 2018 I too have suffered from reduction in girth and length of penis when flaccid. When erect it seems almost the same size. However gaining an erection takes a long time and maintaining it is shorter time
My libido is virtually non-existent, which worsens the problem. but this and my ED were prior conditions for me My ejeculate is about a tenth. of before. The pleasure is different and reduced.
But i have gained (I hope) longer lifespan albeit under testing and MRI checks.
Like others, this was not emphasised before treatment although I would still have proceeded with HIFU. The main question is how can we improve our situation. Any ideas greatly appreciated.
Hi I went through radical prosectomy using Divinchi Robot method in 2011. I was 56 all i wanted at the time was the cancer gone. I had the talk regarding different options for treatment,possible side effects. Dry orgasms ,incontinence,probably not really listening.. I was quite positive until i suffered all the above. Didnt deal with it well, you dont really know how these effects you as a man until you experience it,marriage really struggled. Contemplated suicide but never quite got the nerve to do it. My advice if sex is a big part of you and your marriage go for the least invasive method and accept the risks regarding further cancer. For some people its no big deal, dont do sex very often, marriage is based on real friendship, you will probably cope with radical treatment. Those reading this site probably very concerned about side effects but options available now are much better. You have to listen to the best advice available but make sure you get as much opinion as possible.
ED issues are rarely if ever brought to a patient's attention before ANY treatment. That said, if your life is lengthened without pain, then you did the right thing by being treated. The toss up for some is longer life but without quality of life.
When first told you have Cancer it is such a shock. For me all I could think about was ok, how do I get rid of it. I was a little preemptive and went down to the hospital and got my results prior to my appointment with my urologist. So I already knew what he was going to tell me. I'm the "trust but verify" type. It's an absolute shame we can't trust the urologist to shoot straight with us. They should be required to tell us what they can do and then disclose ALL the negative side effects. They should also be required to encourage patients to explore all options available (perhaps even handing the patient a list of websites to other options available).
My uro told me my only choice was radical prostatectomy. I had to ask what the side effects were. He only admitted to several of the other side effects when I asked about them. So disappointing! Needless to say I switched to another Urologist.
My HIFU experience is different from that of MikeTango. I retained all sexual function with no physical size drawbacks as he mentioned above. My recovery was difficult but the long-term results so far have been great! My annual MRI results have all been good and last week I had a CT scan with everything all clear. (My results are short-term as I am only 3 1/2 years out from my procedure).
I think it is important to keep in mind that we can have the same procedure and experience different results as each one of us is unique. I think what I want to stress most is the results and minimum bad side effects are directly tied to the experience and skill of the doctor/surgeon.
To anyone who has just been told they have cancer, all I can say is do your own research. Be your own best advacate. Learn ALL your option AND KNOW THE SIDE EFFECTS FOR EACH PROCEDURE. Once you have decided on the procedure that you feel is the lessor evil (and they are all evil) and you feel you can live with the side effects, then find the VERY BEST surgeon you can afford and be willing to travel to get to him. You are dealing with the rest of your life...make your decision count!
I agree with barney34. Removing the cancer was the top priority for me too
Even if I had been more aware of the ED problems and loss of size and sexual capability, I would still have opted for HIFU as it offered less damage to nerves and less likelihood of incontinence and lower risk of affecting sexual performance I still have some ED problems but then I had ED problems before the HIFU so I would not advise against HIFU
I do not have the incontinence issues I might have had with prostate removal and there is still hope I can overcome the ED issues with lifestyle, exercise and ED medications.
I intend investigating the use of a pump. If anyone knows anything about pumps I would be grateful for details.
I agree with Sam230. Nothing about PCa is black and white, it is all grey scale. There are many kinds of PCa, and the virility and extent of PCa is different in every patient, and the treatment options are many, with many kinds of outcomes for each kind of treatment option. So best to do as much investigation as possible before making decisions.
Sorry for the late reply, but I had some family matters to sort out. You ask about the pump. I ordered one online after surgery and radiation. It takes a LOT of dedication to use it say 5x a week. I lost interest and dedication after 2 months. As to ED improving....in my case all I can say is that it improved AFTER my testsosterone improved, that is AFTER I stopped treatment.
That said, even with half decent cialis assisted erections, dry orgasms is hard for anyone men and women to wrap their heads around.
I agree. Dry orgasms are strange but women have always had "dry" orgasms (unless you believe porn sites). After being married 10 years or so with 2 kids, my wife and I decided to go to a sex therapist and one of the things I remember saying to the therapist was that I could not understand a female orgasm because there is no "release". Well, now I know what that feels like. I have learned over time to just enjoy the feeling and try to make that feeling last. But it can never compare to an actual ejaculation.
I agree with ES 28567. When I heard I had prostate cancer I explored the surgical options. After many phone calls with cancer and prostate experts I went to the top professor in London who specializes in HIFU. I paid whatever they asked and did whatever they advised. I went to the top private hospital there and it was very expensive. But I think I’m benefiting from that biggest financial investment of my life (excluding car, house) and marriage
I too experience the same after effects. I have some liquid which resembles the semen before I had my hifu operation. But my libido is greatly reduced although I am still working and experiencing stress at work which may partly explain that. I have limited desire for sex these days although I am 65 years old. Looking back my sexual desires reduced in my 50s. Companionship in my marriage is now, important to me. I have a wife who is 20 years my junior so it concerns me that I cannot fulfill her sexual desires. I am working on this and recognize it as a risk factor to my marriage.
Guys, thanks for sharing about the dry orgasms. I always thought this would be a major drawback. Doctors and stuff i read on prostate removal make it sound like this is no big deal, or even put a positive spin on it. But i think most men know intuitively that this is not a minor "side effect." Most dudes are trying to get more ejaculate, not less, and there are products on the market like Semenex which claim to increase the volume of ejaculate, which guys are buying up hoping that it is true.
it would be nice to know of any natural/herbal supplements or medicines that we can take to increase the volume of ejaculate to avoid or mitigate dry orgasms. I was told after my hifu procedure that half my prostate had been a belated, however I have lost 90% of my ejaculate along with ED problems. It has been 18 months since my hifu procedure and I fear I have not used my sexual capabilities and might lose it. This is perhaps more psychological on my part than physical. But my inability to gain and hold any reaction has caused anxiety on my part to initiate sexual relations with my wife.
Glad to hear you saw a sex therapist. I have not needed one yet, but will see one when required. Being open to all solutions is the key to staying healthy & sane.
I too was not fully informed/educated on what is realistic vs what was in the surgeon's brochure, as it relates to ED and related issues. I was 63 (20 months ago) when I had my nerve sparing prostatectomy. And I was told how high the rate of return to near "normal" was. for this particular surgeon For what it's worth and these are just physiological facts, I rated the max points on the International Index of Erectile Function (IIEF) which is the standard questionnaire almost all doctors use to determine your current level of ED. I just never in my life did not get an erection when needed and never experienced any of the standard ED traits. I was told, oh, you have no worries. Given that you have no current ED issues, you will be one of the lucky ones.
One year and eighteen months later, I can get get enough of an erection to masturbate, but not sufficient to have vaginal penetration, unless I use 50mg of Viagra. Yes, then it is sufficient, but the notion that my pre-prostatectomy "virility" made me a shoe in for being up and at'em afterwards , was at best a terrible setup and at worse, just a bad thing for a medical professional to say prior to life changing surgery.
On the issue of dry orgasm. I have been able to dry orgasm, but not during PIV sex. Not an issue before surgery. To suggest that ejaculate doesn't matter, well for me at least, it's just not true. The loss of the ability to ejaculate is not only a physical impact to the experience, for me, and other men I have heard from, it is a significant psychological two by four to the psyche that I never expected or was informed about. Men ejaculate. Your whole life, your whole sexual experience - ejaculation is inextricably tied to the completion of the act. I never once heard anything from health professionals about recommendations on how to prepare or adjust to this.
Like it or not, even intellectually understanding it, there is a connection to manhood and ejaculation, and there are just too many men who express this distress after prostate surgery to pretend it does not exist, at least is some portion of the male experience. Medical professionals should be aware an helpful in this for patients to be prepared and better informed in decision making.
Do I enjoy what sex has become with my wife? It is a complex question where it used to be very, very simple. The level of enjoyment is now always gauged against the level of challenge that must be dealt with (psycological, emotional, physical) vs the adjusted expectations of the ultimate level of enjoyment.
I am one of those that, If I had a crystal ball and knew exactly before surgery what I know now, would have postponed. I did a great deal of research and took ownership as an informed patient, but I am also convinced that the medical professionals I relied on were not as honest or transparent as they should have been.