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Posted 1/3/2009 4:42 AM (GMT 0)

Hi,

I'm new to the Forum.  Had DaVinci RP 10/08 and have recovered to an amazing degree, considering the bad shape a guy is in immediately post-surgery.  I have questions about the return of sexual function.  I read several recent discussions among Forum members and can see that erections DO return with the passage of time if post-RP victims diligently try to bring them back with drugs and use of the pump.  But WHAT comes back?  It appears that erections are attainable, but are they complete with orgasmic function or are they sort of in name only?  Sex apparently gradually becomes possible again in some survivors, but is there any kind of sensory satisfaction for the man or only for his partner?  What body parts are involved in male orgasm?  Just the prostate, which is gone after RP, or are other parts also part of the pleasurable contractions?  I'm uncommitted to the rehab process (and its costs!) if erections are the only positive outcomes. 

Thanks for any available insights.   

Posted 1/3/2009 5:14 AM (GMT 0)

    Jet,  Sorry to welcome you to the HW Club.  As you have read, you will see there are varied results when it comes to recovery from this disease and the treatment options.  In my case I was left with good nerves on one side.  I can not remember when I achieved my first medicated and non-medicated erections.  I can say that my erections take much more work to achieve and maintain. even with Viagra, than before.  As far as quality I would say most of them are about 90% of what they were before.  But there have been disapointments too.  For what ever reason, even with medication I have been left flat at the desired moment!  Some of this could be due to eating too much of the wrong kind of food too close to the time to use the Viagra.  I would recomend reading all the fine print in the instructions that come with the medication.  As far as the orgasam experience mine have been GREAT.  They seem to be stronger, longer, and more intense then before.  Now that I have the AUS urinary device installed I do not "squirt" any urine during climax.  Over all I really do not miss the messy clean up.  I know everyone's experience will be different but this has been mine.

    WIsh you well,  KW

Posted 1/3/2009 5:43 AM (GMT 0)
WOW! Thanks for the info! I am really surprised at the return of sensation! This is very good news. Guess the effort is worth the reward.

Thanks again for your response to my inquiry!
Posted 1/3/2009 12:18 PM (GMT 0)
JET123,
You will find that the nerves controlling erection and those involved in orgasm are completely different. It is not necessary to have an erection in order to orgasm (although admittedly it is a little harder work). Many here (including myself) find that the orgasm is more intense and longer lasting, although I have found that if I make any sort of a "kegal' squeeze during climax, it seems to diminish the intensity. The dry orgasm, I must admit does take a little getting used to though. Once you are erect by drug or pump the action is much the same although more "work" is required to achieve the end result.
Bill
Posted 1/3/2009 3:05 PM (GMT 0)

Jet123- I have been able to obtain an erection but my orgasms pretty much suck.  Regardless of the orgasm, I strongly encourage you to commit to recovering function.  There are benefits to being able to have an erection which have nothing to do with my ability to have an orgasm. 

Posted 1/3/2009 3:14 PM (GMT 0)

Dear Jet,

I am exactly 11 months post-op. all the hard work with the pump, Viagra, and injections is starting to pay off.  I am getting 75% erections with Viagra. 100% with the Bi-mix. I strongly recommend the rehab that I have described as others here on the forum who have noticed improvement will agree.  I had nerve sparing surgery. There are some guys with non-nerve sparing here also who do well with the injections.  My orgasms are stronger and longer since the surgery.  In my case all these things have helped.  Be patient.  These things take time. Good Luck.

Posted 1/3/2009 3:16 PM (GMT 0)
Jet123, Welcome to the club. We just recently had a good overall discussion on male function as related to erections and orgasms. Here's a link to start reading about how your penis, erections, and orgasms happen. I thought I had bookmarked the whole thread where we went into more detail about it, but will have to hunt for it, but don't have time this morning.

www.caitlainscorner.com/content/view/155/59/
Read thru the different sections of this site, its one of the best layman's versions available.

I will say, in my case, that orgasms do occur, and have occurred since a week after catheter removal. Each one has become more pleasureable and intense, in a progression, and now are really outstanding. One thing we joke about here is m-sterbation is accepted, and even encouraged here, by our doctors and by our fellows as a part of penile and nerve rehab. Do it often----as often as you can is good. You are retraining your nerves, as well as your brain to how the new impulses go, and it takes time for them to sort it out and start working well again. Most start with a vibrator or manual stimulation- solo or with your partner if available. Doing this, in conjunction with penis pumps and ed pills will go a long way in restarting your erection and orgasm ability.
Posted 1/3/2009 3:39 PM (GMT 0)
Found it: Here's the link to the thread I mentioned:

www.healingwell.com/community/default.aspx?f=35&m=1327742
Posted 1/3/2009 6:52 PM (GMT 0)
Hmm, I think I'm going crazy. Last night I thought I read a topic about "how soon after surgery is it safe to resume sexual activity". A topic I'd like to know more about myself. There weren't many replies at the time. Today I can't find it---unless it's this one, and my memory is just not so great?
Posted 1/3/2009 8:14 PM (GMT 0)
DJ, that sounded familiar to me also, but going back until the 25th, I couldn't find anything specific. If it is somewhere other than here, it is probably buried deep in some other subject thread. I do know that this is a repeating subject that sorta cycles thru regularly. The answer is always "when your doctor allows you to". Sex being intercourse, not orgasms from vibrators or hand. I get the feeling that most guys just gotta know and does bring themselves to orgasm within a week or two from catheter removal, either by vibrator, hand, or partner. Not that it is recommended then, but it seems lots of guys do try then, to see what the new feeling are like. Full intercourse is usually a longer time, as more stress is place on the bladder incisions and stitching. In my case, it was 6 weeks before the doc told me to resume full sexual activity.
Posted 1/3/2009 10:34 PM (GMT 0)
James, just reading your post above. Not judging anyone here, every man is a different case here, but to me, it seems like some really try to rush to the sex part, perhaps it's like you said, they want to see what the feeling is like or to assure themself that there is hope (?). Or perhaps I am the odd man out here, after 7 weeks, there's no part of me that even wants to think about sexual things, that may because of my never ending catheter problems, I admit. I would love to spend some "quality" time with my wife, but seems like everytime we gave it serious thought, be right back to a cath problem. Guess I am afraid if I got aroused with the catheter in, but then with a non-nerve sparing operation, probaly wishful thinking on my part. When I see my doctor at 3 months mark for the first PSA, he said he would spend some time on the ED part. Please don't get me wrong here, everybody must do what they feel they should and what they need. This whole PC has turned my life upside down, and left me unsure of lots of things in life, that I never felt that way before. Having good sex, whenever I had a need, was always an assumed thing, it was always there, and I could always perform without a problem. Knowing this might or would all change after my operation was theory before the fact, now that it is reality, it is a bit scary, because no matter what I want or think, it will never, ever be the same as before. Part of me can handle that, and part of me can't.

David in SC
Posted 1/3/2009 11:55 PM (GMT 0)
James, thanks, I guess that's the answer.

David, I know what you mean about things might never be the same. This was also true for a previous cataract surgery, and I have the impression that you had some prior experiences that were similar. But it just keeps going on. I don't have an answer, only sympathy.
Posted 1/4/2009 6:30 AM (GMT 0)
Thanks to everyone for the responses to my questions. The information gleaned from the experiences of Forum participants has been (and will continue to be) extremely enlightening and helpful.

JET123
Posted 1/4/2009 2:09 PM (GMT 0)
David, yes, I was talking about the guys who have an 'uneventful' recovery and are ready to think about it fairly quickly after surgery. Yours being an "eventful" recovery, I realize that sex now is the fartherest thing in your mind. confused That's one thing about the human spirit, it does recover from some major blows pretty quickly and last weeks horrors fade. Sex drive is a powerful thing for most of us, and we all have some fear that things may be changed and want to find out as soon as possible if it is so. As you get off the cathter and recover a little, I bet the same curiousity strikes you... tongue
Posted 1/4/2009 2:42 PM (GMT 0)
James, the curiousity is there, but by sheer mind power, I just have to keep putting it out of my mind, BTW, and I will take any opinion on this, did anyone have errections or partial errections while on a catheter, and if so, did it cause any pain or problems? I really don't know, and that is part of my fear of the unknown. Thanks for your response.

David in SC
Posted 1/4/2009 7:30 PM (GMT 0)
I my opinion, too many guys try to rush back to the sexal function. I really think taking time to heal is the most important thing in the first few weeks. As Always, talk to your Doctor. He knows what went on inside you better than anyone.
Good Luck, KW
Posted 1/4/2009 7:55 PM (GMT 0)
Let me start by saying that I am one lucky guy, that what I am experiencing does not apply to everybody, and that I am replying to "How long before big 'O'" and ED timeline as well.

First of all, even while wearing catheter I experienced some nocturnal erections (question from David in SC) which I knew about because they woke me up because of the catheter. Not painful, but I was laying very still and not manipulating anything.

Had my catheter removed, and the nurse practitioner told me that sex could resume whenever I felt like it. There was no medical contraindication (PLEASE check with your own physician, but do not hesitate to do just that. Ask. Directly.). He put me on daily dose Cialis (5 mg, I used 20 mg Cialis regularly in my pre-op sex life). I asked about vacuum pumps, but he said they normally don't initiate that unless there has been no progress by 3 months.

I am one of the incredibly lucky ones. I was dry immediately after my catheter was removed. The robotic procedure WAS minimally intrusive, and other than some slight soreness around the wasteline, and a hard lump the size of a lemon under my bellybutton where they made a small incision to haul out my oversized payload, I feel pretty good. Put in an appearance at the office on Day 11, after New Years.

As far as sex, last night (Day 12) experienced my first orgasm. A BJ w/o the mustard, 50% erect. It felt very similar to pre-op, but I still have to explore this sensation. I did notice that my 'card deck' got all scrambled and confused. What is the purpose of what I am doing if it is not to deliver the all important payload? Powered past it, but it was external rather than internal and I know I have work to do to reprogram my mind if I want to seek this out instead of passively receive. It WILL be different, but so far, like I said, I am one hell of a lucky guy.
Posted 1/5/2009 12:57 AM (GMT 0)
James C.,

 You ststed that ********** to climax is advised to help the healing process during penile rehab.  Do you have any medical resources that recommend this activity that I could read up on?

Thank you,

Geon

Posted 1/5/2009 1:40 AM (GMT 0)
There have been a number of references to treatment with Viargra, Cialis, Bi-Mix injections, alprostadil inserts, etc. My insurance company has refused to support any and all requests for covering these expenses (including the vacumn apparatus) even though I have informed them that this all is related to prostate CA. What have your experiences been? If your treatments are covered, how did you convince them that these treatments were medically necessary?
Posted 1/5/2009 3:38 AM (GMT 0)
geon, my urologist told me that, and I have heard it repeated here many times. I'll look around and see if I can find anything concrete. I tmay bo one of those things we all know is true, but noone can prove it with documentary evidence....lol

Jet123, my insurance (Blue Cross/Blue Shield Tenn. IPO) covers the pump and Caverject in its several forms. They do not cover Bimix or Trimix. They do not cover any ED pills, such as Viagra, etc. If not for alldaychemists, my goose would be cooked, in a manner of speaking smilewinkgrin
Posted 1/5/2009 6:47 PM (GMT 0)
geon, look at the last paragraph of this link, actually, the whole thing contains good info. He is talking about use it or lose it.

www.cpcn.org/arch_0069_penile.htm
Posted 1/5/2009 6:54 PM (GMT 0)

James C.

Thank you for the reference.  Much appreciated.

Geon

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