Sex after (during?) Brachytherapy

I live in the UK but haven’t found a better website forum than this, at least, not covering prostate cancer.

 

I notice a ‘divide by the common language’ but what seems most different is how many facts, test results, scores and terminology most contributors use, certainly compared with how much detail I have about myself!

 

Leaving that aside, I seek assurance from anyone who has been where I have now reached.

 

My family history includes a lot of PCa, including Dad, now 83. I am 55 and scored Gleason 6 (3+3) Stage 1 with PSA at 7.8 but steadily climbing since I turned 50. I had 60 Iodine 125 seeds implanted just over 6 weeks ago and, after some initial recovery, felt pretty good until week 5. The ‘discomfort’ then increased to ‘pain’ but remained bearable, if helped by taking Ibuprofen and Paracetamol. That pain seems to have subsided this week and I can manage, most of the time, without their help.

 

I take 400micrograms of Tamsulosin hydrochloride each day, I believe, to help me pee. I needed a catheter after the implant procedure so I ensure I take this regularly, believing that its affects include keeping the urethra dilated. However, this medication may be adding to the side-effects of the radiation?

 

After the procedure, and with the catheter, I found I had a dribble of seminal fluid for several days and a not entirely unpleasant sensation in the tip of my penis. That ceased after a week. Another week later the catheter was removed. Since then, I have *********d a few times and it all seemed as before but with a little pain at ejaculation.

 

But, when I made love with my wife a couple of days ago, wearing a condom, my climax was very painful and there was no fluid in the condom. I’m not particularly concerned that it was a ‘dry’ climax but the pain, and its memory, is troubling me.

 

I knew that climaxes would alter but believed Brachy was the best way to retain sexual function. I was also given to expect that symptoms would intensify for 6 weeks, then hold steady for another 6 weeks before tailing off over the following year. So this should be within my ‘expectation’.

 

I have read enough strands on the forum to know that no two men will respond identically and so there is no ‘typical’ path I can expect to follow but, please can anyone suggest for how long the painful climax may continue and what, if anything, I can do to help overcome it, and my fear?

Thanks, RalphV

I did wonder but didn't feel I could explain and ask anyone else.

Some contributors' posts implied they carried on after Brachy without any change to sex life or performance. I was warned about some possible changes; ED, dry climax or reduced ejaculate, even impotence and loss of libido and but not that it might hurt so much I wouldn't feel keen to try again!

Gasmeter,
What Ralph said about iodine 125 is correct. The effects should last about twice as long as P 105. I never had any pain on ejaculation, but a have a very reduced amount of semen. After I had a vasectomy I experienced pain on ejaculation that went away after about 6 months. Doctor said it was scar tissue.
JT

John -- did you have the vasectomy after brachy?

ed

 

I had the vasectomy 30 years ago. No sense in having a vasectomy after treatment because you are sterile.
JohnT

Hi to Gas Meter Man from another UK member. My husband had Brachy on 10 th February (under Prof Langley at St Luke’s in Guildford) so he is a few weeks ahead of you time wise. Sorry to hear about the pain you are experiencing.   My husband hasn’t experienced any pain but I too have read it can happen.   Do agree with Tudpock 18 though “ keep on doin' it!” and h opefully it will pass soon. Hubbie is also on Tamsulosin daily to reduce the swelling in the prostate and help with the urinary symptoms.   So far as general recovery goes, we are now at the end of week 10 following implant and all is good.   He did have a slight peak in his urinary symptoms around week 5, lessened off around weeks 6 and 7 so we thought that was it – then had another peak around week 8.   Suppose it isn’t an exact science as to who will get what and when.   The past two weeks he has noticed an improvement and is now only getting up once most nights to pee, occasionally twice.   Fingers crossed he will soon be back to his pre-implant zero times getting up in the night, except after a heavy night on the beer of course! His ejaculate varies from 50% less to just almost zero at the moment but our understanding is that the Tamsulosin does also reduce the ejaculate so possibly it will increase again once he is off the medication? Wishing you a full and speedy recovery and please pass on a huge hug to your wife from me also – for the wives/partners/lovers, our journey is a different one from yours but most certainly no less painful. x Age 62 Excellent health First PSA test 7 Second PSA two months later 11 Biopsy results: Gleason 3+3 in two cores (right medial 30% and right apex 90%) PSA11 with small benign-feeling prostate 10 Feb 2011 – Brachytherapy – Iodine 125

Hi Gasmeter -

Earlier you said "felt pretty good until week 5. The ‘discomfort’ then increased to ‘pain’ but remained bearable, if helped by taking Ibuprofen and Paracetamol."

Could you explain where that discomfort/pain is? I assume you're not talking about the painful orgasm.

I had seed implant on Feb 1, 2011. Have had a "sore" feeling in the lower abdomen ever since that date. Not a horrible pain, but feels like someone kicked me in the lower abdomen.

Just wondered if that's what you're talking about, or if your discomfort/pain is something and/or somewhere else.

Thanks.
Tom in Connecticut

Thank you to everyone for their replies and encouragement.

A couple of responces asked about the pain in week 5. I had/have felt a burning sensation in my lower gut, above my groin, possiby psychogical but conspicous at night and it kept me awake after getting up to pee. Someone suggested ' a bit like having been kicked in the groin' and I'd say; yes, but much less so.

That became more acute and took about 10 days to pass.

I'm now in the 7th week and hardly need painkillers, either at night or during the day.

The pain at ejaculation has, I suspect, had a big deterrent effect upon me and I've had no desire to try, alone or with my wife and, for other reasons, she has shown no interest either.

Perhaps my libido is also down as I don't feel frustrated, so I'll wait and see what happens, try to relax and not to worry.

Hello, especially to any previous respondants!

It's now a little over five months since the implant procedure and, for anyone interested, I still think I can feel a burning sensation in my lower gut/groin area but only occaisionally and haven't needed any painkillers for weeks.

I had a PSA test a mont ago ~ 2.1.

The theme of your previous, collective wisdom was for me to be patient and that's proved correct. My libido has returned, if a little less than before, and I now climax without pain. I do ejaculate but not very much.

I tried managing without the Tamsulosin but, after three days found difficulty peeing and emptying, so resumed, taking it about lunctime after eating.

Generally, I now wake only once a night to pee but that can be around 04:00 and I don't return to sleep so easily. This leaves me with a permanent underlying tiredness but that is about the only symptom of anything connected with the treatment.

My clinic doesn't want to see me again until January.

Best wishes to all,

Gasmeter

Hi Gasmeter. Earlier you wrote "It's now a little over five months since the implant procedure and, for anyone interested, I still think I can feel a burning sensation in my lower gut/groin area but only occaisionally and haven't needed any painkillers for weeks."

I have a similar feeling in my lower abdomen, 24/7. Not pain, but still feels like someone kicked me a few weeks ago, or a tugging on the pubic hair, and I'm "sore". Doesn't hurt to push or press, but still feels "sore" all the time.

Did you ever learn what caused that? My own doctor says it's just a result of the radiation. But I'm surprised I still have it six months after the seed implant.

Wondered what you've heard from your own doctor about the cause.

Thanks.
Tom in CT

I've had a similar experience. I'm 47, only had a 4.2 psa, but a 4 + 3 Gleason and cancer is all 6 samples. Did 7 months of Lupron starting May of 2012, had 25 treatments of external beam radiation in June and July 2011 and brachytherapy in September 2011. My post-op stuff sounds the same as yours. I would let you know that my experience with the painful ejaculation was limited to the first one. There was some brown blood as well. Since then, even though the ejacs feels the same as they ever did, they are dry! I'm hoping this will subside as the prostate is less irritated over time as the seeds settle down. This Lupron is a ***** though, the weight gain and hot flashes are the worst part of this whole experience.

Bronco B

It's now 21 month's since my implants and I've been happily getting on with my life. Sure enough, after an initial period of painful ejaculations (yes I persevered) it did get better! When I say better, I mean pain free, and nice feelings but very little fluid and no longer the climaxes I recall.

I took tamsulosin daily until last Christmas (9 months) as, each time I tried stopping I developed difficutly peeing. I decided to make more effort to wean myself off while away from work and succeeded then.

My latest PSA score was 1.5 in July and the Clinic doesn't want to see me for 12 moinths, which rather suggests things are going well enough.

I still have a sex drive, and ability, but I do feel climax is no longer as nice as it was before treatment. But what would I rather have?

Best wishes,

Gas Meter

powellst said...
Gas Meter,

Not to hijack the thread, but your email address was not available in your profile. Can you explain how you weaned yourself off of the Tamsulosin ? I've been on it for about 12 months, starting a couple of weeks before my BT in Jan 2012, and every time I've tried to stop taking it, I start having urinary problems....such as weak, slow stream and urgency. I would love to be able to be rid of it, one less medicine to take.



thanks



Bob

PowellST

Are you guys referring to the burning sensation when trying to urinate?