Sugery in 5 days prostatectomy robotic

Have my surgery in 5 days. any advice?
Men I hate to ask because this not as important as surviving.
But Can someone explain what sex will be like after ?
I was too embarassed to ask the nurse during the pre surgery class.

Thanks !

  You are asking a great question, and an important question…but unfortunately it is one that is difficult to answer for any individual because the results/outcomes are so extremely variable.   There absolutely are before/after differences.   Some men make a quick recovery to at least being able to achieve penetration; other men recover after months; others resort to medications (pills, insertables, injections); while a small percentage of others finally resort to a subsequent surgery to install inflation devices…and probably none of these men ever believed that they would have such significant post-surgery problems in advance of their prostatectomy.   I cannot overlook the disappointment I feel to hear that your surgeon did not raise this issue with you, a young man with a very small amount of PC (one core of 3+3; referenced HERE ), in advance of agreeing to perform surgery.  A man submitting to an RP should be fully informed/educated about the side effects.      

Hi clocknut...

I've added, as an edit above, a link to Jalvarado's first posting which includes his case info.

 

Jalvarado,

Nobody can answer your question for sure because ever man's reaction is a little different. But here are a few things that are fairly typical for a guy your age:

For the first week or so you will have a catheter. It will bug you enough that you won't even think about sex.

When the catheter comes out you will probably be incontinent for a while. There are guys who are dry right from the start (and you may be one of them, young guys do better) but more likely you will leak pretty good for a month or two. Most guys are surprised how much this puts them off sexually. You probably think now that you will be worrying about your erections but you will find that incontinence sort of trumps impotence.

And, anyway, your doctor won't want you to try anything for the first couple of weeks -- to give things a chance to heal before you try out your new plumbing with intent. How long before he gives the OK depends on the surgeon.

You will probably notice that, even if the surgeon was able to "spare" all your nerves that you will have trouble getting or maintaining an erection after the surgery. Usually this starts right away, lasts four to six months and then goes away gradually over the course of a year or two. Sometimes the problem doesn't appear until a month or two after surgery -- the nerves get stretched and bruised and they can get worse before they get better. But usually they do get better... eventually. If you are lucky you should be back *almost* to where you started after two years. In the meantime you may need to use pills like Viagra or Cialis to have sex (and your doctor will probably prescribe them for you anyway to keep the 'tissues' healthy.) If the pills don't work then he may prescribe injections you can give yourself to get it up. (Doesn't sound that great but it's not so bad. I do it three times a week.)

After your surgery you will never ejaculate semen again. It just won't happen. (But you will climax and it will be pleasurable.) Some guys do squirt a bit of urine when they climax. Don't let it freak you out if it happens. It usually gets better.

It's probably safe to say that your sensations during orgasm will be different. Beyond that it gets vague. Mine are less intense (kind of feathery) but longer lasting and tend to get the job done although I miss the stronger sensation. Other guys claim theirs are more intense.

Good luck.

Jalvarado: I will be honest and tell you that much of what sex will be like is dependent on your age, your pre-surgery abiltiy to get erections, the skill of your surgeon, the amount of cancer that is encountered, and some luck, in my opinion. With a Gleason 6, usually the surgeon can attempt to spare both nerves, so that certainly gives you a good chance of having quality sex again.

Just some thoughts...
1. The abiltiy to have erections that are capable of penetration may take months or up to up to 2 years.
2. Even without an erection, you will probably be able to climax.
3. If things don't turn out well for you, there are always pills and injections. As my ED specialist stated: "We certainly have ways to get you an erection".
4. You MUST be proactive and push your doctor (not the nurse) to get you on a program that may include, Cialis, a vacumm erection device, and injections if things don't respond.
5. You generally will have to resolve urinary continence before ED resolves.
6. Most importantly, your sex life can come back fully and ultimately without any pills, injections or devices.
7. You should not get discouraged if you don't see results that are "fast enough" and your improvements may not be uniform but may come in "jumps".
8. You may require more stimulation to get an erection and often "mentally initiation" is not quite enough.
9. Surprisingly, your climax may be stronger and last longer, although no semen is produced.
10. In my case and many more guys on this forum, our sex lives are basically very similar to presurgery levels. And we are very happy.

Good luck,

Bill K. from NJ

At the recommendation of several others around here, I am reading through John Mulhall's "Saving Your Sex Life" book that was written specifically for guys with PC. Wish I had read it two years ago..even before surgery. There are things you can do to help with your erections and sexual function and it is important to start early.

Here is a link for the Kindle edition on Amazon. Well worth the eight bucks for download. Also available in paperback.

www.amazon.com/Saving-Guide-Prostate-Cancer-ebook/dp/B005AO8UIU/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1373580797

..

Jalvarado you're signature did show up in your last post, so it looks like you've got it!

And by the way, I find the comments made by your first Uro to be very disappointing as that is simply not substantiated, glad to hear you went to a second Uro and an Oncologist. . .

Back to your signature, if you could also add more information such as Stage (for example T1C), % involvement of the two positive cores, NO / MO, PNI present and so on - it would help us understand where you're at.

I will throw in my two cents.  I had stats similar to you and came out with negative margins.  Continence was nea complete for me at 4-5 months and it still gets better daily.  I know almost feel "normal" in that area.  ED has been much more challenging.  Despite being young and having nerve sparing -I had almost NOTHING for eight months.  At that point I started getting morning fullness.  At 15 months I can get half erection with my wife but not enough for penetration. With self stimulation I can get 80%.  When I get half I inject Caverject at the bedside and the whole event feels more normal.  I had a lot of trouble dealing with this but I see myself moving towards normalization by year two.  I must say the the quick recovery in the first year that you hear about is NOT the norm.  Get ready for a long haul.  I am not a radiation expert but at your age surgery probably is the better move in my opinion.  From my standpoint I look at everyday as a chance to get better whereas radiation ED is late.  You would be waiting for worsening while I am now expecting improvement.  At your age AS was not  realistic option.  Good luck - everyone here had the same bad card dealt to them.  There is a downside to every treatment.BW, orgasms are the same and I don't miss ejaculating and either does my wife.