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Blog: 8 Reasons Why Sexual Desire Is Reduced After Prostate Surgery

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Posted 8/5/2017 10:52 AM (GMT 0)
Urologists seem to downplay surgery's side effects. Men diagnosed with low risk prostate cancer need to be informed more effectively about the likely life-changing impact of this surgery.

From the blog's author:
After successful double nerve sparing prostate surgery, I spent four long and frustrating years struggling with erectile dysfunction.

During that time I discovered eight reasons why men withdraw from sex after prostate surgery, and the six sexual triggers men lose coping with ED, which fuels their shame, embarrassment, frustration, and anger. You can read my blog about this at the following link

8 Reasons Why Sexual Desire Is Reduced After Prostate Surgery
Posted 8/5/2017 11:57 AM (GMT 0)
Redwing57,
Thanks for the post , I can totally relate to it .
cmetalman
Posted 8/5/2017 12:38 PM (GMT 0)
Interesting post - thank you. I had a pretty successful surgery in most respects with no incontinence and no significant ED issues but I must say that my desire is not what it was. It's a complicated issue as testosterone drops with age and even men who have never had surgery often experience less desire. I have a friend who is my age, who has never had cancer, whose wife confided that he has basically lost total interest. The best thing that I've found for desire is a good night's sleep but that is not always easy to accomplish when you are working.
Posted 8/5/2017 12:47 PM (GMT 0)
Thanks Redwing -

Wilderness
Posted 8/5/2017 1:14 PM (GMT 0)
To me, it sounds like an ad for penile implants....

"Portions of this blog were taken from the award-winning book my wife and I wrote titled, “Everything You Never Wanted to Know about Erectile Dysfunction and Penile Implants.”
Posted 8/5/2017 3:08 PM (GMT 0)
I could take issue with some of his statements, particularly his use of "all" and "most". Not all men have significant issues, and the published stats are all over the place as to whether even "most" is appropriate.

I do agree with his premise that relatively few doctors even bring it up with patients before treatment, and that there really aren't a lot of resources out there to help people deal with it.
Posted 8/5/2017 3:32 PM (GMT 0)
When you think about it, it's astonishing how much surgeons fail to tell you about prostatectomy. A lot of this comes as a complete surprise to most men.

I understand why doctors don't want to give their patients reasons to avoid needed treatment, but that has to be better balanced with full disclosure about the effects of treatment. The medical community needs to do better.
Posted 8/5/2017 3:53 PM (GMT 0)
it was a double whammy for me (no that's not a fast food burger). I was breaking up with my g/f of 7 years when I had my operation.

it was never lost on me that my sex life would never be the same....they didn't have to go into a long counseling session with me about that. Had they tried....it's not something I'd wanted to hear. No point in listening to the obvious. I really didn't care to talk about it.

Is it that men really don't know (i mean, are they so lost they don't know it's a sex organ that's got cancer in it?)....or is it they know and don't like it...
Posted 8/5/2017 4:04 PM (GMT 0)
some men never recover from it. i think they know going in....

the women know too.... it's just the difference between knowing in the abstract....and living the reality. Women check in here just as frustrated.....




and no Jazzman....i'm not pickin' on you (even though it may appear so....nice comeback in the other one btw). it's the whole thread. It's not the big secret....or conspiracy by doctors....that i think some think it is. one man's opinion.....
Posted 8/5/2017 7:21 PM (GMT 0)
Maybe doctors have changed since I had my surgery ..... my doctor informed me of the possible SE's.

And, if he hadn't, my reading sure as heck did. It is really hard for me to accept the idea that guys would agree to any kind of elective treatment with out looking into the possible side effects.

Island Time ..... I agree with your thoughts on "conspiracy by doctors". Someone's pushing an agenda.
Posted 8/5/2017 7:35 PM (GMT 0)
There is a certain level of denial in all of this. To think that we could mess with an essential part of our reproductive/urinary anatomy without ill effects is a stretch. Now, the reality is that the average person's ignorance of basic anatomy and body functions knows no bounds. Most men don't know what their prostate is or what it does. And, truth be told, most men don't want lots of information from their doctors, at least not till something doesn't work. The doctors are only giving us what most of us want. Those of us who want more are rare.
Posted 8/5/2017 9:59 PM (GMT 0)
I was very fortunate that my doctor talked about all of those with me. He shared that to many men the lack of semen being ejaculated was the toughest part. I count myself as one of the lucky ones as my orgasms are actually more intense since surgery, just nothing there. I do think that those that are considering surgery need to know what expected outcomes can be. My biggest side effect of surgery has been that I never feel like my bladder is ever empty and feel the urge to urinate often.

Thanks for posting.
Posted 8/5/2017 10:19 PM (GMT 0)
YES! #7 was finally mentioned, even though my urologist said that the penis doesn't shorten after surgery.
Posted 8/5/2017 11:00 PM (GMT 0)
I fully understand that most urologists downplay the many side effects of treatment, and I suspect many of them don't know or really care about them. It's off to the next surgery.

However, I also detect some bitterness and over statements by the subject blogger. To wit:

<<<After surgery, men lose their capacity to respond with an erection to each and every one these six triggers. There is a powerful emotional reaction to this loss.>>>

Just not true or accurate for many of us, including me.
Posted 8/6/2017 1:41 AM (GMT 0)
garyi: exactly. The implication is that this applies to ALL men who have RP (or HT or Radiation, not specified), which simply isn't a true statement.

The reality is twofold:

One is that whether we like it or not, PC and it's treatment does lead to both physical and psychological issues for us. In that sense, while I would never draw a parallel, it's not that different from the ravages that women with breast or uterine/cervical cancer face. The loss of those parts of the body that define us as male or female has a definite impact on our sense of self. That those parts that are so important to our sense of personhood have turned against us.

Second is, that we all start from "what do I need to do to kill this monster inside me?". It's only after that question is answered, that we can move to the SE questions. Survival is always the first priority. And, unfortunately, some of the time the treatment leads to awful SE's.

And then, I think back to what the treatment used to be. Survival after treatment was frequently measured in weeks or months, never mind long term side effects. And how far we've come.
Posted 8/6/2017 2:14 AM (GMT 0)
I agree with Halbert that the bloggers use of the words all and most, imply generalizations that in today's world, are not quite accurate. Sure, lots of guys end up with reduced sexual function after surgery. But a fair amount do not.

And my DR was forthright with me before surgery, telling me that while his experience was that 80% of his patients are able to achieve erection good enough for penetration, my chances were 65%, due to the location if the tumor. I turned out to be lucky, but I was prepared for the worst.

I did experience a lot of what the blogger talks about, aside from the sexual aspect, especially post surgery depression.

I'm probably naive, but I can't imagine a surgeon not wanting to educate men pre surgery, about what might not turn out to be an ideal situation.
Posted 8/6/2017 3:20 AM (GMT 0)
I don't find the article all that biased....as biases go....nor really...all that bitter. I think they did a fairly good job of letting men know that anything can be overcome....we have guys on here that have that same outlook, dedication and perseverance. They're attitudes are inspiring, hopeful and contagious.

It's my belief that most surgeons (my dislike of doctors in general notwithstanding) are human enough that given a choice between curing a patient with no side effects or curing a patient with SE's....they'd choose the former. I can't believe any human being wishes that kind of harm on another...and if they seem "uncaring"....it's my belief that a certain amount of that is a pre-requisite to being able to do a job...unpleasant as it may be....day in and day out.


@Halbert.....I always like your posts. They come from the heart....and are almost always "others-oriented". (You're also very smart smile) that doesn't mean we can't disagree from time to time....and your above post I agree with...mostly. It's clever the way you said parallels cannot be drawn between female sex organ treatments and male sex organ treatments......then do so by saying "they're not that different" psychologically and sense of self wise. And they may not be. *Physiologically* speaking...there is no comparison. They *are* different...in one vs. the other's physiological ability to perform the sex act.

The reason I bring this up? It's an analogy I've heard before. It just seems to draw an anology between 2 different things in order to downplay what's at the core of what can happen to a man undergoing prostate cancer treatment. It's an analogy...that can make a man feel responsible.....for something that he, truly...has zero biological control over.

that may be what you were even saying....just not as tactless as I say it. I've just never liked that analogy...because it is a false analogy.
Posted 8/6/2017 4:03 AM (GMT 0)
I wanted to know in minute detail about my surgery and the after effects but the surgeon basically
said if there were any ED side effects they could be dealt with without too many issues.
He essentially pooh poohed my worries so I thought things would be fine especially with having a nerve sparing procedure. They are not fine and 7 years later it is the most frustrating part of my life.

I'm no fighting man but I am from the tough part of a tough city and a large portion of me still wants to beat the crap out of my surgeon. Of course I never would but that's the one of the feelings the experience has left me with.
Posted 8/6/2017 4:13 AM (GMT 0)
Kind of funny. When I woke up after surgery, with my wife at my side, I asked 2 things: "Did the doc say he saw anything unexpected ("no, but we have to wait for the pathology report")," and "WAS HE ABLE TO SPARE MY NERVES?!?!" Yes.....!

THANK GOD!!!!!

Things aren't perfect, by any means. But workable. When I mentioned a few month ago that I get tired of the dribbles (mostly 'stress-related' and not that big of a deal) she said "I'd rather have you and dribbly, than not have you at all."

I guess I have to keep her. I can't even imagine the stress of a new relationship and being expected to 'perform' after all this, lol!
Posted 8/6/2017 12:27 PM (GMT 0)
IT,

thanks for the kind thoughts. The idea that I was attempting to express falls in the category of, I don't know, different societal views. There are endless articles and interviews and blogs and who knows what else that talk about women and their primary cancers, and how they effect their self image and sexuality and so on.

And darned few about men and PC.

Yes, I get the fundamental physiological difference between men and women (and celebrate it), but this blog was mostly about the psychological effects. At least that's how I took it.
Posted 8/6/2017 12:46 PM (GMT 0)

Mr. Redner said...
After four years of failure with pills, pumps, and injections, I decided to have penile implant surgery. That decision gave me back what cancer took away.

Hmmm. This part is slightly hyperbolic, too. I'd let it pass but since it follows so closely upon his "six triggers" discussion it does stand out. He identifies the loss of a reaction to six things that used to trigger an erection as a big part of his distress about his post-surgical sex life. Then he says that his prosthesis gives everything back. I have a prosthesis. It works well enough. I am happy with it. But I still grieve a bit for my inability to respond to his six triggers. There is no sight, no sound or smell that will get me hard. Words and fantasies still don't work and the only touch that works is a slightly ungainly two-handed self-manipulation that takes about two minutes and isn't particularly sexy.

The prosthesis restores much of what prostate surgery took away, but the part he singles out -- his six triggers -- remains lost.
Posted 8/6/2017 1:39 PM (GMT 0)
First a great discussion has been started by this post so thank you. The removal of a man's sexual existence seems like one of the worst things that could happen to a man. That's not some caveman response but it is much deeper then probably anyone of us really completely understands. It's understood that many lives have been saved on the physical level through surgery but how many have been destroyed on the emotional level? Of course that is a taboo subject "emotions" because men are not really allowed to have them. Sometimes I wonder if somehow the world scoff's at men who lose their sexual prowess. Almost like "good serves you right".How many demeaning jokes and cuts have you heard about impotence over your life time? How degrading a thing to have happen to a man to be "impotent". Trying to approach this subject on a logical level is difficult, perhaps that is why the surgeons avoid it in any depth. The logical thought is the cancer must be removed, but the devastation left behind is far to impossible to fully comprehend so best left alone. This is like being told you have brain cancer, which can be removed, but it is going to leave you blind. The medical world needs to find a way to get rid of the cancer without destroying the man's life. That is their challenge. I'm sure there is a counter world struggling to keep the surgery factory alive and well because right now it is the best answer to the fear of the cancer spreading that permeates a man's mind more than the fear of impotency. This whole prostate thing is truly a monster for men and there families to deal with, because it is a subject that can't really be discussed and brought into the open. It's a secret that can only be shared with the closest of the closest in your life. Terrible situation for a man to be placed into and very little attention is being placed on it. The subject doesn't yield profit to deal with the aftermath of a secret subject
Posted 8/6/2017 5:54 PM (GMT 0)
bigal, you're on my page, I think. This is why this forum is so valuable, as well as the relatively rare PC only discussion groups that exist. These are things that really only we can talk about with others who are in it.

Another bit of this thread that is sometimes difficult for me, and I suspect for other men like me is this: It's not hard to feel more than a little guilty for having had an excellent post-surgical outcome. I had a spontaneous night time erection 3-4 days after the catheter came out, and had full sexual functioning by week 4 after surgery, and I've never looked back. Yes, I take 2.5 mg cialis daily--and I may not need it. When I hear the contrary stories I sometimes feel the need to shut up about my good results because I don't want to sound like I'm bragging. I'm well aware that the outcome could have been misery--and no one really seems to know why that happens.

It may be that surgery will become the treatment of exception, not of choice in the future, and it is likely that better diagnostic tools will be developed that really do address the 'when do we treat' question in an honest way.

Even so, the psychological situation will continue. Whether or not a man develops ED after treatment is secondary, really. It is reality that PC, even the diagnosis, strikes us men in our heart of our identity, of our souls. There was no mistake many years ago when (some of you may remember) the Reader's Digest in their series of articles that started with "I am Joe's Heart", titled the one about the prostate "I am Joe's Man Gland". Having PC changes how we look at ourselves in fundamental ways.
Posted 8/6/2017 7:30 PM (GMT 0)

cmetalman said...
Redwing57,
Thanks for the post , I can totally relate to it .
cmetalman

Same here.
Posted 8/6/2017 7:49 PM (GMT 0)

island time said...
it was a double whammy for me (no that's not a fast food burger). I was breaking up with my g/f of 7 years when I had my operation.

it was never lost on me that my sex life would never be the same....they didn't have to go into a long counseling session with me about that. Had they tried....it's not something I'd wanted to hear. No point in listening to the obvious. I really didn't care to talk about it.

Is it that men really don't know (i mean, are they so lost they don't know it's a sex organ that's got cancer in it?)....or is it they know and don't like it...

Personally, I think they do not know, and their doctors for the most part do not tell them. bsolutely, most men, who have no biological/medical education whatsoever, have no idea that the prostate gland buried deep inside of them is intimately associated with all things related to their penis' functioning and sexual pleasure.

My doctor was fairly blunt with me compared to many, I think, when he said of my non-nerve sparing surgery "You will have ED non-responsive to Viagra". He said he saw rare exceptions, but rare is the key. But he seemed to think this was no big deal since I could just inject, and or use a pump, or if that didn't work have implant surgery. Right, no big deal. He did not mention shrinkage, climacturia, or loss of pleasurable orgasm, even if by jumping through hoops like injection and pumps one was actually able to achieve a usable erection, and capable of keeping it if not standing up. He did not mention Peyronie's disease. Or the possibility of all of the above in any one patient. Or the major mind warp that can occur when trying to consider sexual activity with any of the above.

I think most docs don't mention most of the above as actual likelihoods- even if way less than 100%, but still way more than 30%- because many men would desperately try to find any other treatment, or hopefully no treatment at all(AS) , even if it meant a slightly higher risk of no cure, if they really thought there was even a fair likelihood of even a couple of the above items. And if that happened their income would plummet. Thus, we don't here much about these quite likely SEs from surgeons.

Post Edited (BillyBob@388) : 8/6/2017 1:54:08 PM (GMT-6)

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