Post prostatectomy sex life

I am a little over 3 months out from my prostatectomy and am curious what I can reasonably expect from myself sexually. I have not had an erection since the surgery, although blood clearly flows to the penis as I feel the rush of it and have occasionally seen evidence of the penis swelling.

Any suggestions, information or even questions are appreciated.

Welcome to HW.

Three months is just the start. Could take a year before things are back to normal. Hang in there something bound to come up sooner or later.

Welcome, Killerbee.

The key question is whether the surgeons were able to spare one or both nerve bundles that are responsible for erections. Your surgeons should be able to tell you that. They're right that the prediction game is tough, and even if both nerve bundles were spared you could experience longterm ED. Only time will tell. However, at your relatively young age, if you had strong erections before surgery and both nerve bundles were spared, it's probable you'll regain functional wood over time. Johns Hopkins' website reports that "in younger men (less than 58 years old) who had both nerves spared, 82 percent reported intercourse at one year."

If insurance won't cover Cialis, you might try generic Viagra (sildenafil). Unlike generic Cialis, it's affordable.

I am five years out of surgery. Get nearly firm enough for penetration, but this isn't horseshoes. I did try pills injections, pump. None of them satisfactory.
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However - my wife and I are 45 years married and we just work around it orally, digitally. Don't have any toys. We continue to have an enjoyable, satisfying sex life which has improved with practice.

Stay safe -

Wilderness

Killer - Good to see you are young for this part. The pump definitely helped with the length for me and it is the same as before. Make sure you get a water soluble lubricant (ie: Aquagel) to use with pump to seal up the vacuum and other obvious reasons. The link below might help.

https://www.mskcc.org/clinical-updates/early-intervention-can-prevent-permanent-erectile-dysfunction

The cost of generic Viagra (sildenafil) and Cialis (tadalafil) is pretty cheap now if you check GoodRX for coupons and have a prescription. Like <$20 and <$30 for 30 pills respectively so I just pay cash at Costco since insurance will not usually cover.

https://www.goodrx.com/

There are a number of suggested pump use programs, I started with every other day as directed and low dose pills and now am at 3/week since that is easier to keep track of. My urologist's ED assistant says the pump is the most important part after the early months to keep it in shape.

My urologist's practice RALP experience statistics were 51% at 3 months, 74% at 12 mos, 89% at 24 mos for men under 70 based on a survey of 500 patients a few years ago. The definitions of recovery are a little hazy but give you the general idea.

Aquagel is water soluble which makes cleanup easier, not a liquid but not Vaseline, somewhere in between. Pretty cheap on Amazon from vendors. My doctor's office was clear that insurance did not cover the ED meds and actually suggested GoodRX. My current script is for 30 full strength pills/month and I can take them at any rate. Some insurance covers the pump but Medicare does not. My Uro's group (30+ doctors) had monthly evening sessions to go over all this stuff for patients having RALP.

Mumbo-

I appreciate that I will order some aqua, I have really good insurance the Dr said it would cover a pump and the script, but needs a pre-authorization for the cialis, although it doesn't se to be to expensive without it. The pumps on the other hand are hella expensive so I need to wait for insurance to buy a real one.

Reltnie-

Thank you for sharing I really appreciate it. My wife is quite concerned about my lack of erections, she sees it as her fault and what not. I have been concerned with it as well. I've been concerned about my feelings of masculinity and how I would feel about myself as so much of how we feel about ourselves is wrapped up in our sexual abilities. I know I am being impatient, but it is hard not to be. Hearing about how things went for you let's me breathe a little easier.

This video from MSKCC's Dr. John Mulhall was orignally presented at a conference in L.A. in 2014, but a whole lot of it still applies in terms of managing "expectations".

https://www.youtube.com/watch?v=4elsojpfnv8

Charles

Killer B: Don't let your insurance get in your way. If you use GoodRX to shop around at your local pharmacies the generic pills are not prohibitively expensive (especially sildenafil). It will be lovely if you can eventually get your insurance to pay for your daily CIalis but, in the meanwhile you can get generic tadalafil (the generic version of Cialis) for pennies on the dollar. Be sure your doctor writes the scrip for the generic. If the scrip is for the brand name drug the price goes up by a factor of 20 X or more.

It usally takes guys who are ever going to recover somewhere between six months and two years to get back in the saddle. So it's fairly early yet. But you need to keep trying so your parts don't shrink. I'd get your doc to hook you up with some generics, use GoodRx to find the best local cash price, and once you have that working you can get back to negotiating with your insurance company.

Killerbee said...
I always had good erections before the surgery, never showed any symptoms from the cancer other than a ridge my Dr felt. They said they were able to spare the nerve bundles, but do not know if they are still working, time will tell that. I can still orgasm, which is nice there just isn't any fluid. My wife and had a healthy and diverse sex life before and I am starting to wonder what it will be like after. We didn't think about before the surgery as we felt the surgery was the best course of action.

Do most men get their penis size back, I was not prepared for my flacid penis to shrink that way, which is why I ordered the pump.

Well, it just all depends on how lucky you are. Some of us are pretty lucky, some of us it is game over. Of course, if you have nerves spared, the odds are improved for you, though it might be quite a while before those nerves wake back up. It can literally be years before you know about that, but again, some guys are up and running pretty quickly. They are blessed.

While it will be quite a while before you know for sure, the pump and injections ( and some say daily drugs such as Cialis) will maximize your chances of maintaining most of your size until you are, hopefully, back to close to normal function. The key is to keep blood flowing down there, and to keep the tissues stretched out while you wait for months or much longer for significant recovery. Keeping all of that maintained will also work in your favor if you ever decide to go implant.

Good luck to you.

Post Edited (BillyBob@388) : 4/15/2020 4:38:46 PM (GMT-6)

After reading this thread...I’m feeling blessed.

garyi: two thumbs up. As good--or better--than before. Truth.

sex isn't the answer.
sex is the question.
yes is the answer.