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Life after prostate surgery

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Posted 4/21/2024 6:54 PM (GMT 0)
Hello - I am 49 and had a radical prostatectomy a little over a month ago. At this point I am able to achieve an orgasm without an erection which I know is normal. I was wondering if anyone has been able to achieve and maintain an erection without the help of medication or devices and how long it took to achieve post surgery.
Posted 4/21/2024 9:14 PM (GMT 0)
Short answer: Yes.
Longer answer: It can take a while. Anywhere from a few months to a year is not uncommon. If you haven't already, do have your doctor give you a scrip for daily cialis, or try viagra as well. The important thing is to get your blood flow going in your pelvis.

Important question: in your surgical report, does it mention anything related to nerve removal? If the nerves were surgically damaged, either by accident or because the tumors were around the nerves, then your likelyhood of a successful recovery of sexual function goes down.

For me, I had a spontaneous, nighttime erection at about 3-4 weeks post surgery, and haven't looked back.

For others, the ED is permanent and lifelong. Honestly, none of us can say what will happen in your case.
Posted 4/22/2024 12:22 AM (GMT 0)
Welcome - As halbert said, the short answer to your question is Yes. However, that does not seem to be exactly what you want to know.

The statistics on erectile dysfunction recovery (ED) are difficult to evaluate as the skill of the surgeon and the extent of nerve sparing that can be performed are major variables. The man’s age and general condition is another major factor (you are young). There are also different definitions of success so the expectation that one will be 100% of what they were before is a high bar and not what most doctors consider success in their statistics.

The most important part is to follow a “penile rehabilitation” program to provide the best chance for success. This usually starts with low dose Viagra or Cialis after surgery followed by a vacuum device to keep the blood moving. Using higher dosage ED drugs for events is expected to get things going.

ED recovery can take a long time so you should be thinking of months, up to 1 to 2 years in some cases. There is always the possibility that the damage is permanent as well and the nerves do not recover. Some men recover quickly while others take much longer. Some need “help” with meds, some never make it back to serviceable levels, some are on hormone therapy and don’t care.

I never fully recovered but am older and had partial nerve sparing on one side. I also followed up surgery with adjuvant radiation based on final diagnosis which tends to make ED recovery more difficult. I followed the rehabilitation recommendations but never made it back to penetration levels. I have a wife with her own cancer issues so this part of our life has become less important and life goes on.
Posted 4/22/2024 6:13 AM (GMT 0)
I second the viagra or cialis route. See what happens. Remember, you need to be “in the mood” for ED meds to work.

Within one week of my operation with the help of my g/f I achieved an erection (didn’t have sex). That was without any meds. I’ve usually been able to care of business without meds if I am with the right woman lol 😊

Flying solo, I have always needed a med for full mast.

https:// https://www.youtube.com/watch?v=e62p_k4-cvc


If we knew your nerves were both still intact it might help us to help you. (That should be in your path report or just ask your surgeon.

You’ll have no problems. You’re young. May take a bit and I can’t promise that you will ever get to where you won’t need meds. There’s worse things than meds. Be cool. Be patient. This is one of the few things I don’t mind working at.
Posted 4/22/2024 11:24 AM (GMT 0)
Your age works for you. I have a friend who underwent surgery at about your age. It took over a year, including Viagra, but he got it back. Wish you well… Bill
Posted 4/23/2024 3:39 PM (GMT 0)
WP318, welcome to the forum.

I had a full erection upon awakening about a week after surgery. It's important, I believe, to be taking daily Cialis or viagra, to promote blood flow to the area, even if it doesn't produce an erection. As others have said, lot of variables, and everyone is different. I was lucky. I was 65 at the time of surgery. Now I am 73, and while it still works, it doesn't work as well.
Posted 4/23/2024 10:46 PM (GMT 0)
My urologist said that the better your erections are going into surgery, the better they are likely to be coming out. Not an iron rule, of course, but something to think about. The other factor is how much the surgeon needs to cut away to get all of the cancer.
Posted 5/1/2024 1:36 PM (GMT 0)
There are a lot of factors in play. The quality of the surgery and the quality of your nerve bundles prior to surgery being the most important.

At 49, I would definitely be speaking to your Uro about rehab program. Use it or lose it. That is likely to involve both meds and use of a pump until the nerves repair themselves.
Posted 5/7/2024 1:32 PM (GMT 0)
I am 1.5 years out from my surgery and have a little action starting to go on. It helps that my wife is now on a hormone therapy that makes her more interested in play time. In the beginning she was of the opinion of it didn’t work it was ok with her.

I have had orgasm for a long time with some help. I have been doing 20mg of Niagara daily and more when the happy time comes.

Still haven’t had enough for entry.

Progress has been slow but there has been progress.

Good luck to you!
Posted 5/7/2024 4:16 PM (GMT 0)
I had robotic surgery 17 years ago and I was getting full erections without the use of any drugs immediately after the catheter was removed. The only problem I had was that there was no more connection between my mind and my penis. Before my surgery, only thoughts about sex, or looking at a naked woman would give me an erection. But after surgery, this connection disappeared, and now I need some manual stimulation to get and maintain an erection.

orgasms were completely different after surgery, Before, I would ejaculate a dribble of seman. Now after surgery , when I have an orgasm, I will ejaculate urine with the force of a fire hose. Matter of fact, I feel more pleasure now when I ejaculate , then I did before my surgery when it was just a dribble smile

Post Edited (NY-Sooner) : 5/7/2024 8:22:12 AM (GMT-8)

Posted 5/10/2024 9:48 PM (GMT 0)

NY-Sooner said...
(snip)

orgasms were completely different after surgery, Before, I would ejaculate a dribble of seman. Now after surgery , when I have an orgasm, I will ejaculate urine with the force of a fire hose. Matter of fact, I feel more pleasure now when I ejaculate , then I did before my surgery when it was just a dribble smile


How does your partner feel about that? I have a similar situation, unless I remember to pee before hand, and I find it embarrassing. Due to an extra-prostatic extension, the surgeon was only able to spare one nerve during my RALP, which is what I've (perhaps erroneously) attributed the situation to.
Posted 5/22/2024 10:50 PM (GMT 0)
I read a lot of posts re: erections and ejaculations, etc. after surgery and other forms of treatment we all endure and I can relate to all. I have been going through it for about 18 to 20 years and have tried all the so called remedies and none of them work. I finally reached the point that luckily, my cancer is under control, but I want my life back, all of it!
I volunteered at a VA hospital with paraplegics and every other sort of disfigurement these brave men and women have suffered from combat and helped them to never give up and most do, but some do not and they fight like hell to be able to just do some normal things, no matter what it takes. While there, I discovered many mechanical fixes, including replacements of genitalia, just like any other transplant and implants to fix many other issues.
OK, where am I going here and how does it relate to our prostate problems? My Urologist and Oncologist never mentioned anything about having penile implant surgery, I learned about it at the VA hospital. It's fairly simple and done as an outpatient surgery in one day. Well, I had it done and it changed everything for the positive, I finally got my life back as far as possible to normal. No more ED, pills, injections etc. and erections on demand! I wish I knew about this when I first found about the cancer. (look it up in any search engine : AMS 700. I have to run now, but will write more about it in a copuple of days. Hang in there, there is hope and Medicare and most insurance companies cover it.
Posted 5/23/2024 4:44 PM (GMT 0)
NYSooner said:
**I will ejaculate urine with the force of a fire hose.**
I had this occur too, and like Patrick, I found it to be embarrassing -- actually very, very embarrassing. My lady friend at the time never said anything but I clearly sensed that she clearly didn't like it. But, those days are long behind me with lifetime ADT.

So yeah, ejaculating pee, "continence" defined as needing one pad per day, and a significantly shorter penis are some of the RP after-affects that Uro/surgeons tend to "forget" to discuss when pitching their services.
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