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  • Prostatectomy to your first sex post surgery?

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    Old 01-13-2020, 09:49 PM   #1
    IceStationZebra
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    Prostatectomy to your first sex post surgery?

    Had robotic prostatectomy on 12/9. I'm mostly dry now leaking with stress incontinence at times. Also still leaking a little at night.

    So that leaves sexual ability to get back. Wife and I were fooling around today and I was able to get a very small response from my penis. It was never usable but I did get lots of the lubrication fluid.

    So I'm wondering for those who had RP what was your timing from RP to actual sexual intercourse with orgasm. Anyone?

     
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    Old 01-16-2020, 07:02 AM   #2
    djust
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    Re: Prostatectomy to your first sex post surgery?

    7 weeks for actual intercourse for me but that was with the pump and a ring.
    Being truthful I hate the pump, I use it morning and night like I am supposed to but only because I know it keeps things going until I can do it on my own.
    Using a ring for the first time about a week ago to just see how that was going to work. It did but I am not fond of using it.

    I am post 8 weeks right now and have some action going on with the pills which gives me hope but not nearly enough to get the job done.
    Still have an appointment in Houston next month with the penile rehab doc and probably going to start trimix to see if that helps speed things up a little.
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    Age 55
    PSA 3.5 7-16 PSA 4.18 7-17 PSA 3.66 8-17 PSA 4.99 7-18
    Biopsy 8-18 Diagnosed 8-18 12 Cores
    1 Core 5% positive Gleason 6
    PSA 5.3 11-18 PSA 6.01 2-19 PSA 6.73 6-19
    3T MRI 6-19
    MRI Guided Fushion Biopsy 19 cores 7-18-19
    Left Mid Lat 3+4 3mm 25% Left Apex Lat 3+4 2mm 15% ROI RM TZA 3+4 17MM 27%
    RALP 11-11-2019 MD Anderson
    First Post Surgery PSA .064 12-24-2019

     
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    Old 01-16-2020, 11:34 AM   #3
    Prostatefree
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    Re: Prostatectomy to your first sex post surgery?

    Sexual intercourse in no longer an option at my age. My partner enjoys it much less than I do.

    Sexual activity is a high priority of ours. The ability to do so effectively started around one year and improved for another year. It stills seems to be getting better. The biggest issue is keeping it up. Any break in the action and it quickly disappears. Easy to recover, but still.

    My loss of libido is the only real obstacle now and I see little improvement there as I continue to lose testosterone/desire.
    __________________
    Born 1953; family w/PCa-grandfather, 3 brothers;
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2;
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3;
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, G3+4, T vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months;
    12-8-19 PSA less than 0.02, zero club 3.5 yrs

     
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    Old 01-16-2020, 11:41 AM   #4
    Prostatefree
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    Re: Prostatectomy to your first sex post surgery?

    Quote:
    Originally Posted by djust View Post
    7 weeks for actual intercourse for me but that was with the pump and a ring.
    Being truthful I hate the pump, I use it morning and night like I am supposed to but only because I know it keeps things going until I can do it on my own.
    Using a ring for the first time about a week ago to just see how that was going to work. It did but I am not fond of using it.

    I am post 8 weeks right now and have some action going on with the pills which gives me hope but not nearly enough to get the job done.
    Still have an appointment in Houston next month with the penile rehab doc and probably going to start trimix to see if that helps speed things up a little.
    Be careful with the Trimix. Any pain or change in shape around the injection site or in the penis - stop! There is a risk of Peyronies. I experienced it and should have stopped immediately, but pushed through with about 5 more injections and I have some permanent disfiguring. Slowly recovering, but never fully.

    In hindsight, more patience.

    Trimix does work if it works for you. Didn't work for me. I caution patience. Nerve tissue takes much longer to recover than all other tissue. It has been severly traumatized. One source of the trauma is the cauterizing tool generates heat in the surgery cavity which has no where to go and it traumastizes the nerve tissue. It takes time to regenerate even when it hasn't been cut or moved.
    __________________
    Born 1953; family w/PCa-grandfather, 3 brothers;
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2;
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3;
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, G3+4, T vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months;
    12-8-19 PSA less than 0.02, zero club 3.5 yrs

     
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    Old 01-16-2020, 11:47 AM   #5
    IceStationZebra
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    Re: Prostatectomy to your first sex post surgery?

    Thanks all.

    I'm only 49 so losing sexual function at this age, it worries me. I have my follow up with the surgeon tomorrow.

    He is on board with me restarting testosterone replacement in the near future once we get some u psa tests completed. I'm not so certain. I had a tiny 3mm positive margin in the right posterior base and the pathology suggested perineural invasion. However, nothing but G6 was found in the final pathology. I dont know what to do about that.

     
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    Old 01-16-2020, 11:53 AM   #6
    DjinTonic
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    Re: Prostatectomy to your first sex post surgery?

    Quote:
    Originally Posted by IceStationZebra View Post
    Had robotic prostatectomy on 12/9. I'm mostly dry now leaking with stress incontinence at times. Also still leaking a little at night.

    So that leaves sexual ability to get back. Wife and I were fooling around today and I was able to get a very small response from my penis. It was never usable but I did get lots of the lubrication fluid.

    So I'm wondering for those who had RP what was your timing from RP to actual sexual intercourse with orgasm. Anyone?
    Keep the faith, ISZ! You are still in the "aftershock" phase. Men vary greatly in the time to reach whatever level of recovery they will eventually have. Did you doc give you instructions as to the use of daily or "challenge" doses of sildenafil?

    Keep in mind that you can achieve orgasms without an erection -- so keep up the play and be very patient. Morning erections will be a very good sign that things are progressing.

    Djin
    __________________
    69 yr at Dx, BPH x 20 yr, 9 (!) neg. Bx, PCA3-
    7-05-13 TURP for BPH (90→30 g) path neg. for PCa, then 6-mo. checks
    6-06-17 Nodule on R + PSA rise on finasteride: 3.6→4.3
    6-28-17 Bx #10: 2/14 cores: G10 (5+5) 50% RB, G9 (4+5) 3% RLM
    Nodule negative for PCa. Bone scan, CTs, X-rays: neg.
    8-7-17 Open RP, neg. frozen sections, Duke Regional Hosp.
    SM EPE BNI LVI SVI LNI(5L, 11R): negative, PNI+, nerves spared
    pT2c pN0 pMX, G9 (4+5) 5% of prostate (4.5x5x4 cm, 64 g)
    Dry; ED OK with sildenafil
    11-10-17 Decipher 0.37 Low Risk; 5-yr met risk 2.4%, 10-yr PCa mortality 3.3%
    LabCorp uPSA: 0.010 (3 mo.)0.015 (1 yr. 6 mo.)0.015 (2 yr. 4 mo.)

     
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    Old 01-16-2020, 11:59 AM   #7
    IceStationZebra
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    Re: Prostatectomy to your first sex post surgery?

    Quote:
    Originally Posted by DjinTonic View Post
    Keep the faith, ISZ! You are still in the "aftershock" phase. Men vary greatly in the time to reach whatever level of recovery they will eventually have. Did you doc give you instructions as to the use of daily or "challenge" doses of sildenafil?

    Keep in mind that you can achieve orgasms without an erection -- so keep up the play and be very patient. Morning erections will be a very good sign that things are progressing.

    Djin
    Thanks Djin yes he gave me a daily 5mg script of cialis. No morning erections yet but I wake up with the feeling of having one. I look down like a kid opening a package on Christmas only to find socks! 😁

    I'm encouraged that I can get maybe a 10% increase over the completely limp penis with enough play.

    How can one get an orgasm without an erection? My main wonderment is what the orgasm will feel like.

    After the attempt I had copious amounts of lubricant released so that's good.

    Last edited by IceStationZebra; 01-17-2020 at 07:50 AM.

     
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    Old 01-17-2020, 09:04 AM   #8
    DaveinMaryland
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    Re: Prostatectomy to your first sex post surgery?

    A positive margin with G6 - I had that. For now don't worry about what to do with that. Your post surgery PSAs will tell you if you need to do anything. The good news is G6 does not metastasize. You may have to do nothing. You may have residual PSA that will remain constant which means there is a small bit of prostate left. If it rises then that means there is still cancer there and you will most likely need salvage radiation.

    Take it 1 step at a time.
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    Prostate Cancer 3+4 Open RP May 2017
    PSA detectable May 2018, single digit .1 2 digit .06
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    Old 01-17-2020, 09:25 AM   #9
    Prostatefree
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    Re: Prostatectomy to your first sex post surgery?

    The orgasm nerve structure is unaffected by the procedure. It operates as it always has. It is just below the head of the penis on the underside. Stimulate it until orgasm!

    The Cialis is blood infusion therapy. Use it whether you intend to have sex or not. I did it 2 to 3 times a week. It has a few day half life. It encourages the flushing of blood through the region aiding in healing.
    __________________
    Born 1953; family w/PCa-grandfather, 3 brothers;
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2;
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3;
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, G3+4, T vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months;
    12-8-19 PSA less than 0.02, zero club 3.5 yrs

     
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    Old 01-17-2020, 11:28 AM   #10
    Steve135
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    Re: Prostatectomy to your first sex post surgery?

    Zero ziltch nothing LOL!

     
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    Old 01-22-2020, 07:20 AM   #11
    KarlE
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    Re: Prostatectomy to your first sex post surgery?

    Ice, your question tells me things must be quite different for everyone. I never had any issues with getting sensations resembling orgasms, I already tried the workings with cath in and the thing was still twitching. Not a fully real one since the prostate bit is missing from the experience. Kind of an orgasm w/o the ejaculation bit is best I can put it. Still orgasms, and the experience didn't change since my RP in April.

    With hindsight, I didn't practice enough with my VED. I don't particularly like the exercise, but it's definitely helpful. Keep going, Ice, and be patient. For me with only one side nerve sparing surgery, a little bit of erection came back. Not enough to be useful by itself, but a basis for tricks like Muse/Alprostadil which sells as a gel in its least irritating variation.

     
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    Old 01-23-2020, 05:53 AM   #12
    IADT3since2000
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    Re: Prostatectomy to your first sex post surgery?

    Dr. John Mulhall, MD, is an expert on countering sexual side effects of prostate treatment, and he has written books on the subject. He practices at Memorial Soan Kettering Cancer Center in NYC. There are also other experts in the US.

    Jim

     
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    Old 01-23-2020, 06:27 AM   #13
    djust
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    Re: Prostatectomy to your first sex post surgery?

    I follow Dr Mulhall advise through MD Andeson
    20mg sildenafil daily, 5 at a time once a week to see if there is progress.
    Pump 10 times in the morning and 10 times in the evening for 20 seconds each time.
    It sucks to do the exercises but gotta keep things going until they pick up on there own.
    __________________
    Age 55
    PSA 3.5 7-16 PSA 4.18 7-17 PSA 3.66 8-17 PSA 4.99 7-18
    Biopsy 8-18 Diagnosed 8-18 12 Cores
    1 Core 5% positive Gleason 6
    PSA 5.3 11-18 PSA 6.01 2-19 PSA 6.73 6-19
    3T MRI 6-19
    MRI Guided Fushion Biopsy 19 cores 7-18-19
    Left Mid Lat 3+4 3mm 25% Left Apex Lat 3+4 2mm 15% ROI RM TZA 3+4 17MM 27%
    RALP 11-11-2019 MD Anderson
    First Post Surgery PSA .064 12-24-2019

     
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    Old 01-23-2020, 06:44 AM   #14
    IceStationZebra
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    Re: Prostatectomy to your first sex post surgery?

    Quote:
    Originally Posted by IADT3since2000 View Post
    Dr. John Mulhall, MD, is an expert on countering sexual side effects of prostate treatment, and he has written books on the subject. He practices at Memorial Soan Kettering Cancer Center in NYC. There are also other experts in the US.

    Jim
    Thank you. I'll look his books up.

    I talked to my doc who said it is still early for me. He said to keep up with the 5mg daily dose and that I can take an additional 10 mg a couple time a week if I want to try to get an erection. I tried that yesterday, slightly better than without the 10mg dose but no go overall.

    I also asked about the VED and my doc said that the evidence hasn't proven out that it works any better than just the meds. So he said to give it time, use the extra cialis a couple times a week and then we would talk about testosterone replacement after a few stable psa tests and can talk about injections (yikes) if the cialis doesn't work.

    I might get a VED device on my own and try it. my doc didn't say it would hurt but just that the data didn't support it actually making a difference.

     
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    Old 01-23-2020, 10:25 AM   #15
    Prostatefree
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    Re: Prostatectomy to your first sex post surgery?

    Relax. The erection is mostly time. If you're getting some results now you will be fine.
    __________________
    Born 1953; family w/PCa-grandfather, 3 brothers;
    7-12-04 PSA 1.9; 7-10-06 PSA 2.0; 8-30-07 PSA 3.2; 12-1-11 PSA 5.7; 5-16-12 PSA 4.76; 12-11-12 PSA 5.2; 3-7-16 PSA 7.2;
    3-14-16 TRUS biopsy, PCa 1%-60% across 8 of 12 samples, G3+3;
    5-4-16 DaVinci RP, Path-65g, lymph nodes, seminal vesicles, capsule, margin all neg, G3+4, T vol 35%, +pT2c, No Incontinence-6mos, Erections-14 months;
    12-8-19 PSA less than 0.02, zero club 3.5 yrs

     
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