topic Re: No orgasm after prostatectomy in Living with cancer

No orgasm after prostatectomy

wordboy — Tue, 20 Aug 2019 04:55:32 GMT

Hi everyone. I'm 46 and had a radical prostatectomy just under 4 weeks ago. I'm still getting erections (not as strong as they were, but strong enough), and my libido has remained strong. Surgeon said we could have non-vigorous sexual activity from yesterday.

We did, but unfortunately, I was unable to orgasm. I got to the point of orgasm, and then... nothing. To be clear, it wasn't about being unable to get to the point of orgasm. It had been nearly a month, and I was chomping at the bit, so that didn't take long at all. I KNEW I was about to orgasm. In fact, I'd reached the point where I couldn't NOT. And then absolutely nothing.

Tried again later through masturbation, and exactly the same thing happened.

I Googled it a bit, and sadly it appears it's quite common. It's called anorgasmia, and most figures say about 30-40% of men experience it after prostate removal. I couldn't find anything on whether it's permanent, but I'll be absolutely devastated if it is.

My questions are, has anyone experienced this? In particular, has anyone experienced it and then had their orgasms return? Is this happening simply because it's so soon after my surgery?

Thanks in advance.

Re: No orgasm after prostatectomy

sch — Wed, 21 Aug 2019 11:35:21 GMT

Hi Wordboy,

I'm sorry to hear about your surgery and the effect that it has had on your life.

It must be very frustrating.

I haven't had a prostatectomy, but just thought I would message you to let you know that I'd read your message and I have been thinking of you.

How are you coping other wise?

How is your recovery?

Do you need further treatments?

I found some links on the cancer council website.

https://www.cancercouncil.com.au/prostate-cancer/

There's also a link on there to a guide to understanding some more about Prostate Cancer that also describes a little bit more about some of the side effects (a bit late now I guess).

-s

Re: No orgasm after prostatectomy

wordboy — Wed, 21 Aug 2019 22:08:41 GMT

Hi sch. Thanks for your kind reply.

Outside of the orgasm thing, everything's going pretty well. Continence is good, very little pain, I'm very active and mobile, and I don't (yet) need any further treatments. Unfortunately one of my margins was positive, so we have to watch my PSA for a few years. It's possible I'll need a bit of radiotherapy in 2 years to mop up.

Thanks for the Cancer Council link. I hadn't see those pages, but they say the same thing as everything else I've read. In particular, I've read a lot of this: "You will still feel the muscular spasms and pleasure that accompany an orgasm, but you will not ejaculate." So far, that's not the case for me.

Anyway, once again, thanks heaps for your thoughtful reply. Very nice of you. 🙂

Re: No orgasm after prostatectomy

CaptainAustrali — Sat, 31 Aug 2019 03:25:06 GMT

Buddy - this is outside my area, so I only have one brief comment.

In any area of sexual health, stress and worry will only make the problem worse, I reckon.

I'd say try to relax and enjoy yourself - the following will only interfere with any potential splash-factor:

- fearful anticipation (worrying about whether you're gonna)

- overly analytical mindset (trying to assess whether you're gonna or why you may not)

I get that it's a physical thing, but outlook might even play a minor but relevant part, I'd suggest relax, try and enjoy yourself, and talk to your physician in about 6 weeks if things haven't improved.

Sorry if that's not helpful, but your comments read as though they are laced with quite a large dose of stress and concern, and inexperienced (and potentially ignorant) instinct tells me, if anything, that will be counter-productive.

Re: No orgasm after prostatectomy

wordboy — Sun, 01 Sep 2019 23:27:51 GMT

Yeah, I agree, sex is a lot about the mind. But this is definitely physical. I was feeling very excited about getting back into it, and not concerned about orgasm at all. Also (thank god!) the missing part of the orgasm now seems to be returning - based on last two orgasms. Not back to full strength yet, but the last one was better than the one before that, so I'm assuming that means it's just a time thing. Phew!

Re: No orgasm after prostatectomy

CaptainAustrali — Mon, 02 Sep 2019 00:08:19 GMT

You sure do use the word 'orgasm' a lot 😉

Re: No orgasm after prostatectomy

wordboy — Mon, 02 Sep 2019 00:41:23 GMT

Bahahaha. My personal rule is once per sentence! 😜

Re: No orgasm after prostatectomy

sch — Mon, 02 Sep 2019 01:56:51 GMT

Practise makes perfect.

Re: No orgasm after prostatectomy

CaptainAustrali — Tue, 10 Sep 2019 05:16:11 GMT

Just curious (now that a little more time has elapsed) whether we would need raincoats and gumboots if we plan to visit your house, or whether you're still essentially dry-humping ?

Re: No orgasm after prostatectomy

wordboy — Tue, 10 Sep 2019 05:39:36 GMT

Bahahaha! Nah, no news yet. I THINK it's improved a bit since the first couple, but nothing since that possible improvement.

Re: No orgasm after prostatectomy

CaptainAustrali — Fri, 20 Sep 2019 12:34:48 GMT

Buddy, your post has a kind of "avert your eyes" fascination for me. I can't explain why.

There's something about your seminal fluid that holds a kind of cringing, awkward fascination.

Actually, come to think of it, it's a bit like one of those Jack-In-The-Box toys .. I've kind of invested in the idea that at some point it's going to pop, spraying icky everywhere .. and so now .. there's just this small part of me awake at night, wincing in anticipation.

So I need weekly updates. How's it going, have you struck white oil yet ?

Re: No orgasm after prostatectomy

wordboy — Mon, 23 Sep 2019 00:59:07 GMT

Haha! How terrible for you! 😜

Yeah, things SEEM to be improving. Maybe. It's so hard to tell. But I'm 70% sure. 🙂

Re: No orgasm after prostatectomy

dave88 — Sun, 05 Dec 2021 19:16:49 GMT

Hello

I had full prostrate removal including nerves so was told I would not get erection unless I use viagra which didn't work then tried pump..no good felt like my penis was gonna blow up...now on injections direct into penis which does work but bit fiddly BUT I was also told I can have orgasm but will not produce any fluid....I have masterbated and it feels like an orgasm but not as powerful as before and no fluid...hope this helps but probably what you want to hear....better than having the big C ...Dave

Re: No orgasm after prostatectomy

wordboy — Sun, 05 Dec 2021 19:41:25 GMT

Hi Dave. Thanks for your reply. And sorry to hear about your struggles. I've found the injections the most effective thing too.

When did you have your operation? I was told at 12-18 months after my op, all healing would be complete, and so my erections wouldn't improve after that. But they did. I'm now 30 months in, and they may still be improving. (That said, I drastically reduced my alchohol consumption, and that may well have contributed too. It's not just better on days when I DO drink, but on days when I don't.)

Re orgasms, they're still not as powerful as they used to be, but some come close. 🙂

Re: No orgasm after prostatectomy

Wegotthis — Sun, 12 Dec 2021 14:41:46 GMT

I'm glad to hear that things are kinda improving.

As a 55 year old married man I understand how you feel. My wife and I definitely move well together. We have been together for only 22 years . We are at the point where having enough other in our lives is more important than us being in bed together.

We never had kids together but we do have 4 kids and 4 grandchildren.

I guess my point to this is that at some point in our life we changed. I think it happened after our first granddaughter was born .

My wife being the grandmother to our grandchildren has made her more important than keeping me warm at night 😉

Re: No orgasm after prostatectomy

wordboy — Sun, 12 Dec 2021 19:24:18 GMT

That's great. And yeah, I hear you. I'm fortunate enough to have a great wife and our relationship is excellent too. She recognises (better than me) that life is change.

Re: No orgasm after prostatectomy

bighornso — Sat, 11 Mar 2023 16:03:24 GMT

Hey man, how are you doing now? I am 42 and was diagnosed with stage 3 Prostate Cancer last month. I have my surgery scheduled for April. I read your posts and wanted to see if things have gotten better for you? What should I expect and what should I do to prepare for it? I am told I will not be able to ejaculate at all. Does it every change? Does the orgasm get any better? I am sorry for bombarding you with so many questions.

Re: No orgasm after prostatectomy

wordboy — Sat, 11 Mar 2023 20:26:52 GMT

Hi mate. Sorry to hear about your diagnosis, but at 42, at least it sounds like they got it early, and that's good.

The short answer to your question is yes things have improved a lot. It's still different to how it used to be, but a lot better than after the op.

The long answer is much longer, but I'll try to summarise...

1. It takes time. I'm 4 years out from my op and things are still changing. It didn't take 4 years to notice improvements though, don't worry. That happened within the first year.

2. It requires adaptation. Some of the positions / techniques that used to feel good leading up to and during orgasm no longer do. So we had to experiment.

3. No, after a full prostatectomy, you definitely won't ejaculate. This was the biggest loss for me, in terms of orgasm pleasure. It turns out nearly half of the orgasm pleasure for me was here.

4. But if I'm really horny and we've had a long lead up, I occasionally ejaculate what I believe is 'pre **bleep**'. And sometimes, usually in a squatting position, I'll ejaculate urine! Neither feels exactly the same as a pre-op orgasm, but they're sometimes close and occasionally equal in pleasure.

5. All of the above experimentation is fun!

6. There's a lot less cleanup now, which is great! This opens up opportunities for sexual activity at times and places you couldn't do it before because of the mess!

7. I started seeing a psychologist when I was diagnosed. This was one of the best things I could have done. I still see her. I discovered I had a somewhat unhealthy / counterproductive / limited attitude towards sex, and I've now turned that around. As a result, my relationship is even better than ever and I'm definitely happier than before the op. If someone told me they could give me a magic pill to reverse the negative side effects of the op, but I'd have to relinquish all the self growth, I'd 100% say no.

I hope this helps. Good luck, and feel free to ask more questions. 🙂

Re: No orgasm after prostatectomy

bighornso — Sun, 21 May 2023 17:49:30 GMT

Hey Wordboy!

Thank for your response.

It has been 5 weeks since I have my surgery and I have noticed the following:

1. There has been no erections whatsoever. I have noticed that when I am flaccid I am not as big as I was before surgery. Did you notice that? Does it go back to it's normal size? Is it the same for when you get erect?

2. I have masturbated with my flaccid penis and it seems that the orgasms are strong without ejaculating. However I really do miss not been able to ejaculate. It is nice to pull it out, Jo, and put it back inside without having to clean up the mess.

3. Did you use the pump after surgery. Some say it works after surgery.

4. How long did it take you to stop leaking? Sometimes I leak a lot and sometimes I don't but it's annoying and I just want it to stop.

5. Did you have discomfort on your balls? How long does it last.

6. For the past couple of weeks I have excruciating pain when I pee and it continues for few minutes after I am done. Did you experience that? All tests have been negative for me but Dr thinks that it might be part of healing. I just need it to stop.

How are things with you?

Re: No orgasm after prostatectomy

wordboy — Sun, 21 May 2023 21:13:42 GMT

Hi bighornso,

1. I don't THINK it's smaller. Sometimes it seems a bit smaller when erect, but I think that's just because it's not as hard as it used to be. I've read that the surgery itself makes it smaller for some people, because the urethra is shorter after the removal of the prostate. Didn't seem to happen to me.

2. Good to hear you're having strong orgasms. That's great news!

3. Yeah, I used a pump, but didn't like it. It was a bit of fun for us as a sex toy, but the erections it created were temporary.

4. I took notes throughout my recovery, and they say my leaking stopped after 16 days. But then there's a note more than 2 months later saying "almost never get any leaking now" and a mention of a nocturnal leak. So that's about 3 months after the op. There's no mention of leaking after that, but I know I occasionally had a few issues after a few drinks. I still have to be a lot more careful than before, and occasionally I still get a leak. But we're talking once every 2-3 months, I'd say (at a guess), so it's not a problem. Gives me something to laugh about with my wife!

5. No, I didn't have any discomfort in my balls.

6. I didn't have any pain like you describe. I did have trouble urinating after 5 months, and it turns out I had a migrated staple. It didn't really cause any pain though. I had to have another surgery to remove that staple (and another catheter!). Then trouble urinating again 3 months after that (but again no pain), because of scarring caused by the migrated staple. More surgery (and ANOTHER catheter) solved that. All fine since.

All is well with me. It was definitely a hard road, and I miss my old erections and orgasms. But I've grown a lot as a person, and my relationship is even better now than it was pre-op. I wouldn't trade the emotional growth for the old erections and orgasms...

Recovery was a long process but, interestingly, it didn't really follow the timeline my doc predicted. I found my erections kept improving for quite a while after he said recovery would be complete. And my orgasms too. Perhaps one or both of these things was due to us just getting used to things or learning new techniques, but I don't think so. I suspect it's just that bodies heal at different rates.

Best of luck with your recovery. Keep us posted.