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Medical Forum / Diseases and Disorders / Prostate Cancer / August 2006will i still be able to masterbate if they cannot spare the nerves during surgery?
does impotance mean i would not be able to have an orgasim? will i be able to masterbate without an erection? also, if i am currently able to masterbate and use 100mg of viagra to sustain an erection for intercourse, what are my chances of viagra helping me after surgery if i need more help? will it help me if my need for viagra turns out to be more psychological as opposed physiological? i am a healthy 66 year old cotmplating surgery. irwin On August 20, Irwin wrote: > does impotance mean i would not be able to have an orgasim? Probably not. > will i be able to masterbate without an erection? Yes. > also, if i am currently able to masterbate and use 100mg of viagra to sustain an erection for > intercourse, what are my chances of viagra helping me after surgery if i need more help? I understand that, if the erectile nerves were not destroyed in the surgery, Viagra or other such meds will probably be helpful. > will it help me if my need for viagra turns out to be more psychological as opposed physiological? I understand that sex is around 90% mental, so if psychological assistance is needed, one should use it. (snip) Note the weasel-words above. Reason I used them is that everyone is different and what works for A might not work for B. Regards, Steve J "The thing is to expect nothing in particular, but (to) be aware of the lack of enforceable guarantees or enforceable contracts with nature/god/entropy as to the condition or durability of our bodies." -- Brian Brunner, PCa survivor, December 12, 2005 on The Prostate Problems Mailing List Thank you, Brian. Welcome, Gary, to the club no one in his right mind would want to join voluntarily. Before I answer these questions, let me warn you that some are so fundamental as to be evidence that you have not researched sufficiently to be making choices about the rest of your life. You really need to read Dr. Peter Scardino's Prostate Book, Dr. Patrick Walsh's Guide to Surviving Prostate Cancer and/or Dr. Steve Strum's A primer on Prostate Cancer. > does impotance mean i would not be able to have an orgasim? Yes. It will be dry or almost dry, but it can be intense. > will i be able to masterbate without an erection? Yes. It is highly recommended if you wish to have a sex life. Consider if physical therapy to bring you to complete healing. > also, if i am currently able > to masterbate and use 100mg of viagra to sustain an erection for > intercourse, what are my chances of viagra helping me after surgery if > i need more help? At first, almost certainly. Later, nobody can answer that for you. >> does impotance mean i would not be able to have an orgasim? > > Yes. It will be dry or almost dry, but it can be intense. Whoops! I missed that "not" in your question. You WILL be able to have orgasms. > does impotance mean i would not be able to have an orgasim? will i be > able to masterbate without an erection? also, if i am currently able [quoted text clipped - 4 lines] > old cotmplating surgery. > irwin Gary, I acheived an erection with Cialis with no nerves spared. I just posted about it. I didn't masturbate. It was painful and I just sort of stared at it a minute, like looking at a rare, probably extinct bird until it flew away. My uro told me pre RP, that orgasms and erections were possible with pills only. He said he also could prescribe shots (self administered) if pills didn't work. My primary physician prescribed the Cialis after I told him Viagra had not worked. He has a friend in his 60's that the Cialis worked on just lately. Viagra did give my penis the girth, but not length it had pre-RP. It stayed soft with the Viagra. That was just about 5-weeks RP. I might should have waited longer. Now, I'm only 5 months post RP. I've had one erection, and no orgasms. It might have been a fluke. I was standing up, I've heard that helps and in the shower. I wasn't concentrating on sex, but I always think about it.....lol. That's about all I can tell you. Could I have had an orgasm? I don't think so, the erection was realy painful. Keep trying? You bet. I truly think I stand a chance, especially after the ADT drugs wear off. The pump device so far, and I haven't tried it much, was painful and ineffective. The encouragement and advice this group has given me has bolstered my iniative to pick up the pump, use the pills and start flirting again!! Good luck David > My uro told me pre RP, that orgasms and erections > were possible with pills only. My jaw hit the floor on that one. Erections, no, but I have NO trouble having orgasms. The erectile nerves and "orgasmic nerves" are many inches apart and virtually unrelated functionally. I'm beginning to think no doctor should be "ordained" as a urologist until HE has personally experienced every disorder and treatment HE diagnoses and prescribes. That, or ASK HIS DAMNED PATIENTS what's going on. Find some good magazines or an enthusiastic partner, sit on the edge of the bathtub if being upright helps (it often does), get some good silky hand lotion, and do your homework. Before long you'll be getting almost straight A's, and will enjoy doing homework and/or taking tests even if your final grade is an F that day and even if your pencil is merely pencil-sized. Viagra may be necessary for our PARTNER'S benefit, but not ours. And you'll quickly see why you'll want your feet in the tub rather than on the bathroom floor, unless you ENJOY cleaning urine off the far wall. I.P. dave i have never masterbated without an erection. i cannot imagine how that can happen. what do you grab onto, a limp noodle? i remember not having semen until i was about 12 or 13, but i could still masterbate by grabbing my erection. is not having an erection kind of like riding a bike without the handlebars? what do you do with it to get any feeling to reach the orgasm? your description is not graphic enough. please descibe with more detail. gary > > My uro told me pre RP, that orgasms and erections > > were possible with pills only. [quoted text clipped - 21 lines] > > I.P. Maybe I shouldn't be answering this but I'll try anyway. Yes, just grab it and play with it. The nerves that control the orgasm will not be destroyed. You don't need an erection to have an orgasm. That seems hard for most men to fathom until they have experienced it. Most men say it is not the same sensation but it is still quite pleasurable. Some men say it is less intense while others find it very intense, so I guess your mileage may vary. Do not allow this to influence your decision for surgery. Seems no matter what the treatment, most men have a period of time after treatment where they are unable to obtain an erection. There are other things other than Viagra that can be used to obtain a sustainable erection for intercourse. (You can cross those bridges after your surgery if you need to do so, and you might not.) I'm assuming that you have a wife or partner. If your partner is willing there are things that can be done other than intercourse that you will find very pleasurable. Many women find oral sex objectionable because they do not want a mouthful of ejaculate and they don't like something shoved against their tonsils. Guess what? Those days are over - end of excuses. Just make sure you are squeaky clean. And no one will ever sleep on the wet spot again. Because the prostate is what makes most of the fluid in the ejaculate. With the prostate removed or eliminated by brachytherapy, RT, etc., the ejaculate is gone. Thus you'll hear the term dry orgasm. With a little luck you'll be able to obtain an erection again, you will have orgasms (with or without an erection), and yes it will be different. KY now puts out a jelly that warms on contact. You might find that helpful when you're working alone. Just get your head (the one between your ears) in the right place and enjoy it. Since you need Viagra now, you could try masturbating without the Viagra; you will have some idea of what it will be like later. Be patient with yourself and just allow it to happen. Was that graphic enough? Bev > dave > i have never masterbated without an erection. [quoted text clipped - 9 lines] > > gary > Many women find oral sex objectionable because they do not > want a mouthful of ejaculate . . . Guess what? Those days > are over - end of excuses. Unless one's partner also dislikes a considerably more forceful throatful of urine. > And no one will ever sleep on the wet spot again. Unless they sleep on the wall. > Because the prostate is > what makes most of the fluid in the ejaculate. With the prostate removed or > eliminated by brachytherapy, RT, etc., the ejaculate is gone. Only to be replaced by many ounces of urine. I.P. in Spurts IP you are the exception and not the rule! Seriously, can you use a condom or do you leak too much for that? Bev > > Many women find oral sex objectionable because they do not > > want a mouthful of ejaculate . . . Guess what? Those days [quoted text clipped - 14 lines] > > I.P. in Spurts > IP you are the exception and not the rule! > > Seriously, can you use a condom or do you leak too much for that? > Bev Bev, Leaking of expelling urine during intercourse is not uncommon after surgery, but it tends to disappear with time. It would be less common after radiation therapy. Unless there is a bladder infection, urine is sterile. It even used to be used to clean wounds on the battlefield. But I understand why it might be turn off with oral sex or, for some women, vaginal sex. I also like to note that while erections do a good job of closing off the bladder during intercourse, they are hardly perfect. I suspect there is always a small amount of urine mixed in with the semen and from time to time it is more than a small amount. I'm sure this is something that happens regularly in any sexual partnership and no one notices it. So why make a big deal of it when there is no semn present? >>>Many women find oral sex objectionable because they do not >>>want a mouthful of ejaculate . . . Guess what? Those days [quoted text clipped - 18 lines] >> >>I.P. in Spurts > IP you are the exception and not the rule! I have no idea how common urine expulsion is. I had the impression from "the books" that it was common. > Seriously, can you use a condom or do you leak too much for that? I don't know; haven't tried it. We aren't talking about a "leak"; we're talking about a very forceful, high-speed, jet slamming into the shower wall, and that's after I've urinated once or twice during masturbation to empty the bladder. Having sex in the bed would require changing the bedding and mattress pad and any nearby clothes, washing down the walls, and hosing off the dogs, and that's not an exaggeration. What size condom are we talking about here? ;-) I.P. ROTFLMAO! I was a good girl so I never had a lot of experience with condoms. Was told by the doc after some surgery to use them for a while. I think we tried it twice and decided they weren't worth it. I just know they have this little extra space at the tip. I guess a little space is not enough for you. Next time get a baby puddle pad, put some old towels over it, and kick the dogs off the bed! (Skip the oral sex.) Bev > > IP you are the exception and not the rule! > [quoted text clipped - 13 lines] > > I.P. > ROTFLMAO! > [quoted text clipped - 5 lines] > Next time get a baby puddle pad, put some old towels over it, and kick the > dogs off the bed! (Skip the oral sex.) Well, we DO have a big, secluded back yard . . . but I expect that in my case that "little extra space at the tip" would have to hold a quarter-liter some days. I THINK IT WOULD GET IN THE WAY. I.P. > I don't know; haven't tried it. We aren't talking about a "leak"; > we're talking about a very forceful, high-speed, jet slamming into [quoted text clipped - 3 lines] > washing down the walls, and hosing off the dogs, and that's not an > exaggeration. I.P. Have you considered joining the local fire department? ;) B.A. >> I don't know; haven't tried it. We aren't talking about a "leak"; >> we're talking about a very forceful, high-speed, jet slamming into [quoted text clipped - 7 lines] > > Have you considered joining the local fire department? ;) Well, ours IS all-volunteer. But have you ever peed on a fire? Better be upwind. I.P. >> I don't know; haven't tried it. We aren't talking about a "leak"; >> we're talking about a very forceful, high-speed, jet slamming into [quoted text clipped - 9 lines] > > B.A. In all seriousness, well mostly seriousness, urine makes a great weed killer. I used to pee off my deck on the same spot for several weeks. The spot became bare, and nothing has grown there for a year!  SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com I could have told you that. It will also help keep deer off the property. Now if we could figure out how to keep cats from using mulch as their outdoor litter box.... Bev > >> I don't know; haven't tried it. We aren't talking about a "leak"; > >> we're talking about a very forceful, high-speed, jet slamming into [quoted text clipped - 13 lines] > killer. I used to pee off my deck on the same spot for several weeks. The > spot became bare, and nothing has grown there for a year! > In all seriousness, well mostly seriousness, urine makes a great weed >killer. I used to pee off my deck on the same spot for several weeks. The >spot became bare, and nothing has grown there for a year! Pick your weeds with care. Unless you're quaffing quarts of Pathclear, urine is a first class fertilizer and most weeds will flourish beyond your wildest dreams. There's a TV gardener in the UK with the hopelessly apt and allegedly given name of Bob Flowerdew who advocates enriching his compost heap by peeing on it. He calls it recycling his beer... http://www.plantea.com/compost-materials.htm (.. bottom of the page) Of course you could always follow Gandhi's and John Lennon's example and point your powerful stream vertically upwards - mid-flow makes the most beneficial beverage apparently.. >> IP you are the exception and not the rule! > [quoted text clipped - 9 lines] > bedding and mattress pad and any nearby clothes, washing down the walls, > and hosing off the dogs, and that's not an exaggeration. WOW!! You oughta change your name to "I.P. Extraordinarily" >>> IP you are the exception and not the rule! >> I have no idea how common urine expulsion is. I had the impression from [quoted text clipped - 9 lines] > > WOW!! You oughta change your name to "I.P. Extraordinarily" The issue is not so much quantity as aim and control. An ounce goes a long way on a sheet, or wall, or pair of PJs. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. I.P. Amen to that I.P. Mind you, I recently had what is called a Ventral Slit which seems to have improved things somwhat. Warren, peace >>>> IP you are the exception and not the rule! >>> I have no idea how common urine expulsion is. [quoted text clipped - 29 lines] > I.P. I.P. > I.P. IP, Do you imply it's easier have an orgasm with the bladder full? Or, may one void before masturbation and not have to clean the wall? I'm going to start working on it, but am still on ADT and RT (25 down 17 to go). Most days I wouldn't give a nickel to watch a piss ant eat a bale of hay. Would trying to exercise help? Thank-you David > > Many women find oral sex objectionable because they do not > > want a mouthful of ejaculate . . . Guess what? Those days [quoted text clipped - 14 lines] > > I.P. in Spurts > > Many women find oral sex objectionable because they do not > > want a mouthful of ejaculate . . . Guess what? Those days [quoted text clipped - 14 lines] > > I.P. in Spurts Whoa! I don't think that effect is typical. I've never produced urine as a result of orgasm. As they say "your results may vary" but again, I don't think it's a given. One thing to keep in mind though, is that during an erection your ability to urinate is normally blocked (for obvious reasons). Having sex without an erection (or possibly with a "less than complete" erection) means you can still urinate. If you think you might get lucky, it would be a good ideaI make sure your bladder is empty out of consideration to your partner. Steve RP 5/06 > Whoa! I don't think that effect is typical. I don't know its likelihood, but it is in the books. > I've never produced urine as a result of orgasm. Have you had an RP? > As they say "your results may vary" but again, I > don't think it's a given. One thing to keep in mind though, is that > during an erection your ability to urinate is normally blocked (for > obvious reasons). Having sex without an erection (or possibly with a > "less than complete" erection) means you can still urinate. Now THAT is common among up to half of RP pts. > If you > think you might get lucky, it would be a good ideaI make sure your > bladder is empty out of consideration to your partner. As I've said, I can pee within minutes after voiding my bladder, many ounces just in the time it takes to go from "Hello" to "Well, THAT was fun". Sex is no longer something I can do in an environment I can't hose down unless I'm dehydrated . . . which I never know ahead of time . . . or wrapped in a towel, which is seldom 100% effective and gets mighty wet. Beverley commented that the post-op male orgasm is diminished by its lack of ejaculate; I'd say mine is enhanced by the increased volume of ejaculate, even it if IS just urine. I.P. >> > Many women find oral sex objectionable because they do not >> > want a mouthful of ejaculate . . . Guess what? Those days [quoted text clipped - 27 lines] > Steve > RP 5/06 Let me add that I don't urinate when orgasming. but I do when first arroused. I may make a few sudden bathroom runs when we get started for a little squirt. I think it has something to do with a relaxing or tightening of one of the control mechanisms? In fact I tell me wife that the highest compliment I can give is to say that she makes me pee. SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > I tell me wife that the highest > compliment I can give is to say that she makes me pee. Yeah, my wife pisses me off sometimes, too. I.P. Nice comments Beverly, and I think most men agree.... Men can handle plenty of graphics..... thats what gets us going..... John Loomis > Maybe I shouldn't be answering this but I'll try anyway. > [quoted text clipped - 57 lines] >> >> gary gary, I've had one erection, but no orgasm. IP posted about the orgasms. I've only been on this NG about 6 months , but IP is very well informed and articulate. And I think Bev left some instructions. david > dave > i have never masterbated without an erection. [quoted text clipped - 35 lines] > > > > I.P. I asked similar questions prior to my surgery in 2003. I had never had an orgasm without an erection and couldn't figure out how it was done otherwise. Well, it can be done and I might add very satisfactorily. I started off trying a couple of techniques and the "wet noodle" did present a problem. When George Burns was in his 90's he was asked how his sex life was at such an advanced age and he replied, "It's like shooting pool with a rope". Well, that's the "wet noodle" you're talking about. What I ended up doing was lubricating everything with lotion (Lubriderm because it's what I had around the house, K-Y jelly did not work because it dries out too quickly.) Then, I started to manipulate the head kind of like rolling a marble between thumb and fingers, and it worked. In fact, many of these orgasms were better than the old "in and out" intercourse things or the rubbing of the shaft because of the relative sensitivities of the various parts. As the months (now three years) have gone by, little Willie gets partially hard so I am able to do it "the old way". Also a side note, since I'm uncircumcized, I've learned that manipulating the walnut way can aggravate and irritate the foreskin to the point where it tightens up leaving me unable to retract it. Dr. recommended hot soaks in the tub which keeps things under control. Of course, if you are "bald" then this isn't an issue. By the way, your doctor is an idiot to say orgasms require pill induced erections. Did he really say that? Dave Perry > dave > i have never masterbated without an erection. [quoted text clipped - 35 lines] > > > > I.P. > does impotance mean i would not be able to have an orgasim? will i be > able to masterbate without an erection? also, if i am currently able [quoted text clipped - 4 lines] > old cotmplating surgery. > irwin First of all take care of your PCa..... all else will fall into place after the surgery. As for sex.... yes dry and limp orgasms are quite wonderful. Seems like the mind can easily fool the "member" into thinking just about anything. I was "exercising" as soon as the cath was out with great success, well before erections started up again. Although I have no proof, I honestly think that 1 or 2 orgasms a day has helped me regain my erections well before they would have, if ever. I know it sounds crazy, but I can have many more orgasms now than ever before. It's almost as if the old painful part is now dulled. SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com > does impotance mean i would not be able to have an orgasim? No. Impotence by itself should have no affect on the ability to achieve orgasm. Of course, other things may happen in the body as the result of treatment of just because of aging. Some men after surgery or radiation to treat prostate cancer will have decreased orgasms, but usually the effect diminishes with time. Since many men with prostate cancer are older and since the intensity of orgasms decreases with age anyway, it may be difficult to distinguish one effect from the other. will i be > able to masterbate without an erection? Yes, but you may have to change the way you go about it. also, if i am currently able > to masterbate and use 100mg of viagra to sustain an erection for > intercourse, what are my chances of viagra helping me after surgery if > i need more help? You are certainly not going to be better off in this regard after surgery than you were before. How much worse you will be will dpend on many factors. One of the most important can be anxiety. If you worry a lot about being able to have an erection, it will certainly be a lot more difficult to achieve one. Similarly for orgasm. will it help me if my need for viagra turns out to > be more psychological as opposed physiological? Possibly. I assume you mean that your current difficulty has no organic explanation. But, presumably the same psychological factors will play a role, in spades. Perhaps anti-depresant drugs might help, but such drugs can also decrease sexual desire. i am a healthy 66 year > old cotmplating surgery. I was 67 when I had surgery. I was impotent for 18 months but my wife an I managed to have a relatively normal sex life by use of a pump. Now I am 73 and my wife is 71, and considering our age and various arthritic aliments, I think we do pretty well in that regard. Having an understanding, loving partner is a great help. It is very important that you have a surgeon skilled in nerve sparing technique. Even so, the chances of your regaining erections after surgery are probably less than 50 percent. But there are lots of ways of treating impotence ranging from pumps to injections to, in extreme cases, penile implants. > irwin Leonard when you wrote that my chance of having erections after surgery is less than 50%, were you implying that in a permanent absolute sense or do you mean temporarily or degraded or both? i have been beginning to believe that there is an initial period after surgery where there would be no erection. after that it is based on each individual. are you suggesting that i would have less than a 50% chance of having any erection or just degraded? gary > > does impotance mean i would not be able to have an orgasim? > [quoted text clipped - 46 lines] > > > irwin > Leonard > when you wrote that my chance of having erections after surgery is less > than 50%, were you implying that in a permanent absolute sense or do > you mean temporarily or degraded or both? First, note that my opinion is just that and you shouldn't place particular credence in it. Your doctor could give you a better estimate. First, note that the chances of being impotent right after surgery are close to 100 percent. It is long term impotence I'm talking about. My doctor, who is skilled at nerve sparing technique but not one of the leaders in the field, told me my chances of being permanently impotent with him as surgeon was about 50 percent. had I been younger it would ahve been higher. I briefly considered trying to go to Baltimore and have Walsh or one of his associates do the surgery, but I would have had to pay the full cost myself, and I figured that would give me at best a 10 percent greater chance of avoiding impotence. I also decided on the basis of my reading that impotence could be treated and there was an excellent chance I could deal with it that way. As I noted before, I was impotent for 18 months after surgery, and it was more difficult dealing with it than I had imagnined, but I still managed okay. My reason for saying your plikelihood of being permanently impotent was more than 50 percent is that you say you already suffer some degree of impotence. Before my surgery, I didn't even have ahint of such a problem. > i have been beginning to > believe that there is an initial period after surgery where there would > be no erection. the typical time for erections to return is 3 noths to a year, but some men take up to three or four years. Mine returned after 18 months, and it wasn't until two years that I woke up with an erection. > after that it is based on each individual. are you > suggesting that i would have less than a 50% chance of having any > erection or just degraded? The definition of impotence is the inability to produce an erction firm enough for intercourse. Actually, it can be pretty weak and you may still be able to penetrate. Once you do, it tends to become a lot firmer. Given your age and the fact that you already have some problems, I think it is likely that your erections, if they return, will not be as strong. But that doesn't matter if they serve the purpose. My erections are not as strong as those I had before surgery, but my wife and I still manage to be satisfied. The important point is that even if you never have a normal erection, the odds are very high that by one means or another you will be able to maintain a relatively normal sex life. As they say, where there is a will, there is a way. You should not let the fear of impotence prevent you from choosing the appropriate care. But if impotence is really an issue for you, you might consider external radiation instead of surgery. At your age, the odds of avoiding impotence may be higher with radiation. But radiation has its own collection of side effects, including bowel problems, which are rare with surgery. If you do choose radiation, try for 3D conformal radiation with IMRT, which allows for doses high enough to kill the cancer while minimizing side effects. Perhaps there is one other point I should mention. After surgery, when I couldn't produce any kind of erection at all, it felt almost as if I had lost a physical part of me. The point is that men are used to having erections all the time. We usually have several each night for example. When that stopped, I felt a real sense of loss, which had nothing to do with sexual activity, and which I had not anticipated. But in time I got used to it, and it had no profound effect on me. > gary > [quoted text clipped - 52 lines] >> >>>irwin > does impotance mean i would not be able to have an orgasim? will i be > able to masterbate without an erection? also, if i am currently able [quoted text clipped - 4 lines] > old cotmplating surgery. > irwin good questions that all prostate cancer men should have: I am a urologist specializing in robotic surgery. I answered this on my robotic surgery blog: http://www.njurology.com/RoboticSurgeryBlog/2006/06/sexual_life_after_prostate_r emoval.php#more > good questions that all prostate cancer men should have: > I answered this on my robotic surgery blog: Why don't you save us time and just post it here? >> does impotance mean i would not be able to have an orgasim? will i be >> able to masterbate without an erection? also, if i am currently able [quoted text clipped - 11 lines] > > http://www.njurology.com/RoboticSurgeryBlog/2006/06/sexual_life_after_prostate_r emoval.php#more Doc it's spelled "lose"... not loose. SignatureJK Sinrod www.SinrodStudios.com www.MyConeyIslandMemories.com |
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