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Medical Forum / Diseases and Disorders / Prostate Cancer / September 2006

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possible physiological reason for degraded orgasm after RP

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gary.miller12@comcast.net - 15 Sep 2006 07:36 GMT
below is part of a response i got to my question about degredation of
orgasm after RP.
please give me opinions on this.  does this feed back into the brain
via the spine such that the feeling could be different based on
individual wiring?  page 226 of Walsh's book says that  the tiny
branches that connect the nerves to the prostate are divided carefully.
i assume that means they are cut.
below is the the response i got:

"i knew what was involved in the make up of the orgasmic
response and not just the sexual response.

after the RP, i ask my surgeon point blank about specific points and
questions in this area and he didn't blink.   he told me exactly why
the
orgasm is different from surgery, and i can see why the radiation guys
would be affected too.

it's more than just an email can tell.

but this much i will say.

get out your walsh's book and other books and look at the drawings of
the prostate and those nerve bundles.  (not the erectile nerve bundle)
those are feedback nerve loops coming FROM the prostate and going back
the base of the spine.   those nerves are cut during surgery and that
feeling is lost.   now, different people are wired differently.

as i mentioned - far more information than one email can say, but this
is a starting point."
tchtic@yahoo.com - 15 Sep 2006 15:38 GMT
> get out your walsh's book and other books and look at the drawings of
> the prostate and those nerve bundles.  (not the erectile nerve bundle)
> those are feedback nerve loops coming FROM the prostate and going back
> the base of the spine.   those nerves are cut during surgery and that
> feeling is lost.   now, different people are wired differently.

I've been wondering about this too.  I'm 23 months post-treatment
(that's the rad part. I'm about 18 months post ADT) and while my
erection and orgasms are improving, it's still not very satisfying.  I
gotta really get in the mood to get going.

I'm probably doing better than those, low-libido, non-orgasmic, lower
third of the bell curve, women who sometimes wonder if they're missing
anything in life.

They are.

There are women out there who enjoy and crave sex.  One girlfriend,
with runway model legs and movie actress looks, said that she "lives
for her orgasms", "was afraid to get married because that would tie her
down and restrict her sexual range", and she had one rule in life, "if
a guy asks for sex,she always gives it to him."

She had mixed feelings on marriage and said that, "at least then, she
could have sex every day."    When we dated, we only got together once
a week or two.  Then it was a couple times in the evening, in the
middle of the night, and another couple times in the morning.   I'd
call her at work the next day and she'd say that she was "walking
funny" in a heavy, breathy voice.

Post treatment, even when goin' strong, it's not great.  And the
finish?  It's only OK.

That's a lot better than I was doing the other year.  8 months of
Lupron.  Nothing worked for over a year.  As the doc told me, "the good
news is that YOU won't care."

I think, and this is my opinion not scientific fact, that RP and RT
leaves the wiring scrambled.   RP seems worse that RT but as a
rad-grad, the sensations aren't right.

Sometimes I have a urethral burning at orgasm.  I can imagine how some
might interpret this as a stronger orgasm.

The other day, after reminiscing hard about ancient times with that
older, more experienced woman, the 30 year old slim blonde, very
pretty, grad student with perky breasts, the small amount of
semen-dribble was tinged pink.

The next morning I pee'd very light pink and one flake of a blood clot.

I have discussed this with the Rad-doc and he felt that this was a sign
of the 18 month to 20 year Rad induced prostate die-off, a good
indicator.

I wonder what happened to that grad coed, she'd be, what, 70 years old
now!!!   That was almost FORTY years ago.  I guess when you're an
inexperienced 20 year old boy and an old lady of 30 says, "Get behind
me.  I'll bend over on the bed  You'll like this. You'll be able to
watch yourself going in and out."  That makes an impression.

Anyway, practice makes perfect, I'm, er, pulling for everyone.  We
might be old men but there are women out there who want us to recover.
Get better, treat them right.  If Willie won't cooperate, the RX is a
rough wet tongue applied slowly to first the left labia, then the
right.  Don't rush this.

-kh
Ron B - 17 Sep 2006 19:21 GMT
It's been discussed here that the 'orgasmic' nerves are different than
the 'erectile' nerves.

I've found that to be true after an RRP in 3/05.

I was pleasantly surprised that orgasms could be achieved by manual
stimulation even without an erection.

Now...I fully understand that a guy may not FEEL the same
psychologically when he doesn't have an erection...but there CAN be
orgasms and they CAN be good.

Not the same..without erection or ejaculation...but good anyway.

Often as intense...but the lack of erection and ejaculation may alter
ones perception of how good it really is.

It should be OK.

However I DO understand that so much of sex is 'in the head' (no pun
intended :-)...so I can see where guys have different opinions.

Best of health to all,

Ron B.

Chicago
 
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