Is an Orgasm After a Prostate Operation Still Possible?

I asked a friend, who had recently had a prostate operation, if he was still able to have sex, and if so, could he still have an orgasm? This is his reply:

Sex after a radical prostatectomy very much depends on the skill of the surgeon and how much had to be removed in addition to the prostate to get the cancer - not to mention some luck. In my case it was performed using a robot (da Vinci system) which provides greater precision and the surgeon was able to preserve the nerve bundles which means that erections are possible.

But this normally takes some time (months) for the old body to get over the shock of surgery and start returning to normal functioning. Even then, some assistance is normally needed (i.e. Cialis, Viagra, and a variety of other products locally administered (Muse) or even injections in the penis).

Orgasms are possible following post-surgery but alas the level of intensity is significantly reduced. In the past couple of months I have seen some improvement, which I am hoping will continue.

More info on prostate cancer and what to do about it here.

Another initial challenge following the operation is urinary incontinence as muscles are definitely destroyed and you have to retrain or rebuild the muscles to control the bladder. The first few months there were some unpleasant surprises, such as unexpected leakage and squirting when any movement puts unexpected pressure on the bladder, such as bending over, sitting down quickly, tying show laces, running on the treadmill, etc. It took lots of practice and special exercises over a couple of months holding off peeing to stretch the bladder and strengthen the muscles.

Losing control while sleeping was a particular problem, and initially required getting up every few hours for a toilet visit. Failure to control leads to bed wetting or pissing your pants.

During this period I had to wear a special penis pad to catch any unexpected flows. This was a rather demoralizing period and I was concerned that the condition could be permanent, but am pleased to report that I have almost regained 100% control.

Although back on my feet relatively quickly, the operation kind of knocked the pudding out of me, and I am still not back to my pre-operation level of robustness. A friend had the same operation four years ago; he said it took him about two years to recover.

Almost all men eventually have prostate cancer, but it can be very slow progressing, particularly the older the person. The saying is that most men will die with prostate cancer but not because of it. For someone in their 70s, who has a life expectancy of approximately 10 years, surgery is normally not performed. That is why "active surveillance" is frequently the approach followed.

However, in my case, it was apparently advanced and very aggressive, so removal was the only viable option. There are many much less invasive treatments if the cancer is caught at an early stage, therefore I would recommend that every male undergo a PSA test once a year.

More info on prostate cancer and what to do about it here.

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