ED after Radical Prostatectomy: The End of Sex? Maybe, Maybe Not...

I'm currently 65 years old. About 18 months ago, after several prostate biopsies and an MRI discovery of a Gleason 3=3=6 PIRADS 4 lesion on my prostate, I had a radical prostatectomy. In a disturbingly short period of time, I went from a lifetime of being relatively healthy to a cancer diagnosis, major surgery and the very real prospect of the end of my life as a sexual being. It was a major transition, to say the least. I was told going into the surgery that this was to be a nerve-sparing procedure, which gave me some hope. However, I later learned that around 25% of one of my nerve bundles was removed along with my cancerous prostate. While I was obviously pleased that the surgery was successful and that I'd likely be able to look forward to a cancer-free life, I was a little worried about what the quality of that life was going to be.

During the recovery phase, I dealt with the usual discomforts: figuring out how to sleep with a catheter bag, doing kegels, after the catheter was removed, dealing with the irritation and embarrassment of adult diapers. And there was the dispiriting sight of my manhood, looking somewhat shriveled and rather the worse for wear after surgery and associated indignities. I felt pretty down in the dumps, contemplating the idea that my sex life may very well have come to an end. I didn't feel very much "down there" for quite some time, and I began to get curious and a little worried, honestly. After a little "manual exploration," I was heartened to discover that I could have an orgasm, even with a flaccid penis. I didn't feel any arousal in the sense that I had pre-surgery, which I chalked up to either nerve damage or that the nerve bundles hadn't recovered from the surgical manhandling they'd received.

During the several follow-ups with my urologist, he asked me (among other questions) about my sexual functioning--or at the time, the lack thereof. He let me know at it could be years before I regained the capacity for an erection--or it might not ever happen. That was not exactly the happiest of news. He scheduled an appointment for me with an erectile dysfunction specialist, who gave me various exercises to perform and prescriptions for Cialis, and later Viagra. Additionally, she (yes, it was a woman...) had me purchase a vacuum penis pump, and advised me to use it regularly to stimulate blood flow.

Viagra didn't work for me nearly as well as did the Cialis, but neither of them seemed to help stimulate erections. I couldn't, and still can't for the most part, achieve an erection without manual stimulation, which seems in my case to be a function of nerve loss. It's like the arousal/erection connection has been broken, looking at it in electrical terms. That's not completely true, but it's close enough to being true to describe it that way. Over the past year and a half, I have had a total of three erections that have come from sexual arousal as I remember it. I don't know if I'd describe my condition as erectile dysfunction because I can have an erection, but not without some assistance. My current situation is that I'm able to have an erection, but the surest way to achieve one is through manual stimulation. It doesn't happen the way it used to; before I had my prostate removed, I could have an erection by thinking about sex or by watching my wife come back to our bedroom after a shower, but that doesn't happen anymore. Orgasms are not quite as intense as they used to be, and this is probably also a function of nerve loss. I tend to think that this is the case because my perineum has the sensitivity of shoe leather. At any rate, sex is still possible, though the fireworks aren't quite as spectacular as they used to be. But that's okay...

Why am I telling you all this? I'm telling you my story in the hopes that it might help someone else in the same boat. I've read lots of stories of guys who have faced prostate cancer and prostatectomy and resigned themselves to a sexless existence. But for a little bit of experimentation, maybe their lives might not have been quite so bleak. Maybe a little personal exploration might have revealed some residual sexual function that could have restored them to at least a partial sex life. This probably won't be an option for guys whose religious or moral scruples won't allow them to "touch themselves," but if that's not an obstacle, they may find that there's still some life left "down there."