Never Give Up
It’s one of the biggest hang ups for men who have surgery how it will affect their ability to get an erection after treatment. Everyone is very different in how things react (or not) and what treatment or aids are available to try and counter the effects and how effective they are.
For me in the UK after robotic prostatectomy (non nerve sparing) my choices were pretty limited to the good old pump and a constriction ring and injections of Cavajet. The pump does have additional use for muscle exercise which replaces the normal process of erection during the night to maintain healthy tissue in the penis. Other affects of surgery mean an internal vasectomy and once thats done and the prostate are gone dry orgasms. One thing I found early on is that you don’t actually need to have an erection to have an orgasm. The mind needs to be retrained as when you look at something that under normal circumstances would create a reaction in the penis this no longer happens unless you are fortunate to have nerve sparing surgery where depending on how much is spared as to the ability for you to have a normal erection. This can also take time to come back and again everyone is different. Using the pump and ring is not great in my experience as it feels numb, has no direction or stiffness pass the ring and you are limited to 30 minutes use before needing to allow blood flow again. The rings used need to be pretty tight to be effective too and I ended up using two! The other thing is by loosing the prostate you also loose the main producer of lubrication. My experience of water based lubes on their own is not great. After battling with the pump for a while I tried the injections. One of the ingredients in Cavajet can also cause some discomfort plus other side effects but again everyone is different. For me it felt like it was going to explode and after starting on a low 5 mg dose gradually built up to 30 mg before I had sufficient effect to be useable. The down side for me is whilst it is only supposed to last for an hour or less for me it lasted for 3 1/2 hours! Not great bearing in mind how it felt and at 4 hours became a medical emergency! The first time I used it, it took 30 minutes for me to build up the courage to stick a needle in my penis! By the time I had sorted it and got back to the bedroom my partner was asleep! That was a long 3 1/2 hours!
After using this for a while I spoke with my doc to see if viagra might help so I could maybe at least reduce the amount needed to inject. Without the nerves it wouldn’t work but is supposed to help with blood flow also so worth a try. To my amazement it worked on its own! It shouldn’t but it does and I am not complaining! Not sure to this day why as at 1 mm a year growth it is unlikely I have regrown my nerve endings. I have though always remained positive and never given up hope. I have tried to stimulate my mind to encourage the brain to keep active in this area. Keeping the penis active even with the pump also has the effect of preventing shrinkage which happens to all muscle if not used. Try every option, never give up and if all else fails an erect penis is not everything if you are still alive! For some the mental effect of this could well be a major issue to battle but not something I have ever allowed to consume me. Chris ProstateCancer.net moderator
Another thing of note after surgery is you produce very little seminal fluid which also acts as a very efficient lubricant. The water based lubricants I have found dry out too quickly. Whilst you will still produce a small amount if you are using the pump and ring method this will prevent any seeping out which doesn’t help when things are already more difficult. Chris ProstateCancer.net moderator
We run community outreach seminars every month. Anytime the topic is "sex after prostate surgery" is advertised we get between 30 and 40 guys and their wives. We typically have one or two surgeons along with a nurse navigator.
The meeting have been a very effective way to educate men on how to adjust to the changes following surgery. Many guys report great success with the blue pill approach -- others no.
I will say that while guys report being concerned about putting needle into their most private parts, the reports of success are quite high. A few have gone the route of implants and are also pleased. We also have a number of men for whom sex is not an interest. Everyone is different and has different priorities.
There are lots of options always best to speak up and tell your MD what your concerns are ... Dennis (prostatecancer.net) Moderator
Check with Diana Richardson's "Slow Sex" for notes on "soft entry". Sounds very erotic and I almost wish I could avoid arousal just to try it.
She also recommends almond oil for lube. It IS quite nice.
After the lie my surgeon told me about being able to have sex after surgery became clear I tried everything- pills, vacuum pump, penis injections but nothing worked and I am still unable to get an erection or orgasm three years after the surgery. When I recently ask him why he lied to me he just shrugged and denied it. I blame him for the damage to my marriage.
Hi, and I'm sorry to say I'm in the same boat as you and I think 99 % of victims of prostate surgeons, who, indeed, lie. He keeps saying "I preserved the nerves," and, no, I have no ability to have a natural erection (I can with injections). For me his lie is compounded by the fact that no tumor was found in pathology. I didn't need to do this. 
That's terrible,
. Were the diagnostics going into the surgery showing signs of needing the procedure? There certainly does need to be more in-depth conversations about complications of treatment, prior to treatment. We are here to chat anytime. -Samuel, Team Member
