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Post-Surgery Orgasm Pain?

Little background first: I had Retzius Sparing Bilateral Nerve Sparing Robotic Prostatectomy 26 days ago at the age of 53. World class surgeon (over 1,000 surgeries under his belt if not closer to 2,000). Everything went well. Clean Post Surgery Pathology report. Moderate incontinence (2-3 pads a day when catheter out 1 week post-surgery, now at 1-2 pads a day depending on activity level, continence recovery is particularly quick with the Retzius Sparing technique. Could probably go pad free while sleeping).

Prior to surgery my EF was as good as when in my 20's. Got a high quality vacuum device and started using it once or twice a day each time doing two cycles of erect 4-5 minutes, followed by a minute rest period. Feeling took some getting used, not overly painful, just a little uncomfortable but now after a week it feels pretty good/natural to use it. Also on 5mg Cialis a day to help keep things well oxygenated and aid in recovery time. I fully understand it's typically minimum 6 months to get hard without pump (and that's optimistic) and can take up to 2 years to reach recovery pinnacle. So I'm patient on the erection side of things.

RN said no orgasms for 4 weeks after surgery, "it will hurt." So I jumped the gun by 2 days as I knew orgasm and erection recovery are two different animals. So I was curious as to where I was at. Took about 3 times as long, about 10 minutes versus 3 to reach orgasm. Great build up, but not as strong of a "surge" but about 2-3 seconds after the climax, OUCH! Very painful spasm coming from somewhere near the perineum area felt like. No pain in around the penis. It felt like the same location I feel some moderate discomfort when I finish urinating, almost like you feel this very subtle pain like you need to pee more but you don't. So I'm guessing it's bladder or urethra sphincter spasms, not pelvic floor muscle spams? (the Retzius technique doesn't go in through the pelvic muscles so I have very little to no soreness at 26 days post surgery in my perineum area even sitting at a computer all day.)

I'm frustrated as the Urologist (I will be consulting the RN later this week) didn't really talk about this issue. There's little discussion of it on PCa boards around the world. But it seems from a few studies and a couple threads I found, (a) it's fairly common early on with your first few orgasms and (b) it resolves over time - like a year to completely go away!?!?

So I'm sitting here totally clueless and scared to try to orgasm again! Should I give another 2-4 weeks rest before trying it again or is part of getting rid of the pain faster to have more frequent orgasms (one a day or every other day) and just power through the pain at first, as it will diminish for quickly with the "exercise" and not having orgasms will just delay the pain going away?

  1. No matter how you look at this you underwent major surgery and it takes time to heal. The non-medical advice we give men in our pre and post surgery chats is - if it hurts stop, if you are passing some blood - slow down or stop - and stay hydrated Your body is giving you messages it is up to you to listen and adjust or forge ahead .

    1. Which vacuum device would you recommend?

      1. I was looking through previous forum discussions and I found a couple that I hope can help you: https://prostatecancer.net/forums/penis-pumps-for-ed and https://prostatecancer.net/forums/penile-pump. Jill (team member)

      2. thank you!

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