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Sex and Intimacy After Prostate Cancer Surgery

Last updated: April 2021

Before my prostate cancer diagnosis, I took my erections for granted. That is, I never gave them a second thought. They were always reliable, required no foreplay, and were ready for action day or night within a moment’s notice. It wasn’t particularly unusual to get an erection, or two, during the day, even when I didn’t want one.

It seemed my erections had a mind of their own and were outside my control. But I could always count on them whenever required. Therefore, I assumed my erections would continue for life. Like a faithful companion, always eager to please, my erections never let me down.

A drastic change

That all changed after my prostatectomy. Although I researched many treatments before opting for surgery, I didn’t fully explore impacts on quality of life. I knew surgery might be the end of my erections. But I had so much confidence in my doctor that I was eager to move forward.

Even still, it’s critically important to give yourself time to explore all options available and to seek multiple opinions. Please don’t rush into treatment without all the facts. For more details, read my article, “Prostate Cancer and How Not to Make a Decision.”

Considering the risks

Before the surgery, I learned that the nerves responsible for erections ran along both sides of the prostate. And by removing the prostate, there was a good chance these nerves may become damaged or even removed. My surgeon outlined his priorities — remove cancer, preserve urinary control, and maintain sexual function — in that order. Meaning, the surgeon would sacrifice urinary and sexual function, if necessary, to remove all cancer.

I accepted this risk, but not without fear. The surgeon explained that erection and orgasm are separate functions that do not rely on each other. That is, you don’t need an erection to have an orgasm. Just in the same way, you don’t need an orgasm to have an erection. Or in other words, it’s possible to have an orgasm even if the penis is flaccid. He assured me that he would do his best to spare the erection nerves. With that news, I agreed to the surgery.

Thinking about my ability to have erections

I remember waking up in the recovery room, being very anxious to speak with the surgeon. My thoughts were on erections. When the surgeon appeared, I didn’t ask him about the surgery. I didn’t even ask if he ran into any complications or if he was able to remove all cancer.

The only question on my mind was, “were you able to save my erection nerves?” He wasn’t surprised by the question and said he indeed spared my nerves. However, he warned, they might take months or years to recover, with the possibility of never working again. I was happy with the news but worried about recovery.

Getting intimate again after surgery

A few months after surgery, my wife and I attempted to be intimate. It was quite a different experience, as I’m used to being ready for action. But not this time. My wife was very patient, and in some ways, it felt like my first sexual experience.

My penis was extremely sensitive to touch, and within the first few moments, I had already achieved orgasm. The doctor was right. No erection required. And to my surprise, the orgasm was more intense than I remember and lasted much longer. However, it was painful at the end, and I leaked urine. Despite the pain and leaking, I was thrilled to achieve an orgasm.

Turning to romance

Over time, the pain and leakage eventually disappeared. However, the erections were slow to return. My doctor provided a prescription for Viagra but advised me to shift my focus from getting an erection to romance. Advice that my wife appreciated.

It’s not that I haven’t been romantic, but it wasn’t necessary before the surgery. I now focus time and energy on romancing my wife. The more I’m able to stimulate her mentally and emotionally, the more chance she will become sexually turned on. Which in turn gives me more of an opportunity to achieve an erection. And if an erection doesn’t occur, that’s okay. I’m still in for a fantastic evening of pleasure.

How has sex and intimacy changed for you after prostate cancer treatment? Share in the comments.

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The ProstateCancer.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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