I had a radical prostatectomy in April last year at 50 years of age and erections are completely non existent despite several compounded mixtures of bimix and pap, viagra, cialis and 2 different kinds of pumps.
My wife could not be less interested in me sexually and has made it clear that ' there is nothing sexually attractive about a flaccid penis'.
I am finding my enforced celibacy very frustrating and frankly regret my decision to have surgery ( yes I do know the consequences of not treating this cancer). On the rare occasions that I have been able to orgasm despite my permanently flaccid penis it is an unpleasant experience often with a cramping pain in the abdomen that lasts for some time afterwards.
Given that I don't seem to be getting even a hint of sexual function back and the likelihood of any penile rehab involving my wife is zilch where do I go from here?
I feel like the part of my body that allows me to function sexually has been mutilated/removed but the part that makes me want to function sexually is left intact and working as well as ever.
I do not believe I will ever regain sexual function (certainly not in the only way my wife is interested) and I just want any and all sexual desire gone.
It feels cruel to lose the ability but keep the desire so I see the only thing that could alleviate the distress I feel about this is some means of ablating my libido.... castration either chemically or surgically.
Can anyone tell me how effective this is in reducing sexual thoughts and frustration with celibacy and if these procedures are ever done for this reason ?
The only advice Ive had regarding this matter is to keep trying..... well thats just not going to happen.... I just want to reduce the distress my impotence causes me as I hold no hope at all of it being resolved.
I would appreciate your thoughts, thank you.
Mick, I totally understand your situation, but castration has more effects than just removing your sex drive: weight gain, loss of muscle mass, osteoporosis, etc., etc. Your (OUR) problem is twofold; the inability to perform a certain sex act that has not been a problem for the last 35 years until now, and dealing with the emotional, mental strain that comes from the physical problem. Pardon my saying, but, your wife doesn't sound very interested in helping you with either problem. I've spoken to another couple, he a prostate cancer survivor, who underwent a penile implant procedure. She is absolutely thrilled with the implant, because he can stay "erect" for....well....as long as she wants him to be. Their sex life might actually be better than before his cancer surgery. She, BTW is about 15 years younger than he. Might want to get some more information from your urologist...
PSA 6.48, biopsy Gleason 3+4, robotic prostatectomy 9/17/08, pathology Gleason 4+5, pathologic stage T2c, positive margins, SRT completed May 22, 2009. 1st post-radiation PSA, 8-4-09, <0.06. 2nd post-radiation PSA 12-22-09 <0.06. PSA, July 23, 2010: <0.06. PSA, January 10, 2012: 13.90. Re-test, February 6, 2012: 16.47. April 6, 2012: 25.6. PSA, May 2, 2012: 37.74. PSA, May 27, 2012: 37.4. PSA, June 17, 2012: 51. PSA, Sept 27, 2012: 110.24. PSA, January 28, 155. May, 2013, Well, you get the idea...
I agree with mkane09 in feeling that your wife could certainly be more supportive. Most wives are so worried about their husbands' health that they could care less about the sexual part as long as their spouse is going to recover from the cancer. I supposed this is not the situation in every case, but I'd guess that most women understand and are primarily concerned that their husband is going to be okay.
With that said, and please forgive my frankness up above, I believe you are going a bit too far on the pessimistic side. So hopefully the following will help you see your situation in a more hopeful light.....
.....it can take up to 3 years for sexual function to return. I am just now starting to have natural erections at 14 months post-op. Hopefully the nerves that control erections will continue their recovery and I will be able to regain strong erections.
Can you tell us more about your surgery? Was it bi-lateral nerve sparing? If the nerves on either (or both) side of the prostate were saved, you should regain your sexual ability as time goes on. One note: a man's post-operative erections generally are NOT as strong as they were before the surgery. Whatever an individual man's personal performance level was, it will not be quite the same level. Now, if a man's level was VERY strong prior to the surgery, he should be more than adequate to perform because a "strong" level can be just as effective as a "very strong" level.
Also understand that an erection is NOT required for an orgasm. An orgasm is just a muscular contraction and even a flaccid penis can have an orgasm. Most men report that their post-op orgasms, although dry, are often more intense than before the surgery.
The best thing you can do is keep using an erectile pump on a frequent basis and/or keep trying for stimulation -- because this will reintroduce the blood vessels to their designed function and will help take steps toward recovery of erections. It kinda goes along with the old adage, "use it or lose it."
So hang in there -- you are simply experiencing the recovery curve and WILL eventually begin having erections again, even if it takes another year or longer. Some guys are lucky and have erections within weeks of surgery. One guy even posted here that he was getting erections while the catheter was still in. But everyone is different and it also depends on the trauma suffered by the nerves.
Remember that the nerves are kind of "attached" to the prostate. I believe this could be compared to vines on a brick wall -- they are not part of the wall, but are kind of attached to it. Any type of contact with a nerve causes trauma, which requires a long period of time for it to return to normal. Same with the nerves along the prostate. If they are spared during surgery, they must still be "prodded & coaxed" away from the prostate so that the prostate can be removed.
This, in itself, traumatizes the nerves and it simply requires a lot of time -- sometimes years -- before their function returns.
EDITED NOTE: You also have the advantage of youth on your side. Younger patients usually recover more completely than older ones. So, once your sexual function begins to return, the recovery will hopefully be pleasingly dramatic for you.
So try to be patient -- and ask your wife to do the same -- and things should get MUCH better in the future.
Good luck -- to both of you!
July 2011 local PSA lab reading 6.41 (from 4.1 in 2009). Mayo Clinic PSA 9/ 2011 = 5.7.
Local uro DRE revealed significant BPH, no lumps.
PCa Dx Aug. 2011 age of 61.
Biopsy DXd adenocarcinoma in 3/20 cores (one 5%, two 20%). T2C.
Gleason 3+3=6. CT abdomen, bone scan negative.
DaVinci prostatectomy 11/1/11 at Mayo Clinic (Rochester, MN), nerve sparing, age 62.
Surgeon was Dr. Matthew Tollefson, who I highly recommend.
Final pathology shows tumor confined to prostate.
5 lymph nodes, seminal vesicules, extraprostatic soft tissue all negative.
1.0 x 0.6 x 0.6 cm mass involving right posterior inferior, right posterior apex & left
mid posterior prostate. Right posterior apex margin involved by tumor over 0.2 cm length,
doctor says this is insignificant.
Prostate 98 grams, tumor 2 grams.
Catheter out in 7 days. No incontinence, minor dripping for a few weeks.
Five annual post-op exams 2012 through 2016: PSA <0.1
Semi-firm erections 5 years post-op whenever the moon turns blue.
Hi Mickee, There is a chemical you can inject into your penis and you will get rigid. I've done it many times once you get over sticking your penis with a needle it's a piece of cake. Your doctor should have provided that option to you. I'm chemically castrated because the cancer came back after 5years it's called recurrence . It's impossible to create in you head a sexual thought, nothing is a turn on. It is a cruel and horrible way to exist. It's used on convicted sex offenders. Being Italian sex was always big on things to do. I weighed in at 136 lbs, now I'm at 206 down from 217. my breasts are huge ,we literally turn into women. Recurrence happens in a very small percent of us so your probably going to be just fine. Between the recurrence and the castration I had 1 to 2 hookers a day, home just couldn't do the job. You need someone who doesn't know the score and someone who will focus on your pleasure. It will restore your confidence and you'll be the man you were before . It sounds like you and your old lady are not only not on the same page but your not even reading the same book. Can you imagine how she'd treat you if you really got sick!!!! For $10 a hour you can have the cleanest house in town, there are plenty of good restaurants and for a few bucks you can have your pipes cleaned by a different pro every day..I sure miss those days. Maybe just maybe a lifestyle change would lower your stress level and raise your self confidence through the roof. I've been through the whole prostate cancer nightmare so if you ever want to talk just text me. Good luck. ...Gimmy
Thank you for the responses I appreciate your thoughts.
I have tried phentolamine which only half worked but was so painful i will never try it again, bimix and PAP at maximum strength and injecting up to a 100 units didnt work, nor did maximum doses of viagra or cialis (no effect whatsoever).
Going to a prostitute and not being able to get it up would be humiliating so I wouldnt consider that.
There will be no penile rehab for me and all I want is any help I can get in dealing with desires I cannot act upon and I think some form of castration is worth investigating.
I live in a very isolated part of Australia and do not have a regular urologist which is why Im seeking some advice here.
Mick, I share your pain and frustration. I keep telling myself and my wife that it could be another year or two before an erection is part of our sex life. We still have a sex life, because we have gotten creative and I push the issue and she is appreciative and we are in our early 60s. Your age and libido are a powerful tool in your healing. You and your wife may need to sit down with a therapist and see where that takes you.
PSA .864 2009
PSA 1.68 2012
PSA <0.08 7/12 one month after surgery, PSA <0.08 three months after surgery, 9 month PSA <0.08, 1 year PSA<0.08, 15 months PSA <0.08
2/2012 Biopsy 4+3 (7)
Da Vinci Robotic Surgery 6/2012
Histologic grade Gleason 4+5 (9)
Right lobe involved 26%
Seminal vesicles negative for tumor
Lymph vascular invasion not identified
Margins negative for tumors
Pathologic stage: T2b N0
Mate my heart goes out to you. Getting castrated will probably do nothing to take your frustration away after all the primary driver of sex in us is not our genitals but our brain. You may want to have your testosterone levels checked and I also think the suggestion of therapy by fast eddie is a good one. I know its hard getting good help in the bush so a trip to a city maybe in order as well.
Hang in there and don't give up I am sure there is a solution somewhere.
Diffuse Large B cell Lymphoma
Finished six cycles of R chop 21 26th May 2008
Officially in remission 9th July 2008
Remission reconfirmed 1st October 2008
Remission reconfirmed 17th June 2009
Remission reconfirmed 7th June 2010
Remission reconfirmed 6th July 2011
NED AND DECLARED CURED on the 2/01/2013
No more scheduled visits to the Prof
RULE NUMBER 1.....Don't Panic
RULE NUMBER 2..... Don't forget rule Number 1
Great moments often catch us unaware-beautifully wrapped in what others may consider a small one.
I may not have gone where I intended to go,
but I think I have ended up where I needed to be.
Ok Mickee, Castration is absolutely the last option you want to consider and only when faceing certainty of death. Calm down and memorize ChemoMans 3 things to remember. Don't panic,never give up and #3 don't forget the first 2. We have all walked in your shoes. Millions of men who have had their prostates removed live long and happy lives and enjoy sex. A very small percent of us will ever have a recurrence ,and that is usually 5 years after the operation. The environment your living in may significantly impact your ability to perform sexually. There are trained perfessionals who can be used to help invigorate you sex life. As highlander said use it or loose it. Go on line and manipulate yourself every day watching porno.You have to start talking to your penis just like you did when the catheter was removed. It works. You are fine give yourself a break and give it time. You have nothing to be humiliated for , you had a medical procedure just like a heart attack you need patient loving care. Are you getting that at home? Have you checked to see if there are support groups in your town? Please continue to come on line everyone here really cares and prays for you!!! Remember 1,2,3 ...Gimmy ...........By the way I'm 64 prostate removed 2003, recurrence 2008, chemo,radiation 2008,castrated, radiation 2011 matastisized ,currently going through round of radiation and experimently drugs. And hyper baric oxygen therapy ( it helps to make me more comfortable. 1,2,3
I had nothing going on down there for about 3 months after my surgery. I was terrified. I had no results with Viagra or Cialis. I did have good results with the pump - so I don't see how you could not get that working. For me, it took some fiddling, which was annoying, but it got me to a satisfying place. I also had good results with Trimix injections.
I'm now 14 months post-op, and getting better erections. About half the time, I can get things to work out on their own. The Viagra and Cialis are working for me. And I can go to the pump for backup if needed.
What I'm saying is that I think castration is far too serious for you to consider. I have a friend in my support group that is going to get a penile prosthesis - you should at least consider that.
As for me, my wife of 31 years had asked me for a divorce about 4 months prior to surgery - so no sex action there. But I have picked up a wonderful girlfriend who has helped me enormously through all of this.
Hang in there.
Diagnosed at age 52.
PSA in 2000 2.2
Biopsy on 10/3/2011
Malignant in 1 of 8 cores. Gleason 3+3=6
11/15/2011 Open Retropubic Radical Prostatectomy
post - op PSA:
My husband has been on HT now for almost a year ... and it has almost been a year since we have had sex. That is ok .. I still have him. But ... he is the one that feels terrible about it - so, castration is not going to make you feel any better. Just hang in there, get your wife to counseling or something so that she stands with you, instead of against you. That may help in the bedroom area too.