After effects from Robotic Radical Prostatectomy

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I had a Robotic radical prostatectomy in August of 2012. Over time, there has been shrinkage especially when flacid. Orgasm without ejaculation is definitely different, but for some reason I have a mental picture of ejaculating even though I don't. There is some fluid which comes from the Cowper's gland. Sex for me is not the same but I think that is just my fault. I expect to much and therefore sex is pretty uneventful for me. Any similar experiences out there? Thanks.

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  • Edited

    I I had my prostatectomy in 2016 and yes sex has not been the same of course and the uneventful orgasm has been replaced with hers. I have had to use injections to achieve an erection and sometimes I simply don't use them and concentrate instead on the charge I get from achieving her orgasm. it is an amazing thing when you forget about your own physical pleasure and just concentrate on hers it quickens my heartbeat and enhances my excitement in ways I would have never experienced have I not they just need to be with went through the removal of my prostate... just a thought

    ..

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  • Edited

    This is why prostatectomy (or any other treatment) will be an absolute last resort for me. Were you even told what to expect in the way of genital shrinkage and dry orgasm? Many men are not told, or these life altering consequences are dismissed as minor "side effects." For most men, ejaculation is extremely important, and the vast majority of men want more, not less or no ejaculate. That's why there are all those products out there claiming to increase amount of ejaculate (most of which do not work). Same for genital size. I know you are not alone is the dissatisfaction you are experiencing, despite many in the medical community who obfuscate or minimize the significant impact these consequences can have for the vast majority of men. I, for one, view my genital size and ejaculate, and my current sexual abilities, as very important. I am not married and still have to date.

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    • Edited

      Before radical surgery it seems worldwide that most folk, me included are not told a thing about side effects and significant changes to sexual function. That said, in many cases surgery does a better job of ridding a body of the cancer, so in the end one has to consider the choice: less sex and less cancer or more sex with cancer not being treated as effectively as could be.

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    • Posted

      Actually the urologist assistant at the time told me (in front of my wife) that I could still ejaculate after the surgery. When I researched the procedure, I realized her stupidity and wrote a lengthy letter and brought it in to the urologist and detailed what she had said and emphasized her incompetence. Shrinkage was never mentioned.

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  • Edited

    After extensive research, the posts expressed here are the main reasons I went with the HIFU procedure. i still have all my male functions, cancer is in check (or gone) and I have none of the bad side effects. if the cancer comes back, i still have other alternatives. men must be there own best

    advocate. Don't take the urologist word/recommendation. Research and determine what procedure is best for you. Every man is different and each will have different results.

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  • Edited

    I had half my prostate (one lobe) ablated with HIFU in 2018 I too have suffered from reduction in girth and length of penis when flaccid. When erect it seems almost the same size. However gaining an erection takes a long time and maintaining it is shorter time

    My libido is virtually non-existent, which worsens the problem. but this and my ED were prior conditions for me My ejeculate is about a tenth. of before. The pleasure is different and reduced.

    But i have gained (I hope) longer lifespan albeit under testing and MRI checks.

    Like others, this was not emphasised before treatment although I would still have proceeded with HIFU. The main question is how can we improve our situation. Any ideas greatly appreciated.

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    • Edited

      ED issues are rarely if ever brought to a patient's attention before ANY treatment.

      That said, if your life is lengthened without pain, then you did the right thing by being treated. The toss up for some is longer life but without quality of life.

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    • Posted

      I agree with barney34. Removing the cancer was the top priority for me too

      Even if I had been more aware of the ED problems and loss of size and sexual capability, I would still have opted for HIFU as it offered less damage to nerves and less likelihood of incontinence and lower risk of affecting sexual performance I still have some ED problems but then I had ED problems before the HIFU so I would not advise against HIFU

      I do not have the incontinence issues I might have had with prostate removal and there is still hope I can overcome the ED issues with lifestyle, exercise and ED medications.

      I intend investigating the use of a pump. If anyone knows anything about pumps I would be grateful for details.

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    • Edited

      Sorry for the late reply, but I had some family matters to sort out.

      You ask about the pump.

      I ordered one online after surgery and radiation.

      It takes a LOT of dedication to use it say 5x a week.

      I lost interest and dedication after 2 months.

      As to ED improving....in my case all I can say is that it improved

      AFTER my testsosterone improved, that is AFTER I stopped

      treatment.

      That said, even with half decent cialis assisted erections, dry orgasms is hard for anyone men and women to wrap their heads around.

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    • Edited

      I agree. Dry orgasms are strange but women have always had "dry" orgasms (unless you believe porn sites). After being married 10 years or so with 2 kids, my wife and I decided to go to a sex therapist and one of the things I remember saying to the therapist was that I could not understand a female orgasm because there is no "release". Well, now I know what that feels like. I have learned over time to just enjoy the feeling and try to make that feeling last. But it can never compare to an actual ejaculation.

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    • Posted

      Guys, thanks for sharing about the dry orgasms. I always thought this would be a major drawback. Doctors and stuff i read on prostate removal make it sound like this is no big deal, or even put a positive spin on it. But i think most men know intuitively that this is not a minor "side effect." Most dudes are trying to get more ejaculate, not less, and there are products on the market like Semenex which claim to increase the volume of ejaculate, which guys are buying up hoping that it is true.

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    • Posted

      it would be nice to know of any natural/herbal supplements or medicines that we can take to increase the volume of ejaculate to avoid or mitigate dry orgasms. I was told after my hifu procedure that half my prostate had been a belated, however I have lost 90% of my ejaculate along with ED problems. It has been 18 months since my hifu procedure and I fear I have not used my sexual capabilities and might lose it. This is perhaps more psychological on my part than physical. But my inability to gain and hold any reaction has caused anxiety on my part to initiate sexual relations with my wife.

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  • Edited

    Hi

    I went through radical prosectomy using Divinchi Robot method in 2011. I was 56 all i wanted at the time was the cancer gone. I had the talk regarding different options for treatment,possible side effects. Dry orgasms ,incontinence,probably not really listening.. I was quite positive until i suffered all the above. Didnt deal with it well, you dont really know how these effects you as a man until you experience it,marriage really struggled. Contemplated suicide but never quite got the nerve to do it. My advice if sex is a big part of you and your marriage go for the least invasive method and accept the risks regarding further cancer. For some people its no big deal, dont do sex very often, marriage is based on real friendship, you will probably cope with radical treatment. Those reading this site probably very concerned about side effects but options available now are much better. You have to listen to the best advice available but make sure you get as much opinion as possible.

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    • Posted

      I agree with Sam230. Nothing about PCa is black and white, it is all grey scale. There are many kinds of PCa, and the virility and extent of PCa is different in every patient, and the treatment options are many, with many kinds of outcomes for each kind of treatment option. So best to do as much investigation as possible before making decisions.

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