Prostate Surgery
Posted , 15 users are following.
I just had prostate surgery 2 weeks ago. Can’t say it was a success cause I am having to catch myself 3 times a day. Doctor told me in advance I would have retrograde ejaculation everyone gets it. It means your cum goes backwards into your bladder and you will never see it again. Don’t think that is not an issue for a man it is for me. But I decided to go ahead, what the doctor did not tell me is that the sensation of my orgasms would be cut by 2/3. Honestly having to deal with this psychology. Don’t know that I would have had the procedure just accepted cathing myself 3 times a day. Anyone else experience this. I’ll tell you at 52 it sucks!
0 likes, 21 replies
mike588 phys.assist
Posted
first of all which surgery did you have? Why are you having sex after only 2 weeks ? It's way to early, be thankful you know how to self cath so you're not walking around with an indwelling catheter. Retrograde sometimes is not permanent - I know someone who had green light surgery and he said normal ejaculation came back after a while.
kenneth1955 mike588
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dalebf phys.assist
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Why NOT have sex 2 weeks after surgery? I had Plasma Button vaporization and had sex two weeks later and it was fantastic. My surgery was in April, 2017, and sex is even better now and the retrograde ejaculations, which were severe at first are now almost back to normal. Don't rush yourself. Be patient.
kenneth1955 phys.assist
Posted
I know you regret it now but why did you let them talk you into it. Doctor side track when then talk about retro and your orgasm. They tell you it will be the same. It will never bet he same after. Take care I am very sorry At 52 there would be no way.. I'm 62 and it will never happen to me...Ken
derek76 phys.assist
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dalebf phys.assist
Posted
I can understand your frustration, but you have to remember that you are only 2 weeks post surgery. You have only just begun to heal. It is going to be some time before you will know how your urinary function, retrograde ejaculations and orgasms are finally going to be. Not everybody who undergoes prostate procedures ends up with horror stories to share on these forums, so don't get too wrapped up in some of the comments you read. I can tell you from my experience that if you give yourself time to heal (possibly 3 months or more) you will very likely see improvements.
richard29174 phys.assist
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paul96555 phys.assist
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I left it two months after HOLEP before first sex, to ensure I didn't mess anything up. First two times were insensate, it happened but I felt nothing. I was rather horrified. But the sensation did come back over time, by 6 months I had got more than half of it back. It is still not as good as before the op, actually 16 months on it becomes hard to be objective .... at least no ED or other effects, and the benefits of the op - sleeping for 7 hours without needing a pee; decent flow rate - remain.
I do think they last longer ... the lack of peak intensity means you don't at any point instinctively stop, or slow down, as it doesn't become too intense ... so it's a flatter but slightly longer experience. I did read that kegel exercises can help, been doing that a few times a day for a fortnight since I read it, no effect so far. The retro thing seems permanent. I wonder if the issue is that the prostate muscle doesn't have to push so hard to get semen out, as the blocking sphincter's not working so semen goes up easily into bladder, and in not pushing so hard fewer nerves are triggered ... or might it be that there is less prostate and it was nerves in the prostate causing the orgasm (but people who had a radical prostatectomy can apparently still orgasm, so that can't be all of it....) ... or might it be that some nerves got cut away in the removed tissue. In one of my earlier posts I gave the title of a published paper, the only one I could find, about diminished orgasms post TURP/PVP/HOLEP, saying it is a common issue, on average I think it said down to (ON AVERAGE) 60% of original sensation soon after the op, but (there was a little table in the official paper on "orgasmic domain function" after these ops) you get some back over the first year then no further improvement, and you (ON AVERAGE) never get all of it back (I think it said end up 70% or 80% on average, can't recall for sure). Some men do report on forums getting all of it back or even having better ones, some men report a very bad outcome in this respect. Most men annoyingly only post about it a few weeks after surgery, and never post later if it got better, so the data's a bit skewed as they are most likely to have issues a few weeks after surgery?, which might self-resolve partly, or fully, later on.
Age at time of op : 49.
zdzislaw phys.assist
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kenneth1955 zdzislaw
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derek76 kenneth1955
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wally5 phys.assist
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I had the TURP and the orgasm is not even one third. Of course my urologist have never heard of it and I'm the first man with that problem. Keep going back to the urologist who told you that the feeling will be exactly the same and keep going back. They know they lie.
kenneth1955 wally5
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slydog phys.assist
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As you may have gathered, everyone reacts differently. I'm over 9 weeks out from a TURP and I didn't even WANT to have sex at 2 weeks. I started at about 6 weeks and to be honest, I haven't had an orgasm yet. I'm not too concerned at this point as my penis still feels bruised inside - I had a couple of trips to the ER to put a cath in. I think over the course of the next few months, everything will calm down and I'll be alright. This surgery typically doesn't heal in a few weeks. It's more like months.
cartoonman phys.assist
Posted
Sorry to read of your misfortune! And this is why it is a constant theme on this forum: DO YOUR HOMEWORK! I offer this with sympathy, not chiding. Way too often, the docs don't tell all. It's not their body, not their side effects, etc.
paul96555 cartoonman
Posted
I did my homework before my holep, albeit at that time I had not yet found this website, which is all that I now monitor, and instead was reading the large number of posts on the steadyhealth one. I did read all 800 posts. A few raised issues on the matter at hand, mostly in the first few weeks so you couldn't tell if it was a short term issue as they usually didn't post follow-ups. Quite a number reported no real issues with sensation. A typical one is cited at base of this post. I also managed to find one, and only one, study that had specific content on orgasm, as opposed to the many on ED. It's called "Serial Changes in Sexual Function Following Holmium Laser Enucleation of the Prostate: A Short-term Follow-up Study". It said, "Results : Orgasmic function and the overall sexual satisfaction domain score remained slightly reduced up to 12 months postoperatively. ... Conclusions ... overall sexual function decreases slightly in the early postoperative period, but recovers to the baseline at 12 months postoperatively" and "both orgasmic function and overall sexual satisfaction domain scores were still slightly decreased at the 12-month follow-up compared with baseline, but this was not statistically significant".
By contrast reading individual posts isn't very informative ... you can't tell if only a few with issues in that area are posting; you can't tell how representative it is. Stricture issues are more definite and recorded; that's 2% of all TURP and HOLEP patients but you see quite a few posts about it. I did find about 4 posts from men who had long term issues with sensation after TURP or Holep to the point they wished they'd thrown the dice on a less reliable cure to LUTS, that doesn't cause retro or hence the effect on sensation. I don't think the data is there to allow you to reach a reliable conclusion on the risk of effect on orgasm sensation from HOLEP TURP PVP, and I also don't think the data is there to allow you to reach a reliable conclusion on % of men undergoing Urolift or PAE, who get a permanent cure that's as good as from the other techniques. You can tentatively conclude that each has different risks, i.e. risk of not curing LUTS vs risk (nearly certain) of retro and risk (very hard to assess, certainly doesn't seem to be universal) of effect on orgasm intensity/quality. I am squeamish and wouldn't like to keep going back to the uro' for more tabs, or tightening, or other fixes because my urolift didn't work, and the consequences of a bad PAE sound nasty (the severe allergic reaction leading to need for radical prostatectomy, or the pain/can't find artery thing, or ... just annoyingly .... when it just didn't work). However knowing what I know now, I might marginally have thrown the dice on PAE. Whatever you choose it's a gamble, I don't see that there is a perfect choice, also the data just isn't there to quantify the various risks as probabilities for the various choices available.
?Here is the aforementioned typical (ish) post I found :
"A comment about retrograde ejaculation: Retrograde ejaculation is a common side effect of most surgical procedures of the prostate because the internal sphincter at the bladder neck is damaged. Yes, ejaculation feels a little differently, but it personally doesn't bother me and has not affected my orgasmic pleasure. I believe it is really more of a physcological issue for some men. As a very actice person, being able to urinate like a young man again far outweighs any perceived negatives about having retrograde ejaculation."
kenneth1955 paul96555
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All men are different and we deal with things different. I'm happy that your happy with the procedure you had and you don't mind not having a ejaculation. But there are many men that do not want to give it up. And why should we have to pick one over the other. I had retro for 2 pills that I was on and got off them quick. The build up was there but when the orgasm hit It went flat no feeling at all. It was like I was doing nothing. I will not live the rest of my life like that. I can live with not peeing like a teenager But I still what the pleasure like one. Take care Ken
kenneth1955 paul96555
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All men are different and we deal with things different. I'm happy that your happy with the procedure you had and you don't mind not having a ejaculation. But there are many men that do not want to give it up. And why should we have to pick one over the other. I had retro for 2 pills that I was on and got off them quick. The build up was there but when the orgasm hit It went flat no feeling at all. It was like I was doing nothing. I will not live the rest of my life like that. I can live with not peeing like a teenager But I still what the pleasure like one. Take care Ken
paul96555
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More detail compared to the summary section of the paper, "Serial Changes in Sexual Function Following Holmium Laser Enucleation of the Prostate: A Short-term Follow-up Study", look at the orgasm scores before and after the prostate re-bore (I daresay effect is similar regardless of the type of re-bore) in table 2. I would post a URL but it’s not allowed on this site, so just google for it. Same paper, says this “the ED seen immediately after BPH surgery may be temporary and due to the neurapraxia induced by thermal injury”. [not in paper, maybe this heat damage also explains possible effect on orgasm ?]. and, “Another interesting finding was that the orgasmic function or overall sexual satisfaction domain score remained slightly decreased throughout the follow-up period after the HoLEP procedure. In the present study, the scores of "ejaculation frequency," one of two items that compose the orgasmic function domain, were decreased throughout the follow-up period after HoLEP compared with baseline, although not significantly so at 12 months after surgery. Therefore, ejaculatory problems may have an adverse effect on orgasmic function or overall sexual satisfaction after HoLEP. This finding is in accordance with the study by Briganti et al. showing a significant deterioration in the mean IIEF orgasmic function domain score after HoLEP and a recent study by Muntener et al. suggesting that the loss of ejaculatory function after TURP is significant and is associated with considerable bother." Which is a bit more negative than the summary lines