When you are told that you have cancer the last thing that you are worried about is your ability to have sex after the operation, or least that is the way it was for me. I heard the doctors talk about sex after the surgery, but it was like a background noise; a who cares I just want this cancer out of me and so it was with me. I remember the if you had no trouble getting an erection before the operation and if the procedure does not destroy one or both nerve bundles responsible for giving you an erection, than all should be good. I seem to recall the doctor informing what the odds were of having sex again although I seemed to not have heard the time line, or the differences between the way of ejaculating before the operation as opposed to after the operation. I know I was told but I do not remember giving much thought to the partial erection that I might be having for the rest of my life; I think the phrase used is stuffing it in hard, not very professional, but it is to the point. At any rate I was more concerned about getting the cancer out of me, getting rid of the stress of knowing that I had cancer living inside of me and returning back to work as soon as possible. After the operation I do remember reading on the internet an article that said if you do not use it you will lose the ability to do it and I began to think of the problems that would present for me and I think most married men.
I like most people have wrestled with whether we as humans have sex to satisfy ourselves, to satisfy the other person, or both and since having my prostate out I have come to the realisation that although a sensitive person wishes for his, or her mate to share in the pleasure of intercourse or other sexual activity it is only as a bi-product of their need to satisfy themselves. In other words we hope that you enjoy the sex too, but if I am not going to have the pleasure that I want, in the way I want, then forget it. I think that this is more of a male attitude and that is why women adjust better when sex for them is changed, or altered period, not just after say a hysterectomy. I think that women are satisfied sexually in a different way and get gratification sexually knowing we their partners are getting what we want out of sex and in this way they settle for our sexual happiness putting their own on the back burner. In other words when they can not satisfy their partner, most women feel like less of a woman and since they have not been enjoying the ultimate orgasm from the start of the relationship, it is your pleasure that speaks to the success of your joint sex life. I think men’s inability to put their partners pleasure ahead or at least at par to their own is one of the main reasons other than the medical reasons that men can not warm up to the changes that happen when they ejaculate, or do not have evidence of that ejaculation, because they are now doomed forever to have what is called dry ejaculations, where our maleness is no longer evident. The woman does not need our sperm, or our penetration to have a successful sexual encounter, so when the question is asked is their sex after such an operation the answer is yes, depending on what you call having sex. The correct question is whether or not sex will be gratifying for both partners after prostate removal and will the gratification make the male feel that it is worth it to engage in the act of intercourse, because I think that most women could tell a man exactly what he could do to satisfy her and he would not need an erection at all.
I for one wish that the question was put the right way and that I had been thinking the right way, not that it would have changed my decision to have the prostate removed, but it would have left me better prepared and given me something important to consider. Getting an erection is only the first hurdle of many and the intercourse part of intimacy with your partner can not even be considered until you get your urine incontinence in order for most men and women. So I guess what I am asking is when the man says since I had my prostate out I could not please my wife sexually, is he really saying since I had my prostate out I have not been able to please myself and so have not bothered trying to please my wife sexually.
It is common knowledge that men do not get their prostrate checked physically as early as they should because it makes them feel uncomfortable for someone to do to them what the test requires and so very often do not have their physical prostate examination until their symptoms are in full-blown, ie. having problems with urinating, erectile dysfunction and a lack of sexual desire and it all concerns our concern with what is okay for a male and what is taboo. The funny part of this is that most Male General Practitioners avoid embarrassing their male patients with this exam until they receive a complaint from their patients or a PSA test hints that there could be something amiss. So if being what is considered being a real man gets in the way of the discovering prostate cancer in a patient, because of the nature of the exam, than why are we so surprised that a lot of men having temporarily lost their ability to have an erection after their operation fail to regain the ability to have an erection, because of yet another male issue when it comes to sexual activity and being manly and by this I mean masturbation.
Men and women are taught that masturbation is not a practice that decent people engage in and therefore it is done in secret by both and once married never to happen again. So taboo is masturbation that it is not a recommended therapy for the use it or lose it remedy for regaining your erection after you prostate operation, once the catheter is out a week after the operation. The majority of people like to be clean when they have sex, but urine incontinence does not leave you that way. The man is alway dribbling into the napkin, the pull ups, even if he is not whether or not he can maintain his erection is stressful and we all know what happens when a man gets too stressed sexually.
Another problem is spontaneity and urine incontinence leaves no room for that in the beginning and it is in the beginning where the nerves need to be stimulated that are needed to gain an erection. I have experienced and heard of other men that have lost an erection or were unable to achieve an erection, when spontaneity had been broken. Fear of not being able to get or keep the erection after getting started could be avoided if in the beginning masturbation could be used to stimulate the nerves and indeed achieve the use it or lose it goal without taking the risk of failure and at the same time come to terms with what to expect from sexual intercourse. In all of my conversations with men who have had their prostrates removed I hear the same things and they are not very positive when it comes to sexual intercourse and I have realised a few things and would like to share them with you:
- Men are having a hard time with urine incontinence after their surgery for prostate removal and it is getting in the way of them having sexual intercourse with their partners, because they have stopped doing the exercises that help strengthen the sphincter that will stop the urine leakage and therefore find the act of sex too complicated, because at no time are their private parts free of urine and the act of removing the protection and getting washed is somehow making them feel uncomfortable, takes too long and by the time it is all over reduces their desire to have sex and so they stop trying. We who have had our prostrates removed do not have a choice of doing or not doing our exercises given to us on our one and only visit to the therapist that strengthens the sphincter and helps it to act automatically if we want to get our urine incontinence under control and have a greater chance at a normal sex life for us and our sexual partner.
- Men are stressing that they may not be able to hold the erection long enough to penetrate their partner and even if they penetrate will their erection stay up to the finish. When faced with the humiliation of a failed attempt and the less than a man feeling that comes with it, the male often decides not to bother trying and it is here in this type of situation that I feel that masturbation would and could prove helpful. It is private and one can try as much as one needs to without fear of embarrassing failure.
- Men are having a hard time dealing with the new way of ejaculating which is now a dry ejaculation, as opposed to the liquid squirting kind that held the sperm, his ability to make children thought to be the essence of his manhood, or so it is thought. There is also an opinion out there amongst uninformed men that women need your sign of ejaculation to achieve sexual satisfaction and this is simply not true, but makes men feel less than men.
In closing I would like to say 2 things that may help a man make up his mind and not feel as though he was not told everything about sex after prostate removal. The first is that the question and the discussion at the pre-operation stage should be more about quality of intercourse and what makes having sex worth it to you the male. I think that this part of the discussion is down played by doctors who perhaps are not looking at the importance of quality of sex rather than just the importance of being able to have sex in some fashion. For many men that I talk to they consider half an erection unmanly and embarrassing and almost enough not to bother with intercourse and if they are not having intercourse there is no need to bother with sex and sexual intimacy at all, because all other sexual intimacy for them is supposed to end with sexual intercourse. Throw into the mix dry ejaculation and it is almost a given that only a few men will pass the test of being such a sensitive lover that they will fore go what for them says I am satisfied, to please their wives. Finally when it can take over a year of trying very hard to stimulate the nerves enough to get that partial erection, get your urine incontinence in order enough for both of you to feel safe and secure to do all of the things in sex that you used to do before, I would say that there is sex after prostate for very few lucky men and women, who want it bad enough to fight for it; want it bad enough to accept the changes that are inevitable and care about the others quality of life enough to try and keep trying.
Finally to the gentlemen I will say that it is time to find out about your partner, time to talk to them about sexual matters, ie. their likes and dislikes their needs and the problems you are having and your concerns. I think that you will find that your sexual partners are ready and willing to help out in any way that they can. When you chose not to try and help yourself in these matters it is not only your life that you are affecting, but that of your mate, whose sex drive has not diminished, who is wondering what they have done wrong and in some cases are getting tired of being rejected. Only the love that your partners have for you will allow them to put aside their need for sex and remain celibate for the rest of their lives for you, so do you not think that you owe this act of supreme love all that you can do to get back on your feet sexually? Sex is not the only tool that we have to show our love and affection for a spouse, but it is an important intimacy shared by two people who love each other that should not be let go because of a lack of effort on one side, but cherished until all attempts to have it, have been exhausted.
You may be the one who was diagnosed with the prostate cancer and had to under go the removal of it, but it will affect the both of you for the rest of your lives. Your partner should have been in on every decision from the very beginning for just that reason, but if they haven’t, because you thought that it was happening to just you, I think that you should rethink your position, because it will take a joint effort if you are to survive and have a mutually enjoyable sex life after the removal of the prostate. This is not something you can do on your own and there is more than your needs to consider.
Please understand and note that I am no doctor and only offer what I hear from people and have experienced myself, in order to try and solve very human problems for ailing people, like myself.
- Post Prostate Removal Blues / The Road To Recovery (archemdis.wordpress.com)
- Regular Protective Pads, Thin Protective Pads, Or Protective Pull Ups For Men After Prostate Removal Surgery? (archemdis.wordpress.com)
- Prostate Cancer Information (cancercenter.com)
- Prostate Surgery – What is a Radical Prostatecomy (prostatehealthnews.org)
- Prostate Cancer Symptoms (cancercenter.com)
- Policy vs. emotion in cancer testing (hamptonroads.com)