Prostatectomy Recovery: Sex After Christmas?

If you've recently undergone a prostatectomy, you're probably wondering when it will be safe to have sex again. The recovery time varies depending on the type of treatment you received, your age, general health, and sexual function before the procedure. Most sources recommend waiting at least four to six weeks after surgery before resuming sexual activity. However, it's important to note that everyone's recovery is different, and it may take longer for some people to feel emotionally ready to engage in sexual activity again.

Erectile dysfunction (ED) is common after prostatectomy

Erectile dysfunction (ED) is a common issue after prostatectomy, affecting most men for several months to a year after surgery. The prostate is located near nerves, blood vessels, and muscles that are essential for achieving an erection. During surgery, these areas may be damaged, making it more difficult to get or maintain an erection. Additionally, the nerves that control erections may be removed if the tumour has grown into them.

The good news is that ED after prostatectomy can often be managed or treated. Here are some options to consider:

• Medications: Prescription erection pills, such as Viagra, Cialis, or Levitra, can be taken as needed to boost confidence and improve erections. It may take a few attempts to achieve a successful response, and the most meaningful recovery is usually seen around 9 to 12 months after surgery.
• Injection therapy: Injecting medication into the base of the penis can increase blood flow and improve erections. This option has a high success rate of 70% to 80%. However, it may take a few visits to determine the optimal medication combination and dosage.
• Vacuum erection device (VED): This device creates a vacuum to draw blood into the penis and achieve an erection. While it may not be the most effective for intercourse due to the penis becoming semi-rigid and cold, it can be useful for penile rehabilitation and preventing shrinkage after surgery.
• Penile implants: In some cases, penile implants may be considered if drug treatments and other therapies do not resolve ED. These are permanent devices surgically placed inside the penis.
• Penile rehabilitation: This approach focuses on increasing oxygenation and preserving the structures of erectile tissues to prevent long-term damage. It can include oral medications, vacuum devices, and other treatments to maximise the chances of recovery.

It is important to remember that recovery after prostatectomy is a gradual process, and it may take time to regain full sexual function. Open communication with your partner and seeking support from a healthcare professional can also help you navigate this challenging time.

Treatments for ED include pills, injections, and devices

It is normal to experience physical and emotional changes after a radical prostatectomy, and these can affect your sex life. Most men experience erectile dysfunction (ED) after surgery, but treatments are available and you can return to a fulfilling sex life.

Pills

Well-known drugs such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) can improve blood flow to the penis and help with ED. These drugs are taken by mouth and can be effective if your nerves aren't damaged by surgery.

Injections

You can also try giving yourself a shot of medicine at the base of your penis. This is a self-injection that improves blood flow to the penis and can help you achieve an erection without sexual stimulation.

Devices

A vacuum device, or "penis pump," is a mechanical device that draws blood into the penis to achieve an erection. This option is best for men who can get an erection but have trouble maintaining it.

Another device option is a penile implant, which is a permanent device surgically placed inside the penis. This can be a satisfying option if drug treatments and other therapies do not resolve erectile dysfunction.

You may experience a dry orgasm after prostatectomy

Returning to sexual activity

Your medical team will likely clear you for sexual activity after your catheter is removed. However, it is recommended that you wait until the tissue of your rectum and colon have healed before receiving anal sex. This usually takes about six weeks after surgery. You may also find that it takes longer than six weeks to feel emotionally ready for sex again.

Erectile function

Most men who have normal sexual function and receive treatment for early prostate cancer regain erectile function and can have satisfying sex lives after robotic prostatectomy. However, it is a gradual process and may take up to a year. Penile rehabilitation can help you resume sexual functioning.

Dry orgasm

A dry orgasm is when a male has an orgasm without ejaculating any semen. After a radical prostatectomy, you will no longer produce semen, so your orgasms will be dry. This means they will probably feel a little different, and it might take longer to climax.

Dry orgasms can occur when there is no semen being produced in your body, or when your semen travels backwards into your bladder instead of coming out of your penis (this is known as retrograde ejaculation). Retrograde ejaculation can be caused by prostatectomy, as the bladder neck muscle doesn't tighten properly, allowing semen to enter the bladder instead of being ejected out of your body through the penis.

If you experience a dry orgasm, you might notice that your urine is cloudy after ejaculation, as it contains semen.

Although retrograde ejaculation is not harmful, it can cause male infertility. If you are attempting to father a child, you should see your doctor for advice.

It can take a year or more to have satisfying sex after prostatectomy

Prostatectomy is a common treatment for prostate cancer, involving surgery to remove the prostate gland, surrounding tissue, and sometimes nearby nerves. This procedure can have a significant impact on your sex life, and it may take a year or more to resume a satisfying sex life. Here are some things to consider and steps you can take to aid your recovery:

Physical Changes

One of the most common physical changes after prostate cancer surgery is erectile dysfunction (ED). Most men experience ED after surgery, which can make it difficult to get or maintain an erection. This is due to the nerve bundles that control erections being located near the prostate and potentially being damaged or removed during the procedure. However, surgeons make every effort to preserve these nerve bundles, and erectile function can improve for up to two years after surgery.

Another physical change is that you will no longer produce semen, resulting in "dry" orgasms. This means you won't release semen during climax, but orgasms can still be pleasurable. Additionally, it may take longer to reach orgasm, and you may experience a change in sensation.

In some cases, the penis can shorten due to changes in the tissues inside the penis after surgery. This is caused by scar tissue formation and the contraction of collagen in the area. The use of a vacuum erection device (VED) can help prevent this length loss by stretching the penis and promoting blood flow.

Emotional Impact

Prostatectomy can also affect your mental health and sexual well-being. You may experience feelings of grief, a loss of "manliness," or a blow to your sense of self. It is crucial to address these emotional changes and seek support if needed. Talking to your partner, friends, family, or a counselor can help you process these emotions and regain your confidence.

Penile Rehabilitation

Penile rehabilitation is a crucial aspect of recovering sexual function after prostatectomy. The goal is to prevent long-term erectile dysfunction by increasing oxygenation and preserving the structures of the erectile tissues. This can be achieved through various treatments, including oral medications, injection therapy, and vacuum devices.

Oral medications such as Viagra, Cialis, and Levitra can improve blood flow to the penis and enhance erections. These drugs are often the first line of treatment and are relatively inexpensive.

Injection therapy involves injecting medication into the base of the penis to increase blood flow and improve erections. While this method may be effective, it requires the use of a needle and proper instruction to ensure success.

Vacuum devices, also known as penis pumps, are mechanical devices that draw blood into the penis to achieve an erection. They can be a good option if medications are not working or if you prefer not to undergo injection therapy.

Time and Patience

Recovering sexual function after prostatectomy takes time and patience. It is essential to understand that everyone's recovery journey is unique, and it may take longer than six weeks to feel emotionally and physically ready for sex again. Don't be discouraged if you don't see immediate results, as it can take up to a year or more to regain satisfying sexual function.

Open Communication

Open communication with your partner is vital during this time. Discuss your feelings, fears, and expectations regarding your sex life. Being honest and supportive of each other can help you navigate this challenging period and maintain intimacy in your relationship.

Medical Guidance

Throughout your recovery, it is essential to seek guidance from your healthcare team. They can provide advice, treatments, and support tailored to your specific needs. Don't hesitate to reach out and ask questions or express any concerns you may have.

In summary, regaining a satisfying sex life after prostatectomy can take a year or more, and it may involve addressing physical and emotional changes. With time, patience, and the right treatments, you can work towards resuming a fulfilling sex life. Remember to communicate openly with your partner and seek medical guidance as needed throughout your recovery journey.

Penile rehabilitation can help resume sexual functioning

Penile rehabilitation is a course of treatment that can help you regain erectile function and preserve the health of your penis after a radical prostatectomy. It involves various therapies and treatments to improve blood flow and oxygenation to the penis, prevent the formation of scar tissue, and restore erectile function. Here are some key points to understand how penile rehabilitation can help:

Importance of Penile Rehabilitation

• Penile rehabilitation is triggered by a diagnosis of prostate cancer and the subsequent radical prostatectomy surgery.
• The surgery can cause side effects like erectile dysfunction (ED) due to nerve damage and reduced blood flow to the groin area.
• Without treatment, ED can last for up to 2 years, and there is a risk of permanent penis shortening due to fibrosis (scar tissue formation).
• Penile rehabilitation aims to prevent these issues and restore sexual functioning.

Treatment Options

• Oral medications: Phosphodiesterase type-5 (PDE5) inhibitors like Vardenafil, Sildenafil, and Tadalafil are commonly used to improve blood flow to the penis.
• Injections: Medicines injected into the penis help relax smooth muscles and increase blood supply, triggering an erection.
• Penis pump (vacuum pump): A plastic tube and pump are used to draw blood into the penis, creating an erection.
• Penile implants: If other treatments are ineffective, surgery can insert a permanent implant to enable erections.
• Intraurethral pellet: A tiny drug-treated pellet is inserted into the penis opening, absorbed through the urethra, and causes an erection.
• Pelvic floor muscle training (Kegels): These exercises strengthen the pelvic floor muscles, which are important for sexual health and can improve erectile function.

Benefits of Penile Rehabilitation

• Penile rehabilitation can prevent scar tissue formation, restore the ability to have sex, and improve your overall quality of life.
• It can help maintain penile tissue health, oxygenation, and elasticity, reducing the risk of postoperative ED.
• Early rehabilitation is recommended, as it improves the chances of regaining erectile function.
• Combining treatments, such as a penis pump with ED medication, may be the most effective approach.

In summary, penile rehabilitation is an important aspect of recovery after prostate cancer surgery. It can help address erectile dysfunction, improve blood flow and oxygenation to the penis, prevent scar tissue formation, and ultimately restore sexual functioning. By committing to regular stimulation and the right treatments, individuals can work towards regaining their sexual health and enjoying a fulfilling sex life after prostate cancer.

Frequently asked questions