I have found mixed results.
I have found that we (my wife and I) have had to try new methods or variations in stimulation. Pre-surgery, for me, it was a no-brainer. I could see my wife, or touch her hand, or she touch me, and i was instantly erect. And, as for orgasms, 95% of the time, i had complete orgasms. The reason that i mention my pre-surgery results is to make the point that I did not have any 'issues' before surgery. (one of the brochures that I have read discusses how some guys are upset after surgery about
problems with erection and orgasm, and studies have shown that some of the guys had difficulties BEFORE surgery. Well, the surgery is only going to make things more difficult, not make things easier.). With that stated up front, i will continue.
We have had to experiment to find what works now (post surgrey). Where (before surgery) several minutes of intercourse, oral, and hand stimulation, would lead to orgasm. Now, the pleasure is there again, but the final end result (orgasm) does not come as easily as it did. I have found that I now require some timing variations. Slower, faster, harder, softer, etc. Pause a few seconds, then continue. Lest you think that i am just rambling about
the details of our sexual interaction, that is not my intent.
What i have found, is that with the proper variations (as described above), the intensity will continue to increase (which is what is needed for orgasm).
In answer to your question, i have found the best results when fully erect. However, in the past where continuous stimulation would make things work. Now (for me) I need some occasional pauses (for a few seconds). It seems to heighten the intensity, and take me higher on the excitement level. If the timing is good, and the mood is good, and the drug effect (viagra) is good, on occasions it has been very bit as enjoyable as pre-surgery. MOST of the time it is good, but not great. But some of the time it is truly great.
I still miss the mess, and all of the internal pulsations/thrusting that went with pre-surgery orgasms. It truly was a learning experience to discover (after surgery) how much an orgasm is more of a mental thing than a physical thing. Not that you don't need the physical stimulation, but the process (of climbing up the scale, reaching the climax) is more mental than physical. In the early days, after surgery, when i was first able to have some type of orgasm, there was very little sensation in my penis at the exact time of the orgasm, but instead it was more mental that was associated with the heavy breathing and increased heartbeat, the final climax, then cool down. Even now, it is weird to think about
the orgasms that are less physical than mental.
As for my current situation: I am getting ready (have an Appt) to use Trimix. Up till now, i have used Viagra and an Osbon Erectaid pump. I am able to get some mild form of erection with no viagra and no pump, but it is not usable for intercourse. If i take viagra, then i can get firm enough for intercourse. The problem is that the duration of the erection is not as long as i would like (and it not like pre-surgery). and the firmness varies. The pump helps to make things a bit more firm. And the ring, with the pump, maintains the firmness (enough for my wife to have an orgasm). There are minor issues with the pump/ring. (1) she can feel the ring, when she is on top and rubs tightly against me in order to stimulate herself. (2) the erection actually begins at the point of constriction, where the ring is, and therefore there is some slight bending below the pump. Dr Patrick Walsh' book (Surviving Prostate Cancer, 2nd Ed, page 434) addresses this issue. I have heard from guys who use Trimix, that the erection is not associated with the point of the ring, and instead the erection is full born, and therefore it should remove the issues that I have with the pump and ring.
8/1/2008: PSA 6.2, GP recommended retake.
8/27/2008: PSA 5.8 (%free 12.1) referred to Urologist.
9/10/2008: DRE - non palpable. Urologist recommended biopsy
10/21/2008: Biopsy appt: 10 samples taken
10/31/2008: Biopsy results; 1 positive out of 10 samples.
10/31/2008: Biopsy Results: Gleason 7 (3+4) , no evidence of perineural invasion.
10/31/2008: Referred to UCSF
12/19/2008: Transrectal Ultrasound at UCSF
12/19/2008: Consultation with Surgeon.
12/19/2008: Surgeon concurred on Gleason 7=3+4 (per slides).
2/24/2009: Robotic Assisted Laparoscopic Prostatectomy (DaVinci) UCSF
3/5/2009: Cathetor removal.
3/21/2009Post Op Pathology: margins negative/clear, Gleason 4+3=7
4/9/2009: first post-op Ultrasensative PSA: less than 0.01
Currently taking Viagra (since March 2009), Levitra (tried Cialis).
6/2009: Purchased and using Osbon manual pump.
7/28/09: 5 month Ultrasensative PSA: less than 0.01
Post Edited (FiftiesMale) : 7/14/2010 10:02:05 AM (GMT-6)