Painful sex - Am I doing it right?

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English Alf
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Date Joined Oct 2009
Total Posts : 2217
   Posted 10/5/2010 11:02 AM (GMT -6)   
Um....I hope the moderators will be okay with this topic’s subject.
Firstly, I know I should be more than satisfied that I don’t have ED, but being able to get an erection seems not that much of an achievement if the end result is more about pain than pleasure, i.e. if sex doesn’t really work.
Without going into too many details: after yet another “misfire” the other night I was wondering, if I am (we are) doing something wrong with little Alf to cause this problem?
As I have touched on in posts elsewhere my problem is not so much that sex itself is painful, but that after having 10, 15, 20, 25 minutes of “activity” that seems to be heading towards a peak something goes wrong at the last minute/second so that instead of finishing with five to ten seconds of orgasm I simply I experience either a pain or ache in or near my penis and then go into the winding down phase straightaway . The pain/ache is sometimes located inside me (where the prostate used to be) and sometimes in my scrotum or around the base of my penis. It is very similar to the post-op abdominal and scrotum pain/ache that I experienced. I don’t experience any sensation of a (dry) ejaculation and nor do I squirt urine.
I can work out that, whatever sexual activity we engage in, sex, as far as my body is concerned, mainly, if not exclusively, involves a combination of my erection getting pushed and pulled repeatedly towards or away from my insides. Now given all the chopping and reconnecting that occurred at the inward end of my penis is sex putting too much strain on things?
I mentioned my difficulties to the surgeon, suggesting that the nerves were all mixed up or had got crossed. He simply said things will take time to heal, but I’m now 14 months or so post op and 3 to 4 months post RT. Is it possible that the nerve-sparing surgery has saved the nerves that look after erections and damaged the ones that deal with orgasms? Or have I damaged them?
This may be more one for the men than the ladies. However, I also wonder if the ladies here have any thoughts, as while my wife has never had a painful event like this, she says my problems sound a lot like something she experiences where all goes fine for her during sex, then just when she’s expecting “the business” her orgasm sort of disappears before it’s even arrived.
Born Jun ‘60
Apr 09 PSA 8.6
DRE neg
Biop 2 of 12 pos
Gleason 3+3
29 Jul 09 DaVinci AVL-NKI Amsterdam
6 Aug 09 Cath out
PostOp Gleason 3+4 Bladder neck & Left SVI -T3b
No perin’l No vasc invasion Clear margins
Dry at night
21 Sep 09 No pads daytime
17 Nov 09 PSA 0.1
17 Mar 10 PSA 0.4 sent to RT
13 Apr 10 CT
28 Apr 10 start RT 66Gy
11 Jun 10 end RT
BMs weird
14 Sep 10 PSA <0.1
Erections OK

Veteran Member

Date Joined Jul 2010
Total Posts : 3887
   Posted 10/5/2010 11:37 AM (GMT -6)   
I'm only 5 weeks post surgery and I get the feeling things are never going to be the same also. Lets face it, our rather complex plumbing system has been severely tampered with..Half of it is gone, including some very tricky valving..

I still have 80% ED, but when I experimented (por*o, mast****tion) the orgasm was pretty good but the ejaculation was not dry! There was a flood of urine in it's place! Not Acceptable!

Your pain thing is just probably the result of crossed wires and mixed signals being generated by a system that is missing some important parts!

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Date Joined Nov 2007
Total Posts : 598
   Posted 10/5/2010 11:50 AM (GMT -6)   
You might be a bit more free to post this on FrankTalk where it is much more open - and men only. BUT - There are two things: if you are not getting the pulsations of muscle contraction at the point where ejaculation ocurred, that is something I would talk to a urologist who specializes in ED. Clearly, if the best your surgeon can say is, "Things take time to heal" - he does not know an awful lot about what should be happening. Most men, even completely limp, will get those pulsations. The ache is almost certainly nerves firing directions to the nonexistent prostate to let er rip. With nothing there, a sympathetic response is taking over. The prostate bed can certainly feel as if it is at the base of the penis/top of scrotum - at the interior bulb of the penis.

The first sex therapy exercise I would do, would be to ********* and edge for a LONG time. 30-45 minutes at least. do not orgasm. Do you get the endorphin rush when you do that? I would also take an orgasm with sex completely off the table right now. Sex, for the next while, is just about intimacy and her completion. Do not even attempt an orgasm during intercourse. Spend a lot of time rebuilding and retraining nerves with **********. She can certainly help, but do not orgasm yet. Get used to a higher and higher level of stimulation. Then after you master this, we can talk about going over the edge.
Paul ED website for PCa guys

46 at Diagnosis.
Father died of Pca 4/07 at 86.
10/07 PSA 5.06 (Biopsy 11/07 1 of 12 with 8% involvment) (1mm)
Da Vinci surgery Jan 5, '08 at Mt. Sinai Hosp. NYC
Saved both nerve bundles.
Path Report: Stage T2cNxMx
-Gleason (3+3)6
Pad free on March 14 - (10 weeks.) Never a problem since.
ED - at one year, ED is fine with viagra.
Two year PSA - undetectable!

Veteran Member

Date Joined Jul 2010
Total Posts : 3887
   Posted 10/5/2010 12:10 PM (GMT -6)   
I'm glad my wife and I are 68 and not 48...

Veteran Member

Date Joined Dec 2008
Total Posts : 818
   Posted 10/5/2010 2:31 PM (GMT -6)   

I wonder if your problem is related to mine. I find that reaching full size is painful. It was worse in the early months. I could be 95%, 98% there, but at 100% OW, a sharp pain. This wouldn't stop orgasm, but it made the experience totally unpleasant. Like you, I thought my sore insides were getting pulled around. For me it seems related to size, not time. If I remain at <95% size for the whole process, things are fine. My doc said it would get better with time, and it has, but at 20 months out, there is still some pain. Last time I saw him he said it was about as good as it was going to get.

Diagnosis at age 53. PSA 2007 about 2; PSA 2008 4.3
Biopsy September 2008: 6 of 12 cores positive; Gleason 4+3 = 7
CT and Bone scan negative
Da Vinci surgery at City of Hope December 8, 2008
Radical prostatectomy and lymph node dissection
Catheter out on 7th day, replaced on 8th day, out again 14th day following negative cystogram
Pathology: pT2c; lymph nodes negative; margins involved; 41 grams, 8% involved by tumor; same Gleason 4+3=7
PSA 1/22/08 non-detectable! 8-)
4/23/09, 07/30/09, Oct 2009, Nov 09, Feb 10, June 10 still undetectable (<0.01)!

Regular Member

Date Joined Aug 2010
Total Posts : 234
   Posted 10/5/2010 3:32 PM (GMT -6)   
<"Things take time to heal" - he does not know an awful lot about what should be happening. >

Could I speculate that the attitude would be one of "Well, it's done now, and nothing much will ever change it"  (They won't admit that they could have done it differently. and would not be looking to go back in)

They likely consider that "TIME" might change things, and ED meds and other meds might help.
The other thing that I would wonder about, is all that shrapnel left behind.. Check out your Cystogram and see all those sharp clamps, sitting and waiting for you to twist or move and impale bits in your tummy.

What is wrong with the industry, that these clamps are pointed and capable of causing other damage. Could sharp pain during intimacy be caused by these impalers, being moved around?  Poke your tummy and feel where there are sharp pains - I suspect these are a result of those clamps - 1" long stainless wires, bent like a bobby-pin over now superfluous plumbing - I can see about 40 inside me.
Nov 09 = First-PSA 5.0 @ 60yo - Asymptomatic - DRE-Non-Palpable
Jan-2010 = TRUS Bx DX - AdenoCar T1c - GS(3+3)=6 , 5 & 45% max., L-MidZone
May25-2010 = RRP- Nrv-Spare
Post Op. GS(3+4)=7, 1.1cm3, Pos Margins, EPE (focal) Lateral Left
Margin-Involvement (extensive) Posterior , Grade3 x 8mm
+8week PSA<0.01, ED-85%, Incont-30%
+16W PSA<0.01, ED-85%, Incont-5%
+17W First 'DRY' day

Post Edited (BuiDoi) : 10/5/2010 2:41:51 PM (GMT-6)

Veteran Member

Date Joined Jan 2010
Total Posts : 2845
   Posted 10/5/2010 3:46 PM (GMT -6)   
- has it always been just one type of sensation after surgery?
- my orgasms have changed since post-op - initially, it was like before - building and then release - just a lower body shake .... now it has evolved into a kick in the pants feeling ( a boot to the butt) short, sudden and so what ... so with that in my mind, my libido has diminished greatly...
- but I am quite busy right now so I am not focusing on reconditioning my mind to deal with / accept the sensations ( or manipulate them to be more pleasurable)...

-my suggestion - from previous experience.. would be when you are coming to the climax - relax the lower region and just go with the flow - feel the intimacy of being with your wife but not focus on the end result ( which is basically shooting blanks)....

- getting upset about it just reinforces the pain mind set and the sensations... by redirecting it, you can manipulate your feelings to it to a more pleasurable end...
(rather than a kick in the pants !)
- all the best

Age: 55 -gay with spouse, Steve - live in Peteborough, Ontario, Canada
PSA: 10/06/2009 - 3.86
Biopsy: 10/16/2009- 6 of 12 cancerous samples, Gleason 7 (4+3)
Radical Prostatectomy: 11/18/2009
Pathology: pT3a- gleason 7 -extraprostatic extension -perineural invasion -prostate weight -34.1 gm
Post Surgery-PSA: April 8, 2010 - 0.05 -I am in the ZERO CLUB
Sept 23, 2010 -0.05 - again -hoorah !

English Alf
Veteran Member

Date Joined Oct 2009
Total Posts : 2217
   Posted 10/6/2010 5:09 AM (GMT -6)   
Thanks guys.
(by sex I didn't just mean missionary position, but it was easier to put sex that end up with ******, ****, ****, *********** etc all over the post. We have a lot of fun with ****** * ****** and ** ** ** as well!!!.

Paul - We tend not to use intercourse as much and not at all for the "last part" as my abdominal muscles still don't seem to be able to cope too well with the effort. We have thus been using the method you refer to already. And also taking turns as it were rather than trying to head the same way at the same time.

Fairwind - 68 is nothing in my family. My dad was 68 when I was born! (2nd wife, just in case your wife is alarmed if you tell her this!)

DJ - I sort of know what you mean, when things start to hurt it actually seems like my erection has got bigger, I'd go as far as to say 10% bigger than it ever was before surgery. Something is definitely getting stimulated, it just seems to be the wrong thing.

BuiDoi - Yes I have considered that this is down to what the surgery did to me and that this is thus where I am and will be. I think surgeons place too much emphasis after surgery on "can he get an erection" rather than "does he still have a sex life" (Fairwind's unpleasant experience with squirting urine all over the place is part of this aspect too. sex is about pleasure after all.) I am also not aware that any shrapnel was left in me. My surgery was done in Amsterdam and when I asked they said soluble sutures had been used inside me. (On the outside they used both types of sutures, some disappeared, some I had to snip off myself) I don't recall seeing any white metal shadows on the cystogram screen prior to them removing my catheter.

Bronson - yes I think I probably did have more orgasm six weeks or so after surgery as compared to six months after, but I also had more pain. (That was curl up in a ball pain too)
The trouble with relaxing during sex is that little Alf relaxes too, however I agree about some techniques being better - swinging from the chandeliers doesn't work these days.

Luckily I'm not upset by my situation, merely trying to make it better. And if things were really painful I would have stopped doing it wouldn't I!

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