orgasms after non-nerve sparing prostatectomy

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dreyskii
New Member


Date Joined Mar 2017
Total Posts : 1
   Posted 3/9/2017 8:55 PM (GMT -7)   
Hi All,

I'm new to this forum. My partner is 69 and will be having the Da Vinci surgery in 2 weeks to remove his prostate and the erectile nerves. Although CT and bone scans show no spreading of the cancer outside the prostate, the Kaiser surgeon says he has to remove the erectile nerves because of the high Gleason score. So my question is: Can a man still have feeling in his penis after those nerves are removed, and can he still get orgasms? I read that he can, in the case of nerve sparing surgery, but does anyone have any experience in the case of non-nerve sparing surgery?
Thank you,

Dreyskii

logoslidat
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Date Joined Sep 2009
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   Posted 3/9/2017 9:07 PM (GMT -7)   
Nerve sparing means it is possible to have erections at some point...even natural ones...Non nervesparing...means he may/shouldbe able to have assisted erections...pumps...trimix...implants etc.

disected nerve bundles are outside the prostate and have zero effect on feeling in the penis or for that matter anywhere on the body

There is zero correlation...physically between orgasms and nerve bundles...

If the patient is treated with hormone therapy he will loose libido and have no desire for sex...not really sure weather he will sense orgasm...some one else may know that

To answer your question another way...If he is not on chemical castrtion durgs..he will have a normal libido and a normal...some say better orgasm tha before...I will attest to that...having one bundle removed and one spared...had orgasms from the jump...erections with the help of viagra 2 years post op...still have strong both at 74... Ok now ror the best advice you are gonna get...depart thee from your surgeon...hi gleason is a bogus reason to not spare nerves...if the tumor is out side of prostate or close to be ing so...possibly...for both to be removed..that need s to be true on both sides...betcha you are being treated out os america or in a "podunk" kine small setting hospital.... It ain't to late get a second opinion at a major medical center... guarens ballbearens you can save one ot probably both... check it out my freind...check it out...

Post Edited (Bololidat) : 3/9/2017 9:41:29 PM (GMT-7)


Tall Allen
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Date Joined Jul 2012
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   Posted 3/9/2017 9:34 PM (GMT -7)   
Orgasms may be preserved in many men. In the study below, about half the men who had non-nerve sparing were able to reach orgasm - but that was less in older men. Orgasm quality may be impacted too. about a 13% chance of preserved erectile function with non-nerve sparing. Other sexual SEs may include penile shrinkage, climacturia, Peyronie's, and painful orgasms. What are his stats and why did he choose surgery?

www.jsm.jsexmed.org/article/S1743-6095(15)32920-9/abstract
onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2004.05009.x/abstract
Allen - not an MD
•PSA=7.3, prostate volume=55cc, 8/17 cores G6 5-35% involvement
SBRT 9 yr onc. resultsSBRT 7 yr QOL results
•treated 10/2010 at age 57 at UCLA,PSA now: 0.1,no lasting urinary, rectal or sexual SEs
my PC blog

ASAdvocate
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Date Joined Feb 2015
Total Posts : 655
   Posted 3/9/2017 9:52 PM (GMT -7)   
Did he also consult with radiation specialists before making his choice? Age 69 is now about the limit for surgery versus radiation in many practices in the USA.
DOB: May 1944
In AS program at Johns Hopkins
Five biopsies from 2009 to 2014. The third and fourth biopsies were positive with one core and three cores <5% and G 3+3. Fifth biopsy was negative.
OncotypeDX: 86 percent chance of PCa remaining indolent
August 2015: tests are stable; no MRI or biopsy this year for my AS program
August 2016: MRI unchanged from 2/2014; PSA=3.9; FPSA= 26; PHI =28

Tudpock18
Forum Moderator


Date Joined Sep 2008
Total Posts : 3990
   Posted 3/10/2017 4:11 AM (GMT -7)   
Hello drey and welcome. Your orgasm question has been answered. As you will note, the previous posters also questioned the choice of treatment for a 69 year old man with "high Gleason". I will join them in asking if you also considered other options, particularly radiation with or without ADT. If you will give us more info re his stats perhaps we can help more.

Jim
Forum Moderator-Prostate Cancer. Age 62 (69 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6 yr: .1, 7 yr: .1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1

Gemlin
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Date Joined Jul 2015
Total Posts : 623
   Posted 3/10/2017 10:12 AM (GMT -7)   
urology.ucla.edu/dealing-with-erectile-dysfunction
UCLA said...
Can I Have An Orgasm Without An Erection?
Yes. An erection is not necessary for orgasm or ejaculation. Even if a man cannot have an erection or can only get or keep a partial erection, with the right sexual stimulation you can experience an orgasm. Your orgasm has little to do with your prostate gland. As long as you have normal skin sensation, you can have an orgasm.

My personal experience after surgery is that the erection is weaker but the orgasm is the same. Inability to achieve orgasm can probably be attributed to psychological and not physical causes.

NY-Sooner
Regular Member


Date Joined Sep 2009
Total Posts : 460
   Posted 3/10/2017 11:49 AM (GMT -7)   
I had my prostate removed almost 10 years ago with robotic surgery, and from the day the catheter was removed, I was getting rock solid erections without any viagra, and to this day, I still get them, and I am now 65. With respect to orgasms, they are very different now, but in my case, I think they are much better now.

Before I had my prostate surgery, when I had an orgasm, I would have an orgasm and ejaculate with maybe 2 or 3 pulses of pleasure, and with nothing more then a dribble of semen.

Today, without my prostate, when I have an orgasm, YES I still ejaculate, but now it is with urine and much more plaesurable. If my bladder is full when I have my orgasm, I can ejaculate urine across the room like a fire hose with 4 or 5 pluses , and with much MORE pleasure now, then I ever felt when I had my prostate. It is really incredible how much more pleasure I feel now.

Now I know everyone is thinking "Oh how gross, you ejaculate urine, this is nasty and gross" Well that's exactly what I felt also after my surgery, but when I talked with my uro, she told me that urine is 100% sterile and it is not uncommon for men to ejaculate urine after prostate surgery. This is a little known side effect that no ones tells you about.

My uro told me and my wife that if you ejaculate urine inside your partner's vagina , it can't hurt her because there is no bacteria in urine because it is 100% sterile. Also she told us that before having sex, if this bothers you a lot, just void your bladder, and try drinking a lot of water a few hours before sex to dilute any urine you do ejaculate so there is no odor.

At first my wife was grossed out by this and very apprehensive , but when she saw how much more pleasure I had when I ejaculated urine, now she has no problem and finds it rather sensual.

To add some realism , I found that if I add white food coloring to the water that I drink before having sex, when I do ejaculate , my urine comes out almost pure white which gives the appearance of real semen.

Overall, orgasms for me after my surgery are better now then before.

Post Edited (NY-Sooner) : 3/10/2017 12:20:32 PM (GMT-7)


Tudpock18
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Date Joined Sep 2008
Total Posts : 3990
   Posted 3/10/2017 12:54 PM (GMT -7)   
NY-Sooner said...

but when I talked with my uro, she told me that urine is 100% sterile

My uro told me and my wife that if you ejaculate urine inside your partner's vagina , it can't hurt her because there is no bacteria in urine because it is 100% sterile. .


ummm...I'm not so sure about that. A Google search of "is urine sterile" turns up multiple answers that say, "no, it is not". I'm not saying that it is harmful to your partner if you ejaculate urine but I believe the science shows that urine does contain some amount of bacteria even if you don't have a known infection.

JIm
Forum Moderator-Prostate Cancer. Age 62 (69 now), G 3 + 4 = 7, T1C, PSA 4.2, 2/16 cancerous, 27cc. Brachytherapy 12/9/08. 73 Iodine-125 seeds. Everything continues to function normally. PSA: 6 mo: 1.4, 1 yr: 1.0, 2 yr: .8, 3 yr: .5, 4/5 yr: .2, 6 yr: .1, 7 yr: .1. My docs are "delighted"! My journey:
http://www.healingwell.com/community/default.aspx?f=35&m=1305643&g=1305643#m1

vaportrail
Regular Member


Date Joined Dec 2015
Total Posts : 97
   Posted 3/10/2017 2:38 PM (GMT -7)   
NY-Sooner said...
This is a little known side effect that no ones tells you about.



I learn something new, every time I read through peoples posts around here-

JackH
Veteran Member


Date Joined Oct 2013
Total Posts : 2037
   Posted 3/10/2017 2:40 PM (GMT -7)   
vaportrail said...
NY-Sooner said...
This is a little known side effect that no ones tells you about.



I learn something new, every time I read through peoples posts around here-





Agreed!

Food coloring...whodathunkit!?

Graytech
Regular Member


Date Joined Nov 2014
Total Posts : 304
   Posted 3/10/2017 2:49 PM (GMT -7)   
NY-Sooner said...
At first my wife was grossed out by this and very apprehensive , but when she saw how much more pleasure I had when I ejaculated urine, now she has no problem and finds it rather sensual.


Took about 3 months before I had something useable and then urine for a month or so after that. It did feel similar to pre-surgery ejaculation but my wife was never a fan. Luckily it resolved on it's own by completely voiding my bladder. Unfortunately she is still a little "gun shy" to participate in activities that might leave a sour taste in her mouth if I leak a bit of urine at the wrong time.
Age at Dx 54 10/23/14 PSA 9.75 DRE- T1c
Biopsy: 2 of 12 GS7 (3+4) 7% of sample #1=20%G6, #2=10%G7
Scans: 1/22/15 CT / Bone Clear
DaVinci: 1/27/15 Prostate 36gr GS7 (4+3) 8% of organ
PNI+ EPE- SV- LN- Clear Margins pT2c
uPSA Post Surgery Every 3 Months <.05 <.05 .03 .03 .05 .07 .09
22 mons post RALP - 6 Mon Lupron Nov 2016 - May 2017
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InTheShop
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Date Joined Jan 2012
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   Posted 3/10/2017 2:58 PM (GMT -7)   
I had an orgasm once.
I'll be in the shop.
Age 57, 52 at DX
PSA:
4.2 10/11, 1.9 6/12, 1.2 12/12, 1.0 5/13, .6 11/13,
.7 5/14, .5 10/14, .5 4/15, .3 10/15, .3 4/16, .4 10/16
G 3+4
Stage T1C
2 out of 14 cores positive
Treatment IGRT - 2/2012
My latest blog post

logoslidat
Veteran Member


Date Joined Sep 2009
Total Posts : 5383
   Posted 3/10/2017 5:59 PM (GMT -7)   
NY sooner...your info on the sterility is spot on...it don't take much to change that once its in the air t ho hence the urine smell....they all know about golden showers here...whose kidding who?? May i say your sharing was...refreshing???....ooh...ahh...well...I never...clip clop...clip clop...clip clop...harumph...

See what I mean about standup comic...I could do it...any couch in the land...even ya know...da one of late......shows that is.... smilewinkgrin

lapilot
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Date Joined Nov 2012
Total Posts : 827
   Posted 3/11/2017 3:37 PM (GMT -7)   
Tudpock18,

Urine is usually sterile, unless one has a urine infection. I have seen a doctor doing bladder surgery and cuts the bladder with urine pouring into the abdomen. I question several doctors and they said that it wasn't a problem. Plus prior to surgeries a prophylactic antibiotic is always given to minimize potential infection.
Age 60, mpMRI 8/18/13 negative
biopsy 9/5/13, PSA 6.2, 13 core of which 6 are postive
pT2pNO
left laterial base 10% G6(3+3)
left laterial apex 10% G6(3+3)
right base 15% G7(3+4)
right laterial base 15% G6(3+3)
right laterial mid 60% G6(3+3)
right lateral apex 20% G6(3+3)
daVinci 11/11/13
path T2c N0 Stage IIB
PSA 0.1 to 11/15 then 0.2
11/15 IGRT 39 sessions 72 grays. ZERO problems.

mdm1948
New Member


Date Joined Mar 2017
Total Posts : 1
   Posted 3/12/2017 12:51 PM (GMT -7)   
I came on this thread with its tangent on urine during orgasm while looking for a thread that might shed some light on an odd side-effect I am still experiencing 6 years after my davinci prostatectomy. The surgery was nerve-sparing but there was clearly some damage–- bruising if not outright severing of some nerves. The side-effect is that my urinary and sexual responses sometimes get crossed up.

I am 68 and through much patient "homework", as my urologist called it, with a loving and motivated spouse, we have continued to have sex at least 2-3 times/week. I can still have erections w/o viagra or cialis, but find they are much more dependable and robust with them. I don't experience orgasm as frequently as before, but they can be as intense and often more prolonged. And my wife doesn't miss the semen.

The only time anymore that I experience minor incontinence, is in response to sexual stimulus. Not really during foreplay or intercourse, but something like a really good kiss in the kitchen. Where previously that would have prompted the start of an erection, more often now it produces a small squirt of urine.

Conversely, nighttime spontaneous erections seem most often to be concurrent with a full bladder.

Ring a bell with anyone? Or has anyone seen a thread that is more specifically related?
Thanks

NY-Sooner
Regular Member


Date Joined Sep 2009
Total Posts : 460
   Posted 3/13/2017 6:58 AM (GMT -7)   
MDM I have the same problem as you. When ever I feel some stimulation, like from kissing my wife, or in foreplay, etc, it seems that I start to loose a little control of my bladder and I have minor incontinence and I just start dripping everywhere. Not a lot, but drips enough to be bothersome.

I find this very annoying, and this bothers my wife much more then having me ejaculate urine, but after some investigation and experimentation, I found an esay solution which works great to stop this.

Before starting foreplay, I will put some Vaseline in the tip of my urethra to about a depth of 1/4 inch. This acts like a plug and stops all dripping during foreplay. Then when I have an orgasm and I ejaculate urine, this pushes out the Vaseline. This has solved my problem of dripping all over the bed and on my wife during foreplay.
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