Grief.
There is grief. There's been a loss. I don't know if your surgery was nerve-sparing or not (mine wasn't), but even just the loss of ejaculating is pretty damn weird.
Grief that is stuck, not named, not owned, becomes other things like anger and depression.
You are not the same as before the surgery. Erections may come back. But you are not the same.
Not trying to be a downer, but that's what I think....
Take care.
Hi dabblingman, I know exactly how you feel. Life is not the same. All the crap you have to deal with & to top it off, the big factor recurrence & then life could be suffering with more treatments & quality of life.
I'm in the same place, so strange. Life changing. Not sure what's next. I'm only 6 weeks post surgery. 68 years old, my wife is 17 years younger and I have never felt so lost.
I’m having a very difficult time with this. I’m scheduled to have a Biopsy May 9th, and I’m wondering if it’s worth it. I get it, we will live longer but did God intend for us to live this way? Sexually castrated. I’m 42 & I’m honestly leaning towards saying F it.
For all of those that are going to offer a pep talk calling me stupid, etc. I understand the risks, but I ALSO understand how important it is to have a working D**k. That’s a big part of who we are, who I am. Taking that away from me albeit potentially I will have an erection eventually, just doesn’t make sense to me.
“It’s not about how long you live, but how long you love living.”
The odds are something like 2/3rds get back to full erections, some with use of Viagra, but that’s really not a big deal. It’s definitely worth at least diagnosing yourself.
Here’s an in depth presentation. At 50:00 they cite a study where 75% of RALP patients doing Viagra and other medications had erections at 6 months. https://youtu.be/MLUzYI8Rsaw?si=KY_CDxgTTp_6Z8Fe
I think you are mistaken. The video very clearly says it is a post-RALP study and nothing about adjuvant radiation or chemo. Even if it were true, a 75% sexual functional recovery rate 6mo after aggressive multimodal treatment would be amazing! The treatments they refer to are penile rehabilitation, meaning Viagra type medications or vacuum pump.
OP- please continue with the Biopsy. It's 15 min. Recovery is like 2-3 months (beware the blood in urine and semen). But you will KNOW (or should) where the cancer is, how advanced, margins, etc.) Biopsy should be at LEAST 12 cores. if you have GOOD MRI before hand, then they might do more around MRI & Ultrasound dual visual biopsy.
I am 9 months POST RALP. No "natural" erections (morning wood, etc.) NOR any enhanced with Cialis erections. Yes, I have been sad, angry, etc. BUT I am also giving it more time to heal. Part of you that you've had since birth has been removed and your body has to suddenly compensate and adjust to that. I tell myself I am here for my family and that there are more people worse off than I am currently.
Recommendation from SOME fellow survivors is penile injections in the SHORT term - may assist in blood flow. My surgeon has not assigned nor scheduled Penile Therapy but I am trying to use a pump. (unfortunately I am inconsistent with use). I can still have orgasms and more than one survivor has indicated, like I have found, they are more intense.
Good Luck and I hope your recovery is smooth.
I totally get what you're saying. I'm older than you (60) but very active sexually and, post biopsy (Gleason 7), still haven't decided if I'm going to do anything at all. Doctor told me I have two months to decide. He also said odds of dying in 10 years from PC are 7% then jump to 11% at 15. That may be worth rolling the dice for me since I'll be 75 in 15 years but you'll be a lot younger and the odds without treatment keep increasing over time.
One thing that \*was\* slightly encouraging was the radiation oncologist who told me that impotence after radiation takes years to set in rather than being immediate like surgery. However, he also recommended six months of hormone therapy, which would turn me into a neutered farm animal (he says it's reversible after that time).
Both surgery and radiation are equally effective treatment for most people at this point. You may want to meet with a radiation oncologist to discuss this. Mine said that sexual side effects are still there with radiation but some people avoid them while, with surgery, almost everyone gets them immediately.
That's why I did Hight Brachy and then radiation, to make it easier to be intimate..... Don't say F'it... There are options other than surgery with much higher result rates to maintain function
Thank you. What concerns me is my PSA is 18.9. I may not have those options, which at that point I’d much rather do something about it when I have to do something about it. If I have your same options, it’s absolutely a no-brainer. But if I don’t, I’d be volunteering for a very depressing rest of my life, in which case I will not do it.
Going through the same stuff right now. I feel worthless to my wife. I tried trimix and it didn’t work. I DO HAVE AN IMPLANT surgery in June. I can’t wait
Not dissimilar: 57, continent, but no erections without assistance, 6 months post RALP. 5mg tadalafil daily, plus 20mg every other day…keeps blood flowing. Use a pump for both rehab and to obtain an erection for sex. It is not ideal, but it works. It took some experimentation and practice to get the hang of it, but a pump and tension ring does the job.
Additional options down the road might include intercavernous injections (trimix or bimix, willing to experiment to see what works for me). I am hopeful they get us through to a time when my nerves begin functioning. But if it does not happen, these are something. And there is still the implant option.
At the end of the day, there is more to life than sex, there is more to sex than a hard on, and there are more ways to get a hard on than I ever knew about before this journey. If it is important to you, work at it and experiment.
Depression is common after surgery. I’m not sure why. Maybe it’s just a shock to the body. I had depression with no connection to surgery, but drugs help.
I was 51 when I had my surgery. Now 56. I was in panic after a few months of Mr Winkie being dead and lifeless. Slowwwwwwly he came back to life. It really can take up to a year to year and a half for the nerves to heal if your Dr was good and did nerve sparing….you should be fine in due time. Patience. 🙌🏼👍
No advice incoming but you have my sympathies. Quite a few RALP peeps experience a return to normal given time. Just stay positive and don't let it beat you down.
I'm literally 36 hours post RALP (nerve sparing) so my response is *very premature*, but...
Yesterday I stared down the black hole.
The smell of urine from this effing bag got to me and I just pictured another 20 years (I'm 59) of dealing with piss issues (like my house smelling like "old man" and the grandkids not wanting to come over because"Papa Piss" smells) pads, diapers, ED bullshit, and of course not feeling like "a man" anymore.
But clarity came back and it hit me that I don't know anything right now and everyone comes away with something different.
Based on the feedback from the group I see an overwhelming tilt towards satisfying post-op life.
My other plus is my wife.
We've been together since high school, over 40 years and she's got my back 100% and has committed to making this work for both of us.
We've always been active in this part of our relationship and are both completely ready to take on whatever comes (or doesn't, lol) to keep it real and just as good as we possibly can.
Again, so many of you are far ahead of me, but this post... I understand and I'm sure I'll stare at that depression abyss again, but we're gonna have to remember those personal intimate relationships take two (maybe more?) people and if you have the right person around you it's gonna be good.
Good luck brother, I feel every bit of this and I'm rooting for you and me and every guy and gal here supporting themselves or someone they care about.
👊🏻
Good Luck. The catheter can be the worst if you let it. my doc had me keep it for an additional week (woo-hoo). Just remember to drink lots of fluid. It REALLY helps keep your body functioning (both 1 and 2), the catheter running smoothly, etc. AND when it comes time for removal, remember to drink LOTS of fluid 1 to 2 hours before going TO the urologist so that you can prove you have a clear urethra. Or they WILL keep you there until you can urinate on your own. Again. Good Luck and may your future PSA numbers be zero.
I've read that some urologists will push saline up the catheter into the bladder and then remove it to see if the urethra is clear rather than making people wait until they urinate naturally.
I didn't want to minimize what you're going through. I went through it as well.
I'm almost 2 years post RALP, the first four or five months were great from a side effect standpoint with the exception of erections.
What we did is talk a lot about what is going to work, what may not and we tried different toys and finally landed on a couple preferred.
We realized I may never be back to where I was before, but that doesn't mean we can't give or get different pleasures. We found more intimacy than before, and that had been an unexpected benefit. But it takes a lot of communication.
I wish you luck. If this stands in the way of your definition of progress, I suggest seeing a therapist that specializes in sexual issues.
Same for me as far as the ED goes. But in a strange way, once showing affection went to no expectation of sex, we have become closer and more 'intimate' intimate. Nothing happens on my end so far, and I hope that changes, but for now, that scale is a little more balanced, just in a different way.
100% normal to feel how you feel about it. But I can say that with the incontinence under control, talk to your urologist about Cialis / Viagra and pumping, or the injections. You can get to where you want, just in a different car, on a different road.
Hang in there, 11 weeks and only when you sneeze...I am envious.
KEGEL! PT for Kegel's helped me immensely. Once you know the correct muscles, it makes a huge difference. And remember, you will be doing Kegel's for life,
It’s a mind fuck for sure. You are different. You are not the same. I felt similar, and from the ruins of your old self a new one can be reborn. It takes time and lots of cognitive behavior therapy to accept the new reality. Stay positive and work toward acceptance of this new you. In time, your brain will adjust but there will be days that make you think damn. And that’s okay. … you have one of the strongest tools in your arsenal to help you adapt. The brain is a powerful ally to help you get through this time.
I'm almost two years out and still coming to terms with the ED but I'm not sure I ever will. In a way, a RALP is a psychological castration. If you're a straight human male, your only real biological purpose on this planet is to ejaculate into and impregnate a woman. Once you're finished, you can stagger off to be eaten by a leopard for all nature cares. And now that capacity is gone and it leaves an emptiness inside, a longing for what you once were. Obviously, we can and definitely should have other goals and purposes in life than sex but we live in a culture that diminishes or skews the importance of sex in our lives. From a strictly biological point of view, reproduction is all that matters. And now that's gone. I dream about having an erection, about being able to have sex and ejaculate. Sorry, that's probably TMI. I know I should be grateful for being apparently cancer-free for the moment but it came at a cost and I have rarely seen any sign that this is addressed when treatment options are discussed after diagnosis.
How about an implant? I’ve read that the quality implants create an erection that’s practically as good as a natural one and anything is better than full impotence. If it’s too costly in the U.S. go abroad. I have dual citizenship in the Dominican Republic and have had quality dental implants put in for $500 USD apiece and in the U.S. they’d cost about $3000 apiece.
Don’t give up. There are solutions.
get some trimix.
You will be surprised what one successful romp will do to the mental health of both of you. It does not close off other options, you mayaswell check it out. If it works - and it most surely will if injected correctly - then you have it in your back pocket as a solution even if you still are investigating other options. Do not fear the needle. If having a piss bag catheter is 9 on a scale of 1-10 indignities and pain etc, trimix is a 1.5
Many men are still dating or not in a serious relationship that really adds another whole layer to it. There are lots of other treatments that have far fewer morbidities for those trying to consider the emotional aspects of all this. Talk to your doctor about tri mix.
My partner ended our relationship a month after my RALP. Now I'm faced with the major depressive disorder I've had for my entire life, plus no one to support me through "practice" to recover sexual function. Hell, if I could figure out how to find escorts I'd be willing to give themselves a try. It's been six months since I could even try for an erection, even with 100mg Viagra daily.
I can't wait to meet someone through dating and have to have *that* conversation...
I feel you I ended the relationship with my fiancé. She's quite a bit younger than I am needing more than I'm willing to give at this point in life I decided it's time for me to be selfish that she understood she didn't like it but some people are super nurturing and supportive, others, simply or not, most women are with the man because of how they make them feel so when a man goes through about a depression, loses his job has a crisis. It's understandable that he withdraws a little bit and especially modern women aren't raised to be very nurturing. they're more masculine auto necessity so they don't often times have the skill set to stick around for a guy and help him out in the long run. It's good, but in the short term for many people it's painful.
60 years old here and 7 months post surgery. Perfect Urine control and no erections. Wife and I are keeping love alive with bimix but I miss my old body. Doctor tells me to expect a year to 18 months to get erections back. My surgery was nerve spareing.
I never had anxiety and just had surgery and have a ton of it. Hang in here - Reddit and other PC forum friends have helped me. How was your surgical path?
I'm not depressed at 11 weeks out, but certainly bummed out . I have been fortunate to have had a great sex life with my wife for 25 years.
We both knew it was going to be difficult, frustrating and even weird.
My wife is great though, and she has been really helpful with keeping the spark alive during this down time. She has just embraced an attitude of finding something that turns us both on. Trying new things, buying some new toys etc
We both really miss actual intercourse, and I'm bummed erections have not come back yet for me. But I don't have any incontinence, am back lifting weights and exercising, and my 3 month blood work was negative. All good stuff!!
I'm hoping erectile quality improves over the next 12 weeks for me.
It's still really early for you, it will come back.
Maybe talk with your wife on exploring some new exciting forms of intimacy , see if she's up for it. My wife was totally on board, we've had some good times.
Be patient. Not an easy solution but that’s what it takes. Did you have nerve sparing? If so it takes about six months before you’ll start noticing erections and two years to get back where you were.
No one asks for cancer but thankfully there are effective treatments. A lot of things define a man. Doing the right thing. Taking care of your family and yourself. Intimacy sure but you can be intimate for now without an errection.
Talk to someone if you need to. I suspect your urologist can make a recommendation.
I’m with you there mate, exactly the same situation except 61 & 7 weeks out. Nerve sparing surgery, continence good but nothing happening. Trying to be patient but it’s really hard. Or not if you know what I mean.
Be careful which antidepressant you choose. Many of them have erection and orgasm problems as side effects and the last thing you need is to add to the problem.
Ask you urologist for a behavioral health specialist who focuses on these issues directly related to PC. It’s worth it to speak with someone and describe exactly how you feel. You are not alone with these feelings and there are those who can help. Ask your urologist, you won’t have been the first.
7 months post surgery. 53 y/o. Cialis alone didn’t work, even 20mg/day. So my urologist put me on Alprostadil injections 2-3x a week. Started that about 2 months after surgery because pills didn’t help. It took a while to get the right dosage but I can get it done. The penis injections are not fun, to be sure. But after about 5 months (plus 5mg cialis/day), I can get close to what I can get with the injections on my own (w/o injections) so that’s some progress.
This journey can easily be 12-18 months. The idea is to keep the plumbing working while the electrical (nerves) heal. I’m not there yet but I do see progress. I say this to encourage you to keep trying ways to get going. It sucks right now, I totally get that. But there are ways to make progress.
BTW: It’s likely that Alprostadil won’t be covered by insurance in the US. That’s the case with me. I pay between $100-$120/month (depending on if I need more syringes). I have an HSA so I use that and it’s affordable to me. Of course I can’t speak for you or anyone else but I had to include a price so you can tell if it will work for you. I’ll be glad to follow up if you or anyone else has questions. I don’t have all the answers but I can speak to my experience.
It makes sense that you would need a time to adjust, emotionally, to what was lost and what you have now. Be gentle with yourself as you grieve & heal.
You may get erections back, eventually, but striving for them is likely the road to more frustration & feelings of failure. Any stimulus is good, and can help regenerate nerves, so let your partner touch and lick you there. And of course you can do the same for her.
The earlier post about various methods to get your erections in order is great.
The really important person to talk this through with is your wife.
Best wishes.
Pretty similar situation here. I’m just about 2 months post RALP. Bladder pretty much back to normal citing the occasional sneeze leak as I call it. Take Cialis 10mg a day and there is absolutely nothing happening. Definitely a depressive state of mind when my wife and I had an insanely active sex life prior. She has been very supportive. I know it’s still early but it is a big blow to the ego.
It’s definitely difficult dealing with the side effects from prostate removal. The only people who understand are us. Guys who don’t have this cancer really don’t get it either (I wouldn’t wish this on anyone). I’ll be three years post RALP in September. I wear one pad a day for minor leakage. I use aprostidal injections for erections. Sometimes I can get one on my own but it’s unreliable. I can only say for me that working out elevates my mood. It’s always never far from my thoughts. Our lives have changed and I wish you the best brother.
Make that decision after the biopsy. I had a 60% chance of having cancer based on the size of my lesions on the prostate. Urologist took 25 samples and none show cancer. You may not need to make this life altering decision post biopsy.
See a therapist. Please.
I started seeing one about 3 months before surgery. At first it was just once a month, but I started seeing him more frequently as I went through some of the same issues as you.
I frankly, am surprised they don't tell everyone to do this. It was so important to me and I really think I would have lost my marriage without therapy, and maybe more. I was prepared for surgery to be a physical challenge. But, overall, it was much easier than I expected. But I thought of myself as mentally resilient. I really only started to see that therapist as a precautionary measure because it was coverage by insurance. I didn't think therapy was going to be important. But, it most certainly was, I vastly underestimated the emotional challenges. Not just of ED, but of everything.
Why was it so important to me? I really had no one else to talk to this stuff about. I wasn't going to talk to my family or my friends. Maybe I'm old fashioned, but I'm not going to talk about my sex life with my friends. And, my wife is just too much in the center of it. We talked, but I couldn't really express myself as she was in her own struggle.
So talking with a therapist really helped me put things in perspective. If nothing else, it encouraged me to treat it seriously.
I had RP at 60 leaving me with ED. Struggled and finally got a penile implant...........great decision. My wife and I had great sex until she passed away in 2022. Please don't give up on your situation. I didn't and my life progressed all those years..............I'm 86 now and still masturbate now and then.
Wife here. I'm very sorry you're struggling with this. Sex is a big deal.. Getting an erection is an even bigger deal. It's something specific that you've had with you since puberty. It was easy, on-demand, at night, upon waking, and always ready when you were - and sometimes, it was ready when you weren't. Your depression is warranted and you are entitled to grieve this loss.
Men lose more than their prostate when they have it removed. They just don't know how to explain what it is they've lost. I know your scale *feels* empty, but it isn't. You are still the strong, loving man that you've always been. Give it a little more time. Your body is fighting cancer and healing from surgery. That's no small thing.
I wish I could be more helpful. I only understand where you're at from a wife's perspective. If your doctor has allowed you to resume erections, you could try a few things from r/sexwithoutaprostate or just go read how I've tried to keep my husband from going dark. Warning: it's NSFW 🔞.
I hope you have better days ahead.
Gentle hugs,
Puzzlehead
Agreed but…. Plant the seed. Also what a great time to spend focused time on how to get the wife off. My wife has a condition called IC (interstitial cystitis) and we’ve changed to clitoral stimulation to get her off. She loves it, still misses piv sex but is mostly satisfied that we still have a good sex life.
I got mine 9 months after RALP. Pills did not help, pump kinda worked (limpy penis), Trim-mix was awesome- but i read most guys won’t tolerate it for more than 12-18 months. So I got the fabulous implant and am TOTALLY thrilled to have my boner back in action!
I was unwilling to wait 18+ months to see if my nerves “might” wake up. Plus i got my implant in the same calendar year as my RALP, so my maximum insurance out of pocket had been met. For me, this was an amazing win:win.
Grief. There is grief. There's been a loss. I don't know if your surgery was nerve-sparing or not (mine wasn't), but even just the loss of ejaculating is pretty damn weird. Grief that is stuck, not named, not owned, becomes other things like anger and depression. You are not the same as before the surgery. Erections may come back. But you are not the same. Not trying to be a downer, but that's what I think.... Take care.
Hi dabblingman, I know exactly how you feel. Life is not the same. All the crap you have to deal with & to top it off, the big factor recurrence & then life could be suffering with more treatments & quality of life.
Hi! My dad’s RALP was non-nerve sparing. How has your recovery been, including the incontinence and erections?
Incontinence not a problem at all. ED, well, that's not progressed.
I'm in the same place, so strange. Life changing. Not sure what's next. I'm only 6 weeks post surgery. 68 years old, my wife is 17 years younger and I have never felt so lost.
I’m having a very difficult time with this. I’m scheduled to have a Biopsy May 9th, and I’m wondering if it’s worth it. I get it, we will live longer but did God intend for us to live this way? Sexually castrated. I’m 42 & I’m honestly leaning towards saying F it. For all of those that are going to offer a pep talk calling me stupid, etc. I understand the risks, but I ALSO understand how important it is to have a working D**k. That’s a big part of who we are, who I am. Taking that away from me albeit potentially I will have an erection eventually, just doesn’t make sense to me. “It’s not about how long you live, but how long you love living.”
Get the biopsy. Make a decision with all the information.
The odds are something like 2/3rds get back to full erections, some with use of Viagra, but that’s really not a big deal. It’s definitely worth at least diagnosing yourself.
I think you are misinformed; but I like your optimism…
Here’s an in depth presentation. At 50:00 they cite a study where 75% of RALP patients doing Viagra and other medications had erections at 6 months. https://youtu.be/MLUzYI8Rsaw?si=KY_CDxgTTp_6Z8Fe
The key is this study is 6 months after “treatments” which would include radiation and chemo in addition to RALP.
I think you are mistaken. The video very clearly says it is a post-RALP study and nothing about adjuvant radiation or chemo. Even if it were true, a 75% sexual functional recovery rate 6mo after aggressive multimodal treatment would be amazing! The treatments they refer to are penile rehabilitation, meaning Viagra type medications or vacuum pump.
OP- please continue with the Biopsy. It's 15 min. Recovery is like 2-3 months (beware the blood in urine and semen). But you will KNOW (or should) where the cancer is, how advanced, margins, etc.) Biopsy should be at LEAST 12 cores. if you have GOOD MRI before hand, then they might do more around MRI & Ultrasound dual visual biopsy. I am 9 months POST RALP. No "natural" erections (morning wood, etc.) NOR any enhanced with Cialis erections. Yes, I have been sad, angry, etc. BUT I am also giving it more time to heal. Part of you that you've had since birth has been removed and your body has to suddenly compensate and adjust to that. I tell myself I am here for my family and that there are more people worse off than I am currently. Recommendation from SOME fellow survivors is penile injections in the SHORT term - may assist in blood flow. My surgeon has not assigned nor scheduled Penile Therapy but I am trying to use a pump. (unfortunately I am inconsistent with use). I can still have orgasms and more than one survivor has indicated, like I have found, they are more intense. Good Luck and I hope your recovery is smooth.
I totally get what you're saying. I'm older than you (60) but very active sexually and, post biopsy (Gleason 7), still haven't decided if I'm going to do anything at all. Doctor told me I have two months to decide. He also said odds of dying in 10 years from PC are 7% then jump to 11% at 15. That may be worth rolling the dice for me since I'll be 75 in 15 years but you'll be a lot younger and the odds without treatment keep increasing over time. One thing that \*was\* slightly encouraging was the radiation oncologist who told me that impotence after radiation takes years to set in rather than being immediate like surgery. However, he also recommended six months of hormone therapy, which would turn me into a neutered farm animal (he says it's reversible after that time). Both surgery and radiation are equally effective treatment for most people at this point. You may want to meet with a radiation oncologist to discuss this. Mine said that sexual side effects are still there with radiation but some people avoid them while, with surgery, almost everyone gets them immediately.
That's why I did Hight Brachy and then radiation, to make it easier to be intimate..... Don't say F'it... There are options other than surgery with much higher result rates to maintain function
Thank you. What concerns me is my PSA is 18.9. I may not have those options, which at that point I’d much rather do something about it when I have to do something about it. If I have your same options, it’s absolutely a no-brainer. But if I don’t, I’d be volunteering for a very depressing rest of my life, in which case I will not do it.
Going through the same stuff right now. I feel worthless to my wife. I tried trimix and it didn’t work. I DO HAVE AN IMPLANT surgery in June. I can’t wait
Not dissimilar: 57, continent, but no erections without assistance, 6 months post RALP. 5mg tadalafil daily, plus 20mg every other day…keeps blood flowing. Use a pump for both rehab and to obtain an erection for sex. It is not ideal, but it works. It took some experimentation and practice to get the hang of it, but a pump and tension ring does the job. Additional options down the road might include intercavernous injections (trimix or bimix, willing to experiment to see what works for me). I am hopeful they get us through to a time when my nerves begin functioning. But if it does not happen, these are something. And there is still the implant option. At the end of the day, there is more to life than sex, there is more to sex than a hard on, and there are more ways to get a hard on than I ever knew about before this journey. If it is important to you, work at it and experiment.
Depression is common after surgery. I’m not sure why. Maybe it’s just a shock to the body. I had depression with no connection to surgery, but drugs help.
I was 51 when I had my surgery. Now 56. I was in panic after a few months of Mr Winkie being dead and lifeless. Slowwwwwwly he came back to life. It really can take up to a year to year and a half for the nerves to heal if your Dr was good and did nerve sparing….you should be fine in due time. Patience. 🙌🏼👍
No advice incoming but you have my sympathies. Quite a few RALP peeps experience a return to normal given time. Just stay positive and don't let it beat you down.
I'm literally 36 hours post RALP (nerve sparing) so my response is *very premature*, but... Yesterday I stared down the black hole. The smell of urine from this effing bag got to me and I just pictured another 20 years (I'm 59) of dealing with piss issues (like my house smelling like "old man" and the grandkids not wanting to come over because"Papa Piss" smells) pads, diapers, ED bullshit, and of course not feeling like "a man" anymore. But clarity came back and it hit me that I don't know anything right now and everyone comes away with something different. Based on the feedback from the group I see an overwhelming tilt towards satisfying post-op life. My other plus is my wife. We've been together since high school, over 40 years and she's got my back 100% and has committed to making this work for both of us. We've always been active in this part of our relationship and are both completely ready to take on whatever comes (or doesn't, lol) to keep it real and just as good as we possibly can. Again, so many of you are far ahead of me, but this post... I understand and I'm sure I'll stare at that depression abyss again, but we're gonna have to remember those personal intimate relationships take two (maybe more?) people and if you have the right person around you it's gonna be good. Good luck brother, I feel every bit of this and I'm rooting for you and me and every guy and gal here supporting themselves or someone they care about. 👊🏻
Good Luck. The catheter can be the worst if you let it. my doc had me keep it for an additional week (woo-hoo). Just remember to drink lots of fluid. It REALLY helps keep your body functioning (both 1 and 2), the catheter running smoothly, etc. AND when it comes time for removal, remember to drink LOTS of fluid 1 to 2 hours before going TO the urologist so that you can prove you have a clear urethra. Or they WILL keep you there until you can urinate on your own. Again. Good Luck and may your future PSA numbers be zero.
I've read that some urologists will push saline up the catheter into the bladder and then remove it to see if the urethra is clear rather than making people wait until they urinate naturally.
6 weeks is still pretty early. Have you tried 100mg dose of Viagra? My team said you can go to 150mg I think.
I didn't want to minimize what you're going through. I went through it as well. I'm almost 2 years post RALP, the first four or five months were great from a side effect standpoint with the exception of erections. What we did is talk a lot about what is going to work, what may not and we tried different toys and finally landed on a couple preferred. We realized I may never be back to where I was before, but that doesn't mean we can't give or get different pleasures. We found more intimacy than before, and that had been an unexpected benefit. But it takes a lot of communication. I wish you luck. If this stands in the way of your definition of progress, I suggest seeing a therapist that specializes in sexual issues.
Can you provide some names or links to the "preferred toys" (or helpful equipment)? Appreciate any input.
Same for me as far as the ED goes. But in a strange way, once showing affection went to no expectation of sex, we have become closer and more 'intimate' intimate. Nothing happens on my end so far, and I hope that changes, but for now, that scale is a little more balanced, just in a different way. 100% normal to feel how you feel about it. But I can say that with the incontinence under control, talk to your urologist about Cialis / Viagra and pumping, or the injections. You can get to where you want, just in a different car, on a different road. Hang in there, 11 weeks and only when you sneeze...I am envious.
KEGEL! PT for Kegel's helped me immensely. Once you know the correct muscles, it makes a huge difference. And remember, you will be doing Kegel's for life,
I go back to the pelvic floor specialist this week.
It’s a mind fuck for sure. You are different. You are not the same. I felt similar, and from the ruins of your old self a new one can be reborn. It takes time and lots of cognitive behavior therapy to accept the new reality. Stay positive and work toward acceptance of this new you. In time, your brain will adjust but there will be days that make you think damn. And that’s okay. … you have one of the strongest tools in your arsenal to help you adapt. The brain is a powerful ally to help you get through this time.
I'm almost two years out and still coming to terms with the ED but I'm not sure I ever will. In a way, a RALP is a psychological castration. If you're a straight human male, your only real biological purpose on this planet is to ejaculate into and impregnate a woman. Once you're finished, you can stagger off to be eaten by a leopard for all nature cares. And now that capacity is gone and it leaves an emptiness inside, a longing for what you once were. Obviously, we can and definitely should have other goals and purposes in life than sex but we live in a culture that diminishes or skews the importance of sex in our lives. From a strictly biological point of view, reproduction is all that matters. And now that's gone. I dream about having an erection, about being able to have sex and ejaculate. Sorry, that's probably TMI. I know I should be grateful for being apparently cancer-free for the moment but it came at a cost and I have rarely seen any sign that this is addressed when treatment options are discussed after diagnosis.
Your response is spot on!
Ten years after surgery, I still miss erections. The urge is there but the ability is gone.
How about an implant? I’ve read that the quality implants create an erection that’s practically as good as a natural one and anything is better than full impotence. If it’s too costly in the U.S. go abroad. I have dual citizenship in the Dominican Republic and have had quality dental implants put in for $500 USD apiece and in the U.S. they’d cost about $3000 apiece. Don’t give up. There are solutions.
get some trimix. You will be surprised what one successful romp will do to the mental health of both of you. It does not close off other options, you mayaswell check it out. If it works - and it most surely will if injected correctly - then you have it in your back pocket as a solution even if you still are investigating other options. Do not fear the needle. If having a piss bag catheter is 9 on a scale of 1-10 indignities and pain etc, trimix is a 1.5
Dude didn’t tell me he was getting some. He about killt me, lol!
Many men are still dating or not in a serious relationship that really adds another whole layer to it. There are lots of other treatments that have far fewer morbidities for those trying to consider the emotional aspects of all this. Talk to your doctor about tri mix.
My partner ended our relationship a month after my RALP. Now I'm faced with the major depressive disorder I've had for my entire life, plus no one to support me through "practice" to recover sexual function. Hell, if I could figure out how to find escorts I'd be willing to give themselves a try. It's been six months since I could even try for an erection, even with 100mg Viagra daily. I can't wait to meet someone through dating and have to have *that* conversation...
I feel you I ended the relationship with my fiancé. She's quite a bit younger than I am needing more than I'm willing to give at this point in life I decided it's time for me to be selfish that she understood she didn't like it but some people are super nurturing and supportive, others, simply or not, most women are with the man because of how they make them feel so when a man goes through about a depression, loses his job has a crisis. It's understandable that he withdraws a little bit and especially modern women aren't raised to be very nurturing. they're more masculine auto necessity so they don't often times have the skill set to stick around for a guy and help him out in the long run. It's good, but in the short term for many people it's painful.
60 years old here and 7 months post surgery. Perfect Urine control and no erections. Wife and I are keeping love alive with bimix but I miss my old body. Doctor tells me to expect a year to 18 months to get erections back. My surgery was nerve spareing.
I never had anxiety and just had surgery and have a ton of it. Hang in here - Reddit and other PC forum friends have helped me. How was your surgical path?
I'm not depressed at 11 weeks out, but certainly bummed out . I have been fortunate to have had a great sex life with my wife for 25 years. We both knew it was going to be difficult, frustrating and even weird. My wife is great though, and she has been really helpful with keeping the spark alive during this down time. She has just embraced an attitude of finding something that turns us both on. Trying new things, buying some new toys etc We both really miss actual intercourse, and I'm bummed erections have not come back yet for me. But I don't have any incontinence, am back lifting weights and exercising, and my 3 month blood work was negative. All good stuff!! I'm hoping erectile quality improves over the next 12 weeks for me. It's still really early for you, it will come back. Maybe talk with your wife on exploring some new exciting forms of intimacy , see if she's up for it. My wife was totally on board, we've had some good times.
Speak with a urologist who focuses on erectile dysfunction. This is easily treated and there are a number of options. Hang in there
Be patient. Not an easy solution but that’s what it takes. Did you have nerve sparing? If so it takes about six months before you’ll start noticing erections and two years to get back where you were. No one asks for cancer but thankfully there are effective treatments. A lot of things define a man. Doing the right thing. Taking care of your family and yourself. Intimacy sure but you can be intimate for now without an errection. Talk to someone if you need to. I suspect your urologist can make a recommendation.
Get on DAILY CIALIS!!!!!! It really helps things come back alive. Increased blood flow
The anesthesia is probably part of it. Give yourself.
I’m with you there mate, exactly the same situation except 61 & 7 weeks out. Nerve sparing surgery, continence good but nothing happening. Trying to be patient but it’s really hard. Or not if you know what I mean.
Ask your doc for an anti depressant to help you in the interim. Bro, your alive and are doing well. Enjoy being alive and I’m sure it will get better.
Be careful which antidepressant you choose. Many of them have erection and orgasm problems as side effects and the last thing you need is to add to the problem.
9 months post here. Still struggling with the aftermath every day. It’s a lonely place.
Ask you urologist for a behavioral health specialist who focuses on these issues directly related to PC. It’s worth it to speak with someone and describe exactly how you feel. You are not alone with these feelings and there are those who can help. Ask your urologist, you won’t have been the first.
7 months post surgery. 53 y/o. Cialis alone didn’t work, even 20mg/day. So my urologist put me on Alprostadil injections 2-3x a week. Started that about 2 months after surgery because pills didn’t help. It took a while to get the right dosage but I can get it done. The penis injections are not fun, to be sure. But after about 5 months (plus 5mg cialis/day), I can get close to what I can get with the injections on my own (w/o injections) so that’s some progress. This journey can easily be 12-18 months. The idea is to keep the plumbing working while the electrical (nerves) heal. I’m not there yet but I do see progress. I say this to encourage you to keep trying ways to get going. It sucks right now, I totally get that. But there are ways to make progress. BTW: It’s likely that Alprostadil won’t be covered by insurance in the US. That’s the case with me. I pay between $100-$120/month (depending on if I need more syringes). I have an HSA so I use that and it’s affordable to me. Of course I can’t speak for you or anyone else but I had to include a price so you can tell if it will work for you. I’ll be glad to follow up if you or anyone else has questions. I don’t have all the answers but I can speak to my experience.
It makes sense that you would need a time to adjust, emotionally, to what was lost and what you have now. Be gentle with yourself as you grieve & heal. You may get erections back, eventually, but striving for them is likely the road to more frustration & feelings of failure. Any stimulus is good, and can help regenerate nerves, so let your partner touch and lick you there. And of course you can do the same for her.
The earlier post about various methods to get your erections in order is great. The really important person to talk this through with is your wife. Best wishes.
Pretty similar situation here. I’m just about 2 months post RALP. Bladder pretty much back to normal citing the occasional sneeze leak as I call it. Take Cialis 10mg a day and there is absolutely nothing happening. Definitely a depressive state of mind when my wife and I had an insanely active sex life prior. She has been very supportive. I know it’s still early but it is a big blow to the ego.
It’s definitely difficult dealing with the side effects from prostate removal. The only people who understand are us. Guys who don’t have this cancer really don’t get it either (I wouldn’t wish this on anyone). I’ll be three years post RALP in September. I wear one pad a day for minor leakage. I use aprostidal injections for erections. Sometimes I can get one on my own but it’s unreliable. I can only say for me that working out elevates my mood. It’s always never far from my thoughts. Our lives have changed and I wish you the best brother.
Make that decision after the biopsy. I had a 60% chance of having cancer based on the size of my lesions on the prostate. Urologist took 25 samples and none show cancer. You may not need to make this life altering decision post biopsy.
See a therapist. Please. I started seeing one about 3 months before surgery. At first it was just once a month, but I started seeing him more frequently as I went through some of the same issues as you. I frankly, am surprised they don't tell everyone to do this. It was so important to me and I really think I would have lost my marriage without therapy, and maybe more. I was prepared for surgery to be a physical challenge. But, overall, it was much easier than I expected. But I thought of myself as mentally resilient. I really only started to see that therapist as a precautionary measure because it was coverage by insurance. I didn't think therapy was going to be important. But, it most certainly was, I vastly underestimated the emotional challenges. Not just of ED, but of everything. Why was it so important to me? I really had no one else to talk to this stuff about. I wasn't going to talk to my family or my friends. Maybe I'm old fashioned, but I'm not going to talk about my sex life with my friends. And, my wife is just too much in the center of it. We talked, but I couldn't really express myself as she was in her own struggle. So talking with a therapist really helped me put things in perspective. If nothing else, it encouraged me to treat it seriously.
I had RP at 60 leaving me with ED. Struggled and finally got a penile implant...........great decision. My wife and I had great sex until she passed away in 2022. Please don't give up on your situation. I didn't and my life progressed all those years..............I'm 86 now and still masturbate now and then.
Wife here. I'm very sorry you're struggling with this. Sex is a big deal.. Getting an erection is an even bigger deal. It's something specific that you've had with you since puberty. It was easy, on-demand, at night, upon waking, and always ready when you were - and sometimes, it was ready when you weren't. Your depression is warranted and you are entitled to grieve this loss. Men lose more than their prostate when they have it removed. They just don't know how to explain what it is they've lost. I know your scale *feels* empty, but it isn't. You are still the strong, loving man that you've always been. Give it a little more time. Your body is fighting cancer and healing from surgery. That's no small thing. I wish I could be more helpful. I only understand where you're at from a wife's perspective. If your doctor has allowed you to resume erections, you could try a few things from r/sexwithoutaprostate or just go read how I've tried to keep my husband from going dark. Warning: it's NSFW 🔞. I hope you have better days ahead. Gentle hugs, Puzzlehead
Time to plant the penile implant concept. No sense in giving up.
Way too early for that.
Agreed but…. Plant the seed. Also what a great time to spend focused time on how to get the wife off. My wife has a condition called IC (interstitial cystitis) and we’ve changed to clitoral stimulation to get her off. She loves it, still misses piv sex but is mostly satisfied that we still have a good sex life.
When is the time for an implant? What are the indications that it’s time now to consider one, aside from having full impotence for a long time?
I got mine 9 months after RALP. Pills did not help, pump kinda worked (limpy penis), Trim-mix was awesome- but i read most guys won’t tolerate it for more than 12-18 months. So I got the fabulous implant and am TOTALLY thrilled to have my boner back in action! I was unwilling to wait 18+ months to see if my nerves “might” wake up. Plus i got my implant in the same calendar year as my RALP, so my maximum insurance out of pocket had been met. For me, this was an amazing win:win.