Can you come without a prostate
Sex and erection problems after treatment for prostate cancer
Prostate cancer treatments can affect your sex life. Some treatments can damage the nerves that you need to get an erection. Other treatments can affect the levels of hormones needed to get and maintain an erection.
Even if you can't get a full erection, you can still have a sex life. There are several treatments that may help you but not everyone chooses to have treatment. Treatments might include:
- drug treatments such as tablets and creams
- vacuum pumps
Sex therapy and counselling can also help.
How prostate cancer surgery affects your sexuality?
Surgery to remove the prostate gland is called radical prostatectomy. This treatment can affect your sex life in different ways.
Damage to the nerves used during an erection
Radical prostatectomy can damage the nerves you need to get an erection. Nerve sparing surgery can help lower this risk. But not everyone is suitable for this type of surgery. Nerve sparing surgery means that your surgeon removes the cancer without cutting or damaging the nerves. But if your cancer is growing close to the nerves, they will have to remove them.
Some men will get back their ability to have erections. But this can take anything between 3 months to 3 years. And some men will need help to get an erection for the rest of their lives.
After a radical prostatectomy, you no longer ejaculate semen. This is because the prostate gland and 2 glands called the seminal vesicles are removed. Your testicles will continue to make sperm cells but they will be reabsorbed back into your body. So you are still able to have an orgasm, but this is a dry orgasm.
Some men say that a dry orgasm feels normal. But others find them less intense and pleasurable. The loss of a visible ejaculation can also be significant for some people.
A radical prostatectomy can also change the way anal sex feels if you are the receiving partner. Some men find the penis rubbing against the prostate gland pleasurable. So if the prostate is no longer there, anal sex might feel different.
How hormone therapy and radiotherapy affect your sexuality?
Hormone therapy lowers the amount of testosterone in the body. This affects your ability to have and maintain an erection. It can also change the intensity of the orgasms.
Radiotherapy to the prostate can also damage the nerves that control getting an erection. This is usually a more delayed side effect. Men can develop erection problems within 3 to 5 years after finishing treatment.
How high intensity focused ultrasound (HIFU) and cryotherapy affect your sexuality?
HIFU and cryotherapy usually cause fewer problems than surgery or radiotherapy. But there is still a risk of erection problems with these treatments. Researchers are still looking into these treatments and their long term side effects.
Treatments for sexual problems
There are different treatments available to help you manage sexual problems. Talk through your options with a doctor or specialist. Ask them to refer you to an Erectile Dysfunction Clinic if they are not able to give you this specialist advice.
Penile or erectile dysfunction rehabilitation
Treatments for sexual problems are usually part of a programme called penile rehabilitation. This is also called erectile dysfunction rehabilitation. The aim of penile rehabilitation is to:
- maintain blood flow to the penis
- reduce damage to the muscle and tissue in the penis
- provide a stimulus for erections
A penile rehabilitation programme includes:
- counselling and sex therapy
- healthy living
- vacuum pumps
- injections or pellets
Why is penile or erectile dysfunction rehabilitation important
Whether you are single, or in a relationship, you should have the opportunity to discuss penile rehabilitation. Talk to your doctor or specialist nurse even if you are not sexually active, or don’t plan to be. This is because penile rehabilitation has benefits in terms of keeping the penis healthy.
Using and stimulating the penis keeps the tissues active and prevents them from becoming inflexible.
Rehabilitation should start before or soon after your prostate cancer treatment.
Counselling and sex therapy
Talking to your partner about your erection difficulties can help. Or it may help to talk to a close friend if you are not in a relationship.
Counsellors or therapists can help if you’re worried about anything to do with your sex life and sexuality. You can be referred by your GP to a counsellor or therapist within the NHS. You might need to go on a waiting list to see them.
Talk to your GP to find out what is available in your area. Your local hospital or your local Erectile Dysfunction Clinic might have this service.
Making changes to how you live your life can help you feel better and improve your sex life. Being active and having a healthy weight can improve your interest in sex and help you get an erection. Stopping smoking and cutting down on alcohol can also improve erections.
Some studies have shown that pelvic floor exercises can also help erection problems. The pelvic floor muscles are the sling of muscles in between your legs that run from the tailbone to the pubic bone. These muscles support the bladder and bowel.
The drugs used to treat erection problems include:
- tadalafil (Cialis)
- sildenafil citrate (Viagra)
- vardenafil (Levitra)
- avanafil (Spedra)
These belong to a group of drugs called phosphodiesterase type 5 (PDE 5) inhibitors. They work by increasing blood flow to the penis. For the drugs to work, men need to be aroused and have some sort of sexual stimulation. In other words, the drugs won’t cause an immediate erection, some foreplay is usually needed.
As drugs work best in men who have sexual desire, they might not help some men who are having hormone therapy. But some specialists believe that they are still worth a try if you would like to give them a go.
Talk to your doctor about the best PDE 5 drug for you and the best way to take it. Funding for some of these drugs is limited on the NHS. So your GP might only be able to prescribe a limited amount. If this is the case and you are able to, ask your doctor how you can buy these privately.
Possible side effects of PDE 5 inhibitors include:
- back pain
- headaches and dizziness
- feeling or being sick
Vacuum pumps are also called vacuum erection devices (VEDs). The pump fits over the penis and draws blood into the penis to form an erection.
You can then put a soft plastic ring called a constriction ring around the base of your penis. The ring keeps the erection firm. You shouldn’t leave the ring on for more than 30 minutes. As the ring restricts blood flow, using it for longer can damage the tissues.
Vacuum pumps can work well with practice, but they don't suit everyone. It’s worth knowing that the pump can cause the penis to have a blue tinge, this is normal. You can use a vacuum pump without the ring to exercise the penis as an important part of penile rehabilitation.
Your doctor might suggest you use the vacuum pump in combination with PDE 5 drugs. Or you might have:
- the vacuum pump alone
- the pump in combination with other treatments such as injections
Your doctor might suggest you use alprostadil cream. It is also called Vitaros. You use an applicator to put this cream onto the opening of the penis. You usually get an erection within 5 to 30 minutes. The erection can last for 1 to 2 hours.
Injections or pellets
Injection or pellets also contain the drug alprostadil.
Injections are also known as Caverject or Viridal Duo. You put the injection into the shaft of the penis. Or if you have a partner, you might prefer them to do it. Your doctor or specialist nurse will show you how to do this. You usually get an erection within 15 minutes of having the injection. The erection can last 30 to 40 minutes.
Pellets containing alprostadil are called MUSE. They are about the size of a grain of rice. You put them in the opening of your penis, using a small plastic device. The pellet is absorbed into the surrounding tissue. You usually get an erection within 10 minutes. The erection can last up to 60 minutes.
Implants are usually only used if other treatments haven't worked. Implants or penile prostheses are put into the penis during a short operation. There 2 main types of implants:
- inflatable implants. These are the most common type
- malleable implants
Inflatable implants are made up of 2 or 3 cylinders, a pump and a small bag of saline. Your surgeon puts:
- the cylinders in the penis
- the pump into your scrotum
- and a small bag of saline may be put behind in your tummy (abdomen)
Malleable implants are 2 flexible rods that your surgeon puts into the penis. Your penis will be erect all the time, but the implant has joints that allow you to position your penis. You can position your penis up for sexual intercourse and down to pass urine.
Other sexual problems
You may also be worried about the loss of interest in sex (libido) and infertility after prostate cancer treatment.
03 Oct 2022
Next review due:
03 Oct 2025 Print page
Erectile dysfunction (Impotence). Information about your condition from The British Association of Urological Surgeons (BAUS)
British Association of Urological Surgeons, 2020
Electronic Medicines Compendium (eMC)
Last accessed October 2022
Clinical Commissioning Policy: Penile Prosthesis Surgery for end stage erectile dysfunction
NHS England, 2016.
British Society for Sexual Medicine Guidelines on the Management of erectile dysfunction in men – 2017
The Journal of Sexual Medicine, 2018. Vol 1, Issue 28
National Institute for Health and Care Excellence, 2020
The information on this page is based on literature searches and specialist checking. We used many references and there are too many to list here. Please contact [email protected] with details of the particular issue you are interested in if you need additional references for this information.
Can you orgasm after prostate removal? Tips and suggestions
After prostatectomy, which refers to the surgical removal of the prostate gland, males can still climax. However, not all of them do, and some may find that their orgasms change.
Removing the prostate eliminates the ability to ejaculate during sex. The seminal vesicles make up about 60% of ejaculate volume, while the prostate makes up most of the rest.
A surgeon will remove both the prostate and the seminal vesicles during radical prostatectomy. Therefore, after this procedure, most males will experience dry orgasms.
Radical prostatectomy may cause some degree of erectile dysfunction. This is because surgery can damage the nerves that support normal erectile function.
Males who undergo prostate removal may need medical and psychological support to deal with these changes and maximize sexual function.
This article will discuss what dry orgasms are, how prostatectomy affects orgasms, and some tips that may help improve orgasms and sexual function.Share on PinterestA male’s experience of orgasm may change after prostate removal.
A male may require prostate surgery due to the enlargement of the prostate gland or to treat prostate cancer.
Some procedures, such as transurethral resection of prostate (TURP), will only remove a portion of the prostate gland. However, radical prostatectomy removes the entire prostate, plus the seminal vesicles and sometimes the pelvic lymph nodes.
After this operation, a male will no longer be able to ejaculate. This is due to the removal of the prostate and seminal vesicles, which make the fluid in semen. Other prostate operations, such as TURP, do not generally affect ejaculation.
Lack of ejaculation does not mean that a male can no longer orgasm. Many will start to have “dry” orgasms, which are orgasms without ejaculation.
Some may notice that they produce a small amount of fluid before or during orgasm. This is fluid from glands in the urethra. It will be a much smaller amount than a standard ejaculation produces.
Many males believe that ejaculation is synonymous with orgasm. However, ejaculation does not have to happen for a person to orgasm.
Normally, sexual arousal sends signals to increase blood flow to the penis. This leads to an erection. As arousal intensifies, a male gets closer to orgasm. Most ejaculate when they orgasm, though doing so is neither inevitable nor necessary for orgasm.
Undergoing surgery to remove the prostate will likely damage some of the nerve endings surrounding the prostate. This can disrupt the body’s ability to communicate signals about arousal, enabling an erection.
Even if a male does not experience erectile dysfunction following surgery to remove the prostate and seminal vesicles, they can no longer ejaculate.
Males can still orgasm, though they might require help or medication to do so. Most report some degree of erectile difficulty after undergoing radical prostatectomy.
Radical prostatectomy can affect orgasm in two ways: by causing erectile dysfunction, which can make sex difficult or impossible, and by eliminating a male’s ability to ejaculate.
A 2011 study of 63 people who underwent radical prostatectomy found that 74.6% sought treatment for erectile dysfunction. Also, 52.4% reported having less sexual desire.
The inability to orgasm was less common, with 39.7% of participants reporting this. An additional 38.1% reported having fewer satisfying orgasms.
The mental health effects of these symptoms were worse among highly sexually motivated participants. In fact, 52% reported that this had affected their self-esteem, and 36% reported having performance anxiety.
These issues may compound the effects of radical prostatectomy, since anxiety may cause erectile dysfunction or make it more difficult to reach orgasm.
Some males also report urine leakage or pain during orgasm following prostate removal.
There is no way to accurately predict who will have difficulties reaching orgasm after prostate removal. The skill of the surgeon and the equipment they use may play a role, as less experienced surgeons may inadvertently cause more extensive inflammation and nerve damage.
Males who have their prostate removed often have other risk factors for erectile dysfunction and other sexual issues, such as advanced age or heart disease.
A 2004 study that followed 1,187 males for 5 years after either surgery or radiation therapy found that sexual function declined over time in both groups. However, more people in the surgery group (79%) had erectile dysfunction than in the non-surgery group (64%).
Males who enjoy receiving anal sex may notice differences during intercourse, as there is no longer a prostate to stimulate. A 2018 paper suggests that after prostatectomy, males who engage in receptive anal sex could adapt to sexual challenges by changing their sexual role.
Those receiving hormone therapy for prostate cancer will have lower testosterone levels. This can lead to a lower sex drive and possibly erectile dysfunction and difficulty achieving orgasm.
Males should allow time to fully heal before attempting sex. They can ask a doctor how long healing will take.
Some strategies that can help with regaining sexual function after healing include:
- Taking medications: Taking medications for erectile dysfunction can help males who are otherwise unable to get an erection reach orgasm. These medications support blood flow to the penis and can ease many causes of erectile dysfunction.
- Receiving injections: In males for whom oral erectile dysfunction medications do not work, receiving injections into the penis may induce an erection.
- Trying a penis pump: A penis pump functions by pulling blood into the penis, which can help induce an erection.
- Getting penile implants: This is a type of surgery that may restore a male’s ability to get erections through the use of silicone rods or inflatable devices.
It may also be worth considering different types of therapy, including sex therapy and physical therapy.
Sex therapy can help couples enjoy sex, learn new sexual strategies, and communicate more effectively following surgery, while physical therapy can help a male overcome any physical injuries associated with prostate removal.
Prostate removal can also lead to some other complications, including:
- incontinence, such as urine leakage during sex
- reactions to medications and anesthetics
- blood clots
- inguinal hernia
Males should discuss the risks and benefits of surgery and ask about alternative treatment options. They can also consider getting a second opinion whenever a doctor recommends a major surgery or diagnoses a serious medical condition such as prostate cancer.
Undergoing radical prostatectomy may prolong or even save a male’s life, especially when other prostate cancer treatments have not been successful. However, adjusting to life without a prostate or the ability to ejaculate can take time.
With open communication, a sensitive partner, and a willingness to try different strategies, many males will regain full sexual function.
Sex can be an important part of well-being. It is not selfish to ask for help, and sexual dysfunction is not a trivial problem. Males who experience difficulty reaching orgasm after prostatectomy should consider seeking help from a urologist who specializes in sexual health issues.
Prostate adenoma and sex - causes, symptoms, diagnosis, treatment and prevention
At the age of 50-60, almost every second man faces prostate adenoma. It can manifest itself with several striking symptoms, among them:
- frequent urination;
- thin, sluggish urine stream;
- nocturia, that is, a condition when a man is forced to get up 3-4 times at night in order to excrete a very small amount of urine;
- Drawing pains in the lower abdomen.
In addition, a man often experiences erection problems or suffers from premature ejaculation.
Prostate adenoma and sex are incompatible?
The debate about whether sex is harmful or not has been going on for a long time. However, most doctors are still of the opinion that regular, full-fledged sexual intercourse is important for prostate health. They help to "disperse" the blood in the pelvic organs and contribute to the release of excess sperm. Which is very important, since the prostate gland, which is too overloaded with seminal fluid, can become inflamed.
At the same time, urologists and sexologists note that among men suffering from adenoma, erectile dysfunction is common. The fact is that when the tissue of the prostate gland grows, it compresses the blood vessels, thus disrupting the blood supply to the genitals.
According to statistics, approximately 25% of men suffer from such an intimate problem as premature ejaculation. This condition is due to the fact that the gland compresses not only the blood vessels, but also the nerves that control the process of ejaculation.
Diagnosis of adenoma
At the first symptoms, we recommend not to waste valuable time and consult a urologist. And if prostate adenoma has already had a negative impact on sexual life, you should come to an appointment with a sexologist.
Specialists will prescribe the necessary examinations to determine the direction in which the treatment will take place.
You may need:
- Prostate ultrasound,
- determination of the level of PSA (prostate-specific antigen) in the blood,
- prostate biopsy,
In order to determine the causes of erectile dysfunction, it may be necessary to conduct a study to determine the level of hormones in the blood.
Treatment of adenoma
In the early stages, drug treatment is used: it relieves unpleasant symptoms, and in some cases helps to reduce adenoma. During therapy, constant monitoring of the prostate is required in order to be able to see the changes that occur in it and, if necessary, adjust the treatment method.
The fact is that there is a threat that the drugs will remove the main symptoms and give only a visible improvement in the condition. That is why it is so important to monitor the dynamics of the growth of the gland. When medicines fail, surgeons come to the rescue.
Currently, open operations are almost completely abandoned. Today, the "gold standard of treatment" is transurethral resection. An optical instrument is inserted through the natural urinary tract and excess tissue is removed. The manipulation itself is less traumatic, it is easily tolerated by the patient.
The rehabilitation period is quite short, but requires close supervision of doctors.
As for problems with sex, the specialists of the International Medical Center ON CLINIC solve them comprehensively, because erectile dysfunction can develop not only due to adenoma, but also as a result of cardiovascular diseases, diabetes, hormonal failure, and psychological factors. The well-coordinated work of highly qualified ON CLINIC doctors will help maintain men's health for a long time.
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Hypertension and sex
Prostatitis and impotence
Ischemic heart disease and sex
heart attack and sex
stress, depression and sex
Stroke and sex
Climacteric syndrome in women
Cardiovascular diseases and sex
pain and sex
Lack of orgasm (anorgasmia)
Diabetes mellitus and impotence
Chronic pelvic pain syndrome and sex
Urinary dysfunction and sex
Violation of sexual arousal and desire - libido
Alcohol - Potency and impotence
Obesity, metabolic syndrome and impotence 90,000 treatment of prostate adenoma - services
prostate (benign hyperplasia of the prostate gland, DHGPZH) - representing tumor, representing tumor, representing tumor, representing tumor, representing tumor. an overgrowth of glandular tissue.
Prostate adenoma is most susceptible to men older than 45-50 years. Those at risk are also those who have a family history of prostate adenoma.
Symptoms and stages of development of prostate adenoma
Depending on the type and structure of the tumor, the stage of the disease, the symptoms can be either almost imperceptible or pronounced, aggravated by stress, hypothermia, alcohol intake or weakened immunity.
Be sure to visit a urologist if you notice at least one of the following symptoms:
- frequent urination, especially at night
- sluggish or intermittent urine stream
- difficult onset of urination
- drops after urination
- Burning or painful urination
- pain in the lower back and pubic region
- unjustified thirst, weakness, nausea
Men over 40 are advised to undergo a preventive examination by a urologist (andrologist) even in the absence of these symptoms in order to protect themselves from such a dangerous disease as prostate cancer.
Often without any symptoms, prostate cancer is detected too late.
You can undergo a full diagnostic examination by a urologist in Barnaul in one day at the Medline Medical Center by calling +7 (3852) 992-022 or online.
Diagnosis and treatment of prostate adenoma in the clinic "Medline"
The clinic "Medline" provides a comprehensive drug treatment of prostate adenoma, aimed at relieving inflammation and swelling of the prostate gland, improving the function of urination. The combined treatment regimen includes medical treatment with Israeli drugs, as well as physiotherapy.
If you are over 45 years of age, it is advisable to come to the initial appointment on an empty stomach, as there is a high probability of taking a blood test for tumor markers.
Male urologist appointment
- interview with a doctor
- physical examination
- prostate digital examination
- IN COMPLEX TREATMENT - CONTROL ANALYSIS (prostate secret) IN GIFT!
The purpose of the primary appointment is to make a primary diagnosis, to prescribe an examination plan.