Here’s another
prostate cancer article, this time with content from a well-known specialist in
the field. -- Joan
Sex after prostate surgery? Anne Katz answers reader's question
Cancer -- not a sexy
topic, and not what you'd expect me to write about on Christmas Eve. But cancer
knows no seasons and respects no holidays. Maggie, age 62, wrote to me:
Recently, I met a nice
guy who after dating for a while, told me that he had
surgery for prostate cancer 7 months ago. He went on to tell me all the bad
news that the Dr. had told him about side effects. My question is, do you know any where that I can get some straight answers on what we
are looking at, possibility wise? The information I have found online so far
has been very negative, almost always putting the pressure on the woman if
things were going to work or not. He advised me that he would never be able to
have an ejaculation & that sex for him would never be the same. I got the
idea that he would never feel the pleasure of having a climax again. My fear is
that if this is true, what would be the point of him
having sex? I am a very sexual woman & would just like to know if there is
any chance that there can be a sexual relationship? Any guidance that you could
offer would be greatly appreciated.
I sent Maggie's
question to cancer and sexuality specialist, Anne Katz, RN, PhD. Here
is her response:
There are a number of
possibilities in this situation, some of them good and some of them not so
good. Here are the facts:
1. Having surgery for
prostate cancer (a radical prostatectomy or complete removal of the prostate
gland) will result in significant changes in a man's ability to have an
erection. Depending on what his erections were like before the surgery
and the amount of damage done to the nerves responsible for erections during
the surgery, the man may be able to have erections after the surgery but
he is most likely always going to need some help (from medication like Viagra, Cialis or Levitra). These
medications only help about 50% of the time but there are other erectile aids
(the vacuum pump or penile injections) that can help too. Some men are able to
have an erection but it may not last very long. Some men can only achieve a
thickening of the penis and this may not be sufficient for penetration.
Progress in regaining erections may continue for up to two years after surgery
but what he has at that point is usually as good as it is going to get.
2. Orgasms are still
possible, even with a flaccid penis. The orgasm will not be accompanied by
ejaculation however (the prostate gland makes the fluid portion of the
ejaculate and so when it is gone, so is the emission). Some men report more
intense orgasms after this surgery; some say they are much less intense.
3. Libido (or sexual
desire) is not affected by removal of the prostate but the
mind is a very important part of a man's sexuality. Repeated failure to have an
erection sufficient for penetration may cause him to lose some interest.
Although some men just keep on trying and trying and trying - the human spirit
is a powerful force and many men retain hope for many years despite little
success.
4. Many couples find a
way around these difficulties. There are more ways than just penetration for
both the man and the woman to achieve orgasm and satisfaction and some
creativity goes a long way. This may be challenging for a new relationship. But
the lust and attraction in a new relationship may also provide more impetus
than a 30 year relationship! There is no right way or
wrong way in this; a lot depends on how you want to look at the situation.
5. If you read
anything that you feel puts the onus on the woman (or male partner) to fix
things, then stop reading! This is a couple's issue and both partners have to
work on finding a solution. Communication is a very important part of
sexuality. You should be able to talk openly about what works for him and what
doesn't. You should be able to talk about what you want and what creativity you
can both bring to sexual activity. In your letter you state that you "got
the idea" - you will have to ask questions and not rely on innuendo to
help you understand what is possible and what is not.
New relationships are
challenging and exciting and inspiring and joyful. When illness or injury have occurred it puts a lot of pressure on this new
partnership. Good luck!
Anne Katz, RN, PhD, is the author
of the award-winning text book Breaking the
Silence on Cancer and Sexuality: A Handbook for Health
Care Providers .
Dr Katz has also written three books for consumers: Sex When You're
Sick: Reclaiming Sexual Health after Illness or Injury;
Woman Cancer Sex,
and Man Cancer Sex.
She is the sexuality counselor at CancerCare Manitoba
in Winnipeg, Manitoba, where she provides counseling to men and women
experiencing sexual difficulties as a consequence of cancer and its treatments.
Visit her website at http://www.drannekatz.com/.
© 2009 by Joan Price, may not be reprinted without permission.
