My 72-year-young husband is almost completely recovered from nerve-sparing prostate surgery . . .he can get a relatively-firm, penetrating erection with manual &/or oral stimulation; and he can get a firmer erection with cialis. BUT he says that he does not achieve an intense orgasm as he did before surgery. He says it’s pleasant, stimulating; but not the same, not as intense. We are doing every creative, patient thing we can think of . . . but we’d like him to get that intense “reward,” so he will continue to want to engage in lovemaking. Hoping for some insight. . . Brady

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  • Michael Castleman says:

    You say your husband is “almost completely recovered.” To my way of thinking, that means he has not fully recovered. Nerve-sparing surgery has one major advantage, less risk of erectile dysfunction afterwards. But it also has a downside, more complicated surgery that takes longer to perform and as a result is more physically traumatic, meaning a longer recovery time. In my experience, surgeons generally underestimate recovery times after surgery. My personal rule of thumb is that you take the surgeon’s estimate and double or triple it. So I’m guessing that your husband has a way to go before he’s truly recovered and can be fully sexual again. In other words, things should continue to improve over the next several months.

    Meanwhile, the prostate gland is involved in men’s orgasms. The majority of semen is prostate fluid and the gland contains small muscles that contract as part of orgasm, helping expel semen. Without a prostate, there’s no semen, and no prostatic muscle contractions. As a result, even after your husband has fully recovered from surgery, his orgasms may feel a little different.

    I’ve talked with many men who have had prostate cancer treatment. The consensus is that by six months to a year afterward, sex returns to a reasonable approximation of what it was before, maybe not the same, but close…and still enjoyable.

    For more information, read Sex After Prostate Cancer.

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