NOTICE: THIS BLOG IS FOR ADULTS ONLY. IT INVOLVES A DISCUSSION OF SEXUAL ORGANS AND IS NOT FOR PEOPLE BELOW THE AGE OF 18-YEARS-OLD. DO NOT READ BEYOND THIS POINT UNLESS YOUARE OVER 18-YEARS-OLD AND YOU ARE A MATURE, AND RESPONSIBLE ADULT. ALSO THIS IS VERY PERSONAL AND POTENTIALLY DISTURBING AND EMBARRASSING MATERIAL. ONLY READ ON IF YOU ARE A PROSTATE CANCER PATIENT OR CLOSE TO ONE. YOU ARE RESPONSIBLE FOR YOUR ACTION IN READING THE FOLLOWING.
For a long time I debated with myself about whether to share about this aspect of having a radical prostatectomy. Before my surgery my urologist warned me that removing the prostate involved the high probability of severing the essential nerve bundles around the prostate that allowed for the sexual functions of the penis. In other words, the surgery could result in impotency. Like I wrote previously, I saw this as a choice between peeing and having sex, or living. I chose living. It took several weeks after the surgery, but when I had recovered control over my bladder and urination, I saw it was now time to see if I had retained the sexual functioning of my penis. Two acquaintances I met who both had radical prostatectomies shared with me that they were now impotent. This was very discouraging, but I wanted to go for a total, elimination of the cancerous tissue. While recovering from the surgery, I recounted my sexual performance over the past, few years. Around two years before I learned I had prostate cancer I noticed that when I ejaculated, the amount of semen I produced was decreasing. It was as little as a teaspoon. Since I was in my late 50’s I took this as a sign of ageing. In hindsight, I can see that this was evidence, that the healthy cells which produce the seminal fluid in the prostate gland were being displaced by the cancerous cells which were not healthy or functional prostate gland cells. This resulted in a decrease in seminal fluid. After the removal of the prostate, a biopsy proved that there was a high, dense concentration of cancer in the prostate gland. Obviously, having the prostate removed was the proper choice to remove all traces of cancerous tissue. Now I was cancer-free, but it was time to test whether or not I had retained my ability to perform sexually. I tried to watch soft pornography on HBO. I tried looking at adult magazines I still had from my younger days. I even looked pornography on the Internet. I found that mentally I was aroused, but there was no stiffness, or erection achieved with my penis. I had to face the facts. I was now impotent. When I asked my doctor about what could be done to regain my ability to have erections and have sexual intercourse, he said, that the drug of choice was expensive but effective, VIAGRA. Those blue pills that I have been hearing about in all of those jokes about ageing over the past decade. I couldn’t believe that I was now a candidate for this prescription. My urologist made out a prescription and let me know that this was all up to me. There was a little discomfort in his attitude and tone as we discussed this. I was surprised to see that sexuality was still not a free and open subject even with modern medicine. My doctor kind of skirted the issue, like it wasn’t his area of expertise.
Going to the neighborhood drug store to fill this prescription was embarrassing. I wanted to explain to the female pharmacist, an attractive Asian doctor at CVS Pharmacy, that I had just had prostate surgery, but being over-explanatory would just add to the embarrassment. The doctor read the prescription, and looked at me and smiled. What is she smiling about? How unprofessional I thought. She looked at me and said that she could give me a discount, but this was still very expensive. I asked her how much it cost, and she quoted $20.00 a pill. I thought about this, and decided that I wasn’t going to get a full order and asked for 6 pills which came to $120.00 plus tax. I felt like I was buying sex. Like this was a form of prostitution. The assistant rung up the order, and I asked myself, why of all days did I come on a day where all of the staff were young, females? I felt totally self-conscious.
Reading the directions on the bottle, I saw that I was to take one pill about one hour prior to sexual activity. I didn’t want to involve my wife in this activity yet. I had told her about this situation weeks ago, and she was patient and understanding, and even sympathetic about this. I waited for a day when I was home alone, and had total privacy. I took the pill and waited. After an hour had passed, I was disappointed that it had absolutely no effect. This was dismaying. Prior to my cancer, I was a victim of the “morning wood” condition literally every morning from age 13 to age 58. It would normally take a cold shower to disappear the erection. It looks like the nerve bundles had all been severed during the surgery. I was now impotent.
However, I did notice that back when I first had my catheter tube removed, and I had a hard bowel movement, I would achieve a partial erection. The activity of applying my rectal and abdominal muscles seemed to force blood into my penis. An erection after all is the penis being filled with blood. It wasn’t really just a muscle, but a blood flow infusion into the penis. It looked like there might still be hope for me after all.
Watching television, and searching the Internet for the key words penis pump and erectile dysfunction, I found several sites. Some of which proposed a plastic pump device, which would fit over the penis, and create a sealed, vacuum condition around the penis. The pump would create a strong suction, which would force blood into the penis until the desired stiffness and size was achieved. There upon, you would slip a plastic “O” ring around the base of the penis, which acted as a turnicate which would lock the the blood pressure in the penis, and maintain the erection. I studied several models on the Internet, and television and purchased the one on television. For around $108.00 in just a few days the plain, brown package arrived, discretely. I waited again for the right day, in which I could practice this new procedure with total privacy. I was happy to find that this system worked! Where Viagra failed me, this vacuum pump system worked.
Now the rest of this story is too personal and too adult for your ears. I do plan to maintain some privacy for my life. However, I decided to blog the above for the benefit of men who contract prostate cancer, and have to make the same difficult decisions I had to make. I am happy to report that I am able to perform sexually, achieve a sufficient erection, and orgasm, and even ejaculate (Note: With a radical prostatectomy the vas deferens, and seminar vesicles are removed.) My ejaculate is therefore not sperm or semen, but pre-ejaculate (also known as pre-ejaculatory fluid, pre-seminal fluid, or Cowper’s fluid.) It is not the same as it was before I got cancer, but I still live a satisfying and fulfilled sex life. I cannot have anymore children, but as I already have grand-children, this isn’t necessary.
I am happy I elected for the surgery. This way the fear of remission of the cancer is minimal, because it was all physically removed. If I had to do it all over again, I would have done exactly the same thing. If you have prostate cancer, or know someone who has, I hope my sharing and my blog gives you some power and freedom to make your choices. If this writing makes a difference for just one person who reads it, then it was well worth my efforts. Good luck, and God bless.