Sex life after prostatectomy

Hi all

After 5 1/2 years on active surveillance my husbands  cancer has progressed and he will be having a radical prostatectomy in a few weeks. For the first time in our almost 40 years together he is depressed (understandably) at the thought of impotence and is really struggling to deal with it all. Any advice or tips on how we can get through this together , both mentally and physically? He is 62 and very young in his outlook and we have a fantastic , loving, relationship, we’ve been though a lot together over the years but I am struggling with how best to help him..


  • Hi jowoomot

    Sorry to hear about your situation and good wishes to you both.

    Leaving aside the issue of dealing with uncertainty (I'm assuming that you've not been told that for his situation impotence is definitely going to happen - my understanding is the likelihood of impotence dependes on lots of factors), I'll just talk about my own experience of impotence and my relationship.  

    For me impotence happened as a result of HT and there was an associated loss of desire, also there was a fair amount of penis shrinkage.  One of my biggest problems was the feeling of guilt towards my wife (maybe this isn't rational but there's often not much rationality in these situations) and something about not feeling a "man" anymore.  It was a surprise to find that I felt so deeply diminished. Dark times and quite depressing.  What helped was two-fold: "doing somthing" about it and sympathetic support from my wife. 

    Being a practical sort of person the feeling that there are avenues to explore to counter impotence was helpful.  My cancer nurse specialists referred me on to a specialist department for dealing with impotence.  So, I had several things to try (chemical and mechanical), some of which worked better than others and sex was possible (by the way: I'm highly conventional in terms of what "sex" means - and therefore probably incredibly boring, but hey ho, that's me;-) ).  I would recommend finding out what support might be available to you both - knowing there are options to try may be supportive.

    A supportive relationship is really useful.  At times it's been walking on eggshells for my wife but what has really helped is not being shamed by what's happening (whether it's impotence, incontinence or the other less than delightful side-effects of cancer and treatment).  Talking, sharing, sympathy.  They are all important but I can't give you a recipe for what's worked and what hasn't - partly this is because I've been so down.  Perhaps the best advice I can give is to be open as possible, whether it's active listening, asking "open" instead of "closed" questions, and seizing what opportunities there might be.

    Good luck.

  • Hi J 

    You don't say what the stats are, this info can help with advice.

    ED problems are often usual after surgery, was RT not offered as an alternative, just a thought.

    Best wishes


  • Sorry to hear, on a practical note has your husband been advised to do pelvic floor exercises? I was recommended the nhs squeezy app by my consultant as a reminder to do them as I'm likely looking at prostatectomy or radiation treatment within a year.

  • Hi

    i was 63 when I had my robotic prostatectomy.  To be honest I couldn’t wait to have the opp.  I had the procedure last December.  Your husband should be out the day after his opp.  I had a complication in that I have only got one kidney (congenital) so I had a stent put in.  I was out within the week.  My consultant advised that I exercised like I was training for a marathon.  I just cycled from October.  The pelvic floor exercises are important, there was a good video on YouTube showing the correct way to do it.  I wore incontinence pads but only had small leakage mainly when I was standing up from sitting.  Everyone is different, I was dry within 4 weeks.  I have been going to a local wall nut group meeting,   They are very supportive, and do have experience of most of members worries.  Maggies are also really good and of course MacMillan are just brilliant.

    I hope that all goes well for your husband, you and your family.


  • Hi, my husband is 56 and 7 weeks post radical prostectomy. They were able to spare one side of nerves. We had a good sex life before surgery and was obviously very concerned about the after effects. Your husband will be prescribed 3 months worth of sildenafil to encourage blood flow. After 4 weeks he started to get some movement down there and now 7 weeks on we are pretty much back to our normal sex life. He’s still got some way to go on the incontinence side although improving every week. I keep reminding him of the small positives and comparing the weeks instead of the days. I wish you and your husband the very best with the upcoming surgery and a speedy recovery. 

    Sam x

  • Hi Entremet,

    I also have lost all manly functions down there.  If I didn't still have my sense of humour...

    Before I started the Hormones, the Nurse told me that everything would shrink (meaning the Prostate) making it easier for the Radiation treatment.

    Well, everything shrank.  I finished my 20 VMAT Radiation sessions on 2nd November.

    By the middle of February I actually stood up for a Pee.  Ran home from work (well, walked, not up to running yet...if ever).  Told my partner "Guess what I did today?". She never guessed it.

    Still can't stand up if anyone else is around.

    Had my last Decapeptyl injection on Christmas Eve. Oncologist told me that I won't require another one.  Touch-wood!

    I used to be a red blooded male, but even that's deserting me.  I'm on blood-thinners and my blood resembles watered down Ribena.

    But, I'm not complaining, really.  Once the testosterone is switched back on... who knows!



    'In Remission' Fingers crossedFingers crossedFingers crossed

  • Thanks everyone , seems we just won’t know until after the op - we have been together 38 years now , been through a lot of hard times (both diagnosed with cancer within a few weeks of each other) and so I am sure we will get through this , he seems in a better place mentally so hopefully that will continue.

    Jo x

  • Hi Sam, was your husband prescribed Sildenafil straight out of hospital?, I'm only 2 weeks post op but this option has never been mentioned to me. 

  • Hi Spursy1882, yes he was prescribed 3 months worth on discharge. We assumed this was normal procedure as have also read the same on other peoples comments. Maybe you should contact a MacMillan nurse?