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Peter Griffiths

Prostate cancer hits us men, at the core of our sense of "manhood". We, and our partners, can survive that hit, - BUT we need to figure out who we are, as men, in new and better way as well.

Sex is usually seen as a very private affair. Yet, every human being is sexual. Men seldom discuss sex OUTSIDE of marriage, except in locker rooms, or in jokes, often designed to cover up feelings of inadequacy, or to project being "one of the guys". Even today, many men seldom discuss sex much, even WITHIN their marriage. Sex, isn't something men talk about. It is something men DO! - Or not, in some cases after treatment for prostate cancer.

This is the story of my sexual experiences after I opted for surgery in 2000 following my diagnosis of prostate cancer. I decided on that route after investigating all my options and knowing of the side effects of the procedure.

The results of surgery on my sex life weren't as traumatic, as they would be if I hadn't had problems before. Losing my fertility was not a problem. I had a vasectomy back in 1980. Erectile Dysfunction (ED), known as the DOWNER that gets you down was nothing new. I had experienced ED earlier, way back in 1996 and had already come to grips with the fact that my "elevator," was no longer automatic, but needed outside assistance. I needed engineering advice on how to cope with my Leaning Tower of Pisa.

Men with no sexual problems before surgery may be shell-shocked at first by the effects of treatment, despite the information and warnings given them by their doctor. Many men suffer in silence, too embarrassed to reach out for help, or to even talk about it. That is why urologists, and family doctors, need to encourage their prostate cancer patients to meet other survivors, either individually or in a support group. But they need to understand that setting a goal of unassisted, prop-free, intercourse would be like trying to reach the moon, when getting to the top of a stepladder, is more achievable.

The issue of erections doesn't seem as important to me now, as they seemed to be, right after surgery. I focus and enjoy the sensations however that I still do have. I read on the Internet, about men who experience improvements in their sexual functioning, even two years or more, after surgery, My urologist says, however, I have likely got back, most of what I will get back. Maybe he's right. Maybe he's wrong. I have to accept, that the old grey horse of my potency, ain't like he used to be. Yet, it doesn't cost anything to hope.

Before surgery, I used a VED (Vacuum Erection Device) with good success. Later on, I had also used Viagra, also with good success. However, AFTER surgery, Viagra let me down, or to be more correct, Viagra LEFT me down. I also experimented with injections. However, the injections have to be made, in a particularly, sensitive, part of a man's anatomy. If you don't hit exactly the RIGHT spot, in exactly the RIGHT way, you may experience several hours of discomfort. Or, if you inject too much, you may have to rush to hospital to get an antidote. Despite how much a man may enjoy being aroused, it does become a bit of a nuisance, and a bit of a pain, after several hours. I believe that every time you inject a needle in your penis, you do some damage, as minimal as it may be. So, after some experimenting, some success, and also periods of discomfort, and discussing it with my partner, WE decided that the VED was going to be a regular partner, in our intimate life.

Our lovemaking became a three-some: me, my wife Ruth and our pump. After surgery, my particular pump or VED needed more priming than before. I had to pump it up, release the pressure, which retained the blood already pulled up into the penis, and then pump again, adding more blood. It became more like the old hand pump on the farm. You had to pump away at it for quite a while, before anything of considerable notice, happened. I did however, recently discover the value of the battery-operated pump, and almost decided to re-name myself Speedy Gonzales. I also recently discovered the efficiency of the Rejoyne VED system.

The constriction rings you use with a VED, to hold in the blood you have pumped into your penis, have a couple of undesirable effects. I found new meaning, to the children's nursery rhyme, "ring around the rosy", and, because blood circulation to the penis is restricted while the ring is on, my wife found new meaning to the expression, Cool, Man, Cool.

The constriction rings also dam up the new, frustrating, problem, of spurts and dribbles that now may accompany feeling turned on. Unexpected urine leakage can turn romantic things off in a hurry. I learned to make a last minute dash, to the bathroom, before getting too intimate, to avoid DAMPENING the romantic mood. When I feel frustrated about changes that surgery brought, I remind myself that the old clean-up problem isn't there anymore. There are no more arguments about who has to sleep, on the "wet spot", although the back-up towel to deal with leakage is still often needed.

I discovered pleasant, side effects, to my surgery. Sensations I used to only experience with a reasonably full erection, are now often experienced, in a flaccid state. This new sensitivity adds new meaning, and new levels of experience, to driving down bumpy, potholed, highways. For once, I didn't complain about the condition of the roads. However, it did take more effort, at times, to keep my mind, on my driving.

Orgasms changed dramatically. Besides being dry, they weren't what they used to be. The Fourth of July explosive fireworks were much subdued. They became "new age" orgasms, more relaxed and subtle, something I had to train myself, to detect, and to enjoy. I also learned to focus on what I had, not on what I had lost. The "big bang" has definitely gone from my sexual constellation, replaced by a new experience, more like the Northern Lights - softer, spread out, and still delightful, like the delicate bouquet of a good wine. Instead of the traditional curve of orgasm, when a man ejaculates, and sexual excitement drops quickly, making love became like surfing. It was frustrating at first, not going over the top, with a traditional orgasm, but, being able to stay on that edge or that wave, for a lengthy time, if I want to, is VERY exciting and VERY interesting. I could ride near the top of that wave, almost as long as I wanted to.

Sex is not just the act of intercourse. Intercourse is only one of the ways we use to express sexuality to each other. The sensations in a man's penis may no longer be experienced, the same way as they were, with a natural erection. But a man can focus, in many ways, on his own, and on his partner's, physical and sexual enjoyment and satisfaction.

A couple can enjoy the emotional closeness that comes from - holding hands, hugging, or cuddling up to each other, In a variety of comforting, comfortable, and perhaps, exciting, positions.

All of our body has sensitivity to touch and pressure. But many men, after discovering the main area of sexual sensitivity in their body, i.e. their genitals, usually before, or during puberty, often don't bother to explore, or to discover, these other areas. People can enjoy gently touching of any part of their partner's body: face, hair, neck, limbs, breasts or torso, as well as genital areas. Partners may find those touches, perhaps in different and creative ways, almost as pleasurable as intercourse itself.

And, if you had nerve sparing surgery, and end up with increased sensitivity in your penis, as I did, snuggling can be VERY interesting and satisfying, in itself. You learn to focus and enjoy intimate, physical sensations, and togetherness, and focus less, on the traditional end point of intercourse.

What may have been seen as a loss at first, may become, in time, a net gain. Yes, things may have changed sexually, in some ways, but, new innovative avenues, of experience and closeness, can open up.

There are two other pages dealing with sexual activity after surgery one by Lennie Hirsch and the other by Glen Leslie.

Two other pages that might be useful for men having surgery are Useful Items for Those Undergoing Surgery and Me and my Catheter.

Finally, a book has been written by Dr. Jeffrey Albaugh, PhD, that addresses sexual issues during and after prostate cancer treatment specifically for patients and their partners: Reclaiming Sex & Intimacy After Prostate Cancer: A Guide for Men and Their Partners. That book is available for purchase online at www.drjeffalbaugh.com for $12.00 plus shipping/handling.