Had surgery a week ago and I am planning my approach to post surgical rehabilitation. One tool suggested in most resources is the regular use of a penis pump. Just wondering if anyone has a recommendation as to type/brand that worked well for them.
Thank you
Tom
Try Vacurect. Erectile Dysfunction pumps. Medical grade pump. I am in Australia but hopefully pump is available in America.
Thank you for the recommendation!
Mine arrived this week.
Realities of Sexual Restoration For Gay Men after Prostate Cancer Treatment
Thank you so much!
the brand a friend gifted me is Passion Pump — sleazy name, but easy to use and not pricy. You’ll want to learn to trouble shot using it — things like not letting your balls get pulled up into it, how to get a good seal especially if you’re not hairless, and don’t be an over achiever w power more than 2.
I also use Vacurect. It’s been a year and a half and, although not back to normal, I’ve had significant progress. If you’re not already aware, there’s a website called A Touchy Subject out of Australia. It’s run by an expert named Victoria Cullen. She offers a free program on the site for those who have had surgery. I highly recommend the program and her website.
Thanks Mike. I received my Vacurect this week. I’m glad I did. It works easily and quite well from the first time I tried it. I also found that site you mentioned and signed up for that program this week also. Appreciate your advice and input. Curious-since you’ve been at it with the Vacurect for 1 1/2 years, have you used it daily? Or more than once a day? Just trying to sort out the best cadence for using it, how long a session should be, etc. Perhaps the Touchy Subject program will help answer that question, but any guidance based in what you have done is very appreciated.
Tom
Tom, I use it daily, and I try to use it for 15 minutes total. Pumping up and then releasing the vacuum for a minute, then pumping again, doing this four or five times. I’m sure others have different regimens. Victoria might suggest something else on her site and program.
Mike: I received the second module from Victoria last night so I will watch it today. Thank you!
Hi Tom
My urologist and my clinical prostate cancer nurse said by all means use the pump but go easy the first six weeks post op as the anastomoses, the area where they reattach the urethra to the bladder is still healing. So at first it was suggested to me to use the pump with the largest ring, pump to enrich the penis with blood then release, do this five times, but just pump until the penis fills with blood then release. After six weeks I choose a suitably smaller ring to help maintain an erection once I had finished pumping.
My urologist also has me on 5 mg of tadalafil daily, I can use 10 mg on demand daily if I need. My erections are still a work in progress. I had the op in September 2022 so I am told early days yet. My dry orgasms are very nice, but of course I miss the cum.
You will work out the best way for you with the pump, ring size, how much pressure to apply, they do say don’t leave the ring on once an erection is achieved for more then half an hour. Have fun.
Take Care
Ian.
Thank you for the response, Ian. Appreciate your advice very much 👍
Ian: I have some follow up questions for you. Have you incorporated a regular masturbation practice as part of your rehab? And when it comes to orgasm, have you had any issue with urine leakage when it occurs? I am wondering if that issue tracks along with one’s general level of continence or if they can diverge? I have started to masturbate (which is still pleasurable despite the lack of an erection) and can achieve orgasm rather quickly (which is also odd since that was not the case before surgery) but have definitely had urine leakage when orgasm occurs. My general level of continence is pretty good (no leaking when sitting or lying down, no leaking at night when asleep, it only occurs when standing and is pretty minimal even then), but it’s not 100% yet which is why I am asking if it tracks with climacturia.
Cheers!
Tom
Hi Tom
I have been extremely fortunate and have not had any incontinence issues since the catheter was removed 7 days post op. It did take awhile for the sensation of wanting to pass urine to settle down, a week or so. So no climacturia, but I hear that climacturia is not always associated with urinary incontinence, it can occur post prostatectomy regardless of continence or not.
I am also very fortunate to have an extremely supportive partner who I have a very satisfying sex life with, even without a penis that isn’t hard enough for penetration. Anal play, oral, mutual masturbation, kissing, cuddling are still very pleasurable, erection or not.
Masturbation is a must as part of our sex rehabilitation, as my urologist said. Use it or loose it. I take a lot longer that I did before op to orgasm but when I do it’s still very pleasurable. The big difference is in the way I now masturbate it’s a totally different stroke as my penis is not hard like it used to be. But it’s getting harder as time goes by, well sometimes anyway.
I am now waking at night, after pleasurable dreams with an erection nearly as hard as before op. Good sign.
I say just enjoy yourself erection or not, use medications, pumps and whatever other means you find pleasurable. Be open to your sexual partner. A new thing for me is the acceptance of the way my body now performs. Plus I find even if i am not erect or don’t achieve orgasm during sex I still love the moment. I get a great deal of pleasure just pleasuring my partner.
I know this isn’t everyone’s story, I don’t know how I would navigate this if I was a single guy, or looking for sex outside of my relationship. Erections, cum and performance have been easy to negotiate with my partner but it would be very different if I was not partnered.
Masturbate away Tom, it’s for your health, but who needs an excuse, no one.
Take care mate.
I was part of a study out of U of MN re gay men and prostate cancer rehab. The basis was that, yes, gay men have different "issues" than straight men and many docs are clueless about how PCa affects gay men. The study provided a pump, cock rings, butt plugs, sildenafil, videos, literature, and guidance. The pump was made by NuPath and is available online. Although I had zero interest in all things sexual (was taking Lupron at the time), the study encouraged regular use. I think that its use helped. Please note: I had radiation and ADT, not surgery.
Good luck to you.
EdinBaltimore
Thank you for your response! I would agree with your first statement about clueless docs when it comes to treating gay men for this. My sildenafil RX talks about dosing to achieve an erection for “intercourse” 🤷🏽♂️ and I am in San Francisco! I ended up getting the Vacurect which has been working well. I also purchased a a Hydromax to use in the shower. This aspect of rehab is certainly one thing I can control and it’s just sorting out the best way to incorporate it into daily life particularly once I return to work (still on medical leave at the moment).
Tom
Btw, the study recommended 3 tabs of sildenafil (60mg total) 3 times/wk. They provided this through HealthWarehouse. I've been able to renew this script several times at minimal cost.
Ed
I’m on 20 mg Sildenafil once daily since the cath came out which was about two weeks ago. I’m supposed to up that dose after a month post op to the higher therapeutic dose a”as needed” (60-100mg) presumably in combination with attempting to achieve an erection for intercourse, but I assume the doc will keep me in some ongoing daily dose ongoing. Haven’t had my first post op appt yet to discuss this.
How long ago was your last lupron, and have they tested your testosterone level yet?
My treatment was in 2018-19: external beam (IMRT), brachyboost and ADT (Lupron). The ADT was 3 injections, each lasting 3 mos (I thought that I could endure most anything for 3 mos..providing me some sense of control, I thought) for total of 9 mos. However, the return to "normal" took about 16 mos; slower than most men report (lucky me! Being sarcastic.)
Re: testosterone. I had a relatively low T (250ish) prior to treatment. The most recent (2023) result was a whopping 249.7. So, it took approx 4 yrs for T to return. I have considered Testosterone Replacement Therapy (TRT) but my uro recommended not to do it because my PSA at the beginning of treatment was 23 which put me in a high risk category. However, from what I've read, the jury is still "out" on whether and for whom TRT might be worth a try.
EdinBaltimore
Post Surgery Blues
Post radical prostatectomy 
5 week post op.
Gay man post surgery.
