I’m hearing from several doctors and a counselor who swear there are men who have maintained size, resolved incontinence, and restored erectile function (albeit with pills, injections, prosthetics) following nerve sparing radical prostatectomy.
When I ask how I can connect with just one of these men before having the surgery myself, they deflect with their trusty HIPAA shield that protects them from having to prove their words before experimenting on my body.
So I’m asking you. Is there anybody out there that has successfully done all of this? If so, how long did it take? Are you an active top? Is there anything else I should know that they’re not telling me?
I appreciate your responses.
Jeff
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LakeGuy22
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I have not any. After a radical I experienced size reduction, incontinence and erectile issues. The incontinence is mostly gone , and the erectile has work around, but size does not come back unfortunately.
Thanks for the info. I read it all when you sent it before and I completely agreed with everything in your newsletter. But since then I’ve located a urologist who is gay. He is the director of the Feingold Gay and Bisexual Men’s Urology Clinic at Northwestern University. My surgeon is perhaps the best in the country with the fewest complications. As a result, I have a few questions for you. Are you saying size cannot be restored/maintained with the introduction of injections and pumping at 4-6 weeks? Are you saying that incontinence cannot be resolved even with the insertion of a new sphincter, if necessary ? Are you saying that erectile function cannot be achieved through pills, injections or a prosthetic? Or are you just saying that most gay men are cunts?
I'm not sure if you meant your comments sarcastically or not. Sarcasm doesn't come across in writing. I'll answer as if you meant it all.
" Are you saying size cannot be restored/maintained with the introduction of injections and pumping at 4-6 weeks? " Many men lose size in spite of penile rehab. When nerves are no longer innervating the penis, the tissue atrophies. You are fighting against it.
"Are you saying that incontinence cannot be resolved even with the insertion of a new sphincter, if necessary ? " Artificial urinary sphincters usually work great.
"Are you saying that erectile function cannot be achieved through pills, injections or a prosthetic?" Penile rehab may help, but even with rehab, erectile function is seldom as good as it was before prostatectomy. Prosthetics usually work great but count on losing another ½"
"Or are you just saying that most gay men are cunts?" I'm saying that most gay men don't want to suffer with size loss, incontinence, and impotence, especially if they don't have understanding and committed partners, as many gay men don't.
I'm especially saying that there is no need for a gay man to have a prostatectomy when there are radiation alternatives that work as well or better that probably will not force you to take all those drastic measures and still may not get you back to baseline.
Nope. No sarcasm here. I’m genuinely interested in your opinion. Have you experienced any of the degradation I’ve been told will occur over time with radiation? Do you top? bottom? Do the spacer gels work?
I honestly do not see myself surviving any of this regardless . In fact, I’m trying to figure out how to die on the table so I never have to deal with this and family and friends will be “happy” that I at least sought treatment.
Yes, I top, and have had no loss of erectile function over 14 years since SBRT. My experience is typical. I didn't have SpaceOAR and had no late term rectal side effects, which are very rare.
I had robotic- prostectamy surgery 5th February this year following my cancer diagnosis. I'm really fit and healthy in all other areas. Non smoker. I don't take any form of medication.
Weight good. 78kg.
Its now mid July. Incontinence, is at around 90% good. Just wear z small discreet pad for a few dribbles. Been doing pelvic floor exercises, every day, 3 times a day yo help with the pee control.
On the man side, is really useless. Can't get anywhere near an erection at all. Despite taking 5mg cialis every single day since surgery. I have with a lot of perseverance, managed a dry orgasm a few times, by messaging the head of my penis. Very strong, but if course dry orgasm. Feels ok, but different from before.
Penis shrinkage, yes, yes. I was only just average size before surgery, but was ok and accepted that. Now even after using a pump I've lost a lot of size. I feel how its more a micro penis. I doubt it will return to normal unfortunately.
But my psa tests are coming back as undetectable, so that's the main thing for me. I'm for now, clear of cancer. Hope this helps..
Neil, good to hear you are clear of cancer. And it sounds like you’re in the middle of this nightmare (I refuse to call it a “journey” because this is definitely not a trip anyone wants to take.) Thank you for sharing your experience. Good luck to you and the remainder of your recovery.
Thanks so much. Ive got my next PSA test next week. I'll see how that's looking. Don't give up, and keep your chin up buddy. That's all we can so and so please remain strong. As you say, it's no journey anyone would want to take!!!
I had rp in 2018. I got my first post surgery erection before the catheter was removed. Yes it was a bit painful. After catheter was removed, I had no real incontinence. At first, thinking about sex resulted in a drop or two. In time I mastered that. I used cialis for a while but now get perfectly good erections without it. Orgasms feel the same as ever. I do miss producing semen. I am very thankful- cancer free and enjoying a full life.
I had nerve sparing Prostatectomy using DaVinci laproscopic. I did loose about 1 to 1.5 inches in length. I do not have incontinence. I started kegels six months prior to surgery and continue to do them. I did use cialis after to maintain circulation. It was not successful in giving me erections (he had to get really close to left nerve to get all cancer. I did get partial erections, but not really satisfactory for sex. Used injections successfully for 6 years. At beginning gave best erections ever had, but was needing to increase amount and was not always successful. Last year urologist recommended and went with an inflatable penis implant. Very happy with results.
I'm 67 now. At 54 I had Da Vinci rip out my prostate. Was mad at the world for a long time. 13 years later and I'm happy again and no longer mad. It took almost 10 years to regain my length. I jelked, I yanked, I pumped, I took pills.. all sorts. I heard a porn star once say "If you want a big cock never let go of it"! So to this day I'm always pulling and yanking on it, not for sex, not to get off, just to keep the blood flowing and everything alive inside. So I'm back to 6.5" when right after surgery it was only 5"! I'd do have some pseudo foreskin which I love and I would say my erections are around 95% of what they were. My dry orgasms are very, very intense and I do miss seeing my ejaculate! One other thing I'll say is that when you use a cock pump don't get crazy and use a thick tube... go with one about the same thickness as your cock..... you don't want that "pumped up" look, not attractive. Pump 5 days a week and give it a break every now and again. I hope I've given u some hope. You have to be persistent!!!! I'm still cancer free and thankful to my doctor and husband. I'm topping regularly but still enjoy using the bottoming skills I learned over the years!
You have certainly given me hope! Especially when it comes to topping. It sounds like there will be a lot of work to recover after the surgery. I started kegels and will be seeing a pelvic floor therapist in the coming weeks. I’ve had retrograde off and on as a result of previous colon surgeries so I don’t think I’ll miss seeing the ejaculate. Good luck to you!
I agree with Tall_Allen. Radiation will spare you of much of this and has equal or better outcome. I had LDR brachytherapy 2.5 years ago, 3 +4, favorable intermediate risk. (Also had gay urologist, gay oncologist and gay PCP guiding me.) And all went very well, no complications, no issues with sexual function (still some ejaculate too) or urinary issues. And PSA dropped and continues to drop. Within a period of a few months it was as if nothing had happened at all.
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Regarding shrinkage...
Diagnosed March 2019, prostate removed June 2019. 58 year old, Navy Veteran living near San Francisco. PSA undetectable twice. 
Radiation Proctitus
If You Are A Practicing Bottom, please help me
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