The journey to maintaining a satisfying sexual life after a radical prostatectomy is entirely possible. Many individuals find that alternative forms of pleasure can still exist, even if they differ from their pre-surgery experiences.

Yes, most individuals can still achieve orgasm post-surgery, although the sensation may change. “After a radical prostatectomy, while orgasms are still achievable, they do not come with ejaculation. This phenomenon is known as a ‘dry orgasm’ or ‘orgasmic anejaculation’,” explains Dr. Mohit Khera, urologist specializing in sexual health.

The terms orgasm and ejaculation are often confused, yet they denote distinct experiences. While they can happen simultaneously, they can also occur independently. Generally, an orgasm is defined as the peak of sexual pleasure, described by sexual health expert Caitlin V. Neal, MPH, as a “pleasurable release of sexual tension.” The following types of orgasms can be experienced, particularly by those assigned male at birth:

• Penile orgasm
• Prostate orgasm
• Anal orgasm
• Nipple orgasm
• Breath orgasm
• Coregasm

Each type of orgasm is generally characterized by a combination of muscle contractions, increased heart rate, and heightened sensory experiences. Ejaculation specifically refers to the release of semen, which contains sperm, from the penis. Notably, an individual can experience ejaculation without reaching orgasm, known as an anorgasmic ejaculation.

The relationship between radical prostatectomy and orgasm is complex. "The prostate is not essential for achieving an orgasm," says Dr. Jordan Soper, a licensed sex therapist with expertise in sexual wellness. Consequently, orgasms are still possible, but their nature may change. Following the removal of the prostate, one can no longer experience prostate orgasms, as noted by sex educator Searah Deysach.

However, most individuals can still attain penile-centered orgasms through means such as masturbation or oral sex, although these orgasms will occur without ejaculation. "In the absence of ejaculate, some individuals report that orgasms may feel different or less intense," explains Dr. Soper. Even those who experience erectile dysfunction post-surgery might still achieve orgasm through sufficient stimulation, even without an erection.

It is crucial to remember that intimacy encompasses much more than just achieving orgasm. “Sex should be seen as a holistic experience, allowing for pleasure, connection, and intimacy,” states Deysach. Exploring varying techniques and sensations can enhance enjoyment—even if the experience differs from before the surgery.

The impact of a radical prostatectomy on your sex life can be significant, but it doesn't have to be entirely negative. Open dialogue with your partner is essential. “Discussing the potential changes after surgery is vital for both partners,” says Dr. Soper.

To facilitate this conversation, consider these prompts:

• “Sex is an important part of our connection, and I’m concerned about changes after my surgery. Can we discuss how we can maintain intimacy post-recovery?”
• “I find it challenging to talk about how this procedure may affect our sexual life. Would you consider joining me for a session with a couples therapist to explore our feelings together?”
• “I cherish our physical connection, but I’m anxious about how the surgery will affect my performance. Would you accompany me to my next appointment for more clarity?”

Can You Still Get Erections After a Radical Prostatectomy?

Many individuals experience difficulty in achieving erections right after surgery. Some may regain erectile function within 3 months to 3 years, while others may not. Treatments are available, including:

• Counseling and sex therapy
• Pneumatic devices
• Testosterone therapies

Can You Still Ejaculate After a Radical Prostatectomy?

No, ejaculation is not possible after this surgery, per Dr. Khera.

When Can You Resume Sexual Activity?

Consult your healthcare provider for specific timelines. Typically, experts suggest waiting about one month before engaging in penetrative sex, while alternative forms of intimacy can be explored in the meantime.

Is Erectile Dysfunction Common After Surgery?

Yes, it is common. Studies indicate that up to 85% may experience erectile dysfunction following a radical prostatectomy. It's essential to discuss concerns with healthcare providers, as this procedure is often deemed necessary to treat prostate cancer effectively.

Can You Impregnate a Partner After Surgery?

No, because seminal fluid—carrying sperm—is no longer produced following the removal of the prostate. Consult your healthcare provider for guidance on contraceptive needs moving forward.

Can Other Prostate Conditions Develop After Prostate Removal?

No, once the prostate is completely removed, other prostate-related conditions cannot occur.

While prostate orgasms are off the table after a radical prostatectomy, other forms of orgasms can still be experienced. The sensations may vary, but they can remain pleasurable. Consult a healthcare provider for personalized guidance and solutions regarding any sexual health concerns after surgery.