Topic
ED post prostate cancer
I am a 66 year old former technical executive (computers and network for an entertainment company) who retired in 2000. I had always had a very active sexual life and had been married from the age of nineteen with a short break between wives in 1982-1983. I was diagnosed with prostate cancer in 2001 and after careful consideration, opted for radical surgery to remove my prostate. Almost all the doctors I consulted with recommended the surgery – primarily because of my age. My final decision was based on the logic that they’d actually see the cancerous prostate and analyze it and if they didn’t get it all, I could always get radiation later. If I had the radiation first and it didn’t get it all, subsequent surgery was not an option.
The surgery was performed by a very experienced surgeon at a leading hospital in Los Angeles and it went well. Recovery was quick and it didn’t slow me down very much at all. I had no issues with incontinence.
Starting with my earliest consultations, I was not able to get a good grip on what my sex life, if any, would be after the surgery. I did get elementary questions answered, but most doctors were either not well informed or not comfortable discussing the subject. For example, when I asked “Will I still be able to have an orgasm even when there is nothing to “squirt””, one doctor said it would be “pretty dry”. My surgeon responded by saying “The male orgasm is in the brain!” So, I had no idea what to expect. What I did expect was that it would be some time before I could get an erection. I was told it could be anywhere from a few months to years.
I was not able to get an erection for about one year. When I did and we had intercourse I did have orgasms but they were different. “It” kept trying to “squirt” but since there was nothing to squirt, it eventually stopped trying. The orgasms were quite intense and longer lasting than before the surgery. It was difficult to get regular erections even with the erectile dysfunction drugs that were available. I would say that during this period I was frustrated that I couldn’t perform as I had or wanted to, but was very grateful the cancer had been found early and apparently removed. I say apparently because after a slowly rising PSA I had another biopsy and guess what – they didn’t get it all with the surgery! In 2005 I underwent 40 radiation treatments and it looks like that finally did the trick. As far as we know the cancer is gone. The radiation wasn’t that big a deal although I had some side effects which have pretty much cleared up. The most problematic was scarring in my colon which caused some discomfort and a little embarrassment once in a while.
My sex life was pretty mediocre as I was not able to perform as I wanted. I used the ED drugs with limited success. The past few years I could get a decent erection, but it wouldn’t stay hard very long. So, if we engaged in foreplay, by the time we were ready for intercourse, the erection went away. So we ended up having intercourse as soon as I got an erection and this wasn’t very satisfying for either of us. I was pretty frustrated but accepted the situation as a result of the cancer and its treatment. I did try to get some answers, but wasn’t very successful. Before one checkup with my surgeon I faxed him a list of questions relating to my situation that I hoped he could answer for me. His answer was “I don’t know what to tell you”! I figured if he couldn’t or wouldn’t help, no one could.
Over the next few years things gradually got worse and the ED drugs stopped working. I went to another urologist (2008) who prescribed 100mg Viagara and that seemed to help for a while. At that time I had noticed a distinct upward curvature of my penis and he diagnosed it as Peyronie’s disease. He gave me a pamphlet on it and a pamphlet on injections for ED.
At no time during the period from 2001 to 2009 did anyone recommend seeing a sexual health specialist or facility. I had no idea such things even existed. I was aware of the groups who advertised “sex for life” and found out they were dispensing injectable medicine for ED. I didn’t like the way they operated or the bad press they got from other doctors so I did not pursue this avenue.
When we moved back to California in 2009, I went to a urologist at UCSD for a consultation and 6-month PSA blood test. As I was describing my sexual problems, he recommended Dr. Goldstein at San Diego Sexual Medicine in San Diego and said he had referred a lot of patients to him and that they had been helped. Based on this recommendation and my strong desire to try to do something to improve my sex life, I contacted Dr. Goldstein. I was surprised that the first step was a no-cost 15 minute phone consultation. During the consultation, I learned quite a bit and felt Dr. Goldstein could help so I filled out some paperwork, got the blood tests he recommended and made an appointment.
I’ve always had a good attitude about my “problems” and considering the alternative of dying from prostate cancer, I never really looked back or felt sorry for myself. I decided to treat my appointment with Dr. Goldstein as another life “adventure”. Dr. Goldstein has a great bedside manner with lots of good humor and enthusiasm. Although I was prodded, poked, zapped and whatever else and in the presence of his assistant, I was never uncomfortable or embarrassed.
I was given an injection in my penis to cause an erection so Dr. Goldstein could do his diagnostic tests. The injection was not painful and didn’t bother me. I’ve never liked needles, but I figured it was time to get over that, especially if that was the solution to my problems! Well, a little while later I had the hardest, stiffest erection I had had in years. I liked that. After the diagnostic tests, it was determined that the self-injection would work for me. After my erection went down (with an assist from an injection) I left and received a detailed medical report from Dr. Goldstein a few days later. Basically I needed more blood flow into the penis and improved sealing to keep the blood in to sustain the erection. The self injection medication was the solution. Hurray! The only problem now was that I’d have to learn how to stick a needle in my penis to inject the medicine. Yes, it takes some motivation to do this, but the alternative is a very poor sex life. I was motivated!
The next step was to make another appointment to be instructed in self injection. The instructions are very simple, easily learned and easy to execute. First you prepare the needle (small diabetes needles) with the medication. Secondly, you wipe the injection site with an alcohol swab to clean it. Thirdly you stick the needle in, inject the medicine and compress the site for a few minutes. That is all there is to it. I did the first one during this visit and it went well. I got an erection as expected and it wasn’t that big a deal to stick a needle in a very sensitive area. I left with a couple of prepared needles for home use and we placed an order for my prescription and the necessary supplies.
One of the things that concerns anyone who takes any of these types of medicine is the warning that “if an erection lasts for more than 4 hours…” If that ever happened to me, I would have run up and down the street cheering before going to the hospital! Of course it never happened, but I was concerned that it might with the self-medication. Well, it turns out Dr. Goldstein also instructed me in how to do a self injection to solve this problem. It has a different set of instructions, supplies and medication, but having this medication removes any fear of having to go to an emergency room and having an inexperienced person stick a needle in your penis.
I did have one incident where it appeared the medicine did not work. I made an appointment to see Dr. Goldstein and after observing my technique, he found I wasn’t doing it right. I was actually pulling the needle part way out as I injected the medicine. I have not had a problem since I “corrected” my technique.
Although I’ve only been doing this for a couple of months one might ask – is it worth it. The answer is definitely “Yes”. Our sex life has returned to normal. We actually engage in foreplay and there is absolutely no rush to get it done! The medication works very well and it isn’t a big deal to get ready for sex. While I’m prepping and injecting, it gives my wife a few moments to get her mind thinking about sex. After intercourse, the erection slowly goes down, but my penis stays somewhat swollen for a couple of hours. Sometimes I get a small drop of blood at the injection site and subsequent bruising, but neither is serious and the bruising goes away in a day or two. Sometimes there is a little sensation at the injection site, but it is not a real concern. Again, being able to have good sex again is clearly worth a little annoyance.
This is my experience and I am sharing it to help others who have similar issues. If they can find help in less than the nine years it took me it will have been worth it. If I can do this, anyone can!