Sex After Radical Prostatectomy
Q: On September 13, 2023, I had a radical prostatectomy. My doctor never told me I was going to lose my ejaculate, just the sperm. Is there any way to achieve the feeling of ejaculating again? I need to feel the fulfillment and the finish. Could you please help me, thank you.
A: After the removal of the prostate gland, ejaculation does indeed change significantly. I’m surprised your medical professional did not tell you what to expect. The prostate gland is responsible for producing a large part of the fluid in semen (the ejaculate), and therefore, without it, the volume can decrease significantly and sometimes results in what is called a “dry ejaculation.” For some men, they may experience “retrograde ejaculation” which involves the semen being redirected to the bladder instead of expelled through the penis with ejaculation. This happens because the valve that normally prevents semen from entering the bladder during ejaculation is affected during the surgery. Thus, whatever semen is there gets mixed in with urine and expelled when you urinate. Having said all this, a prostatectomy and the drastic reduction in ejaculate does not usually affect pleasure or the ability to achieve orgasm. So the finish will not be the same as before because little or no liquid will be expelled, but that doesn’t mean you can’t have the feeling of an orgasm.
Hemorrhoids
Q: After some stomach issues, I ended up with a hemorrhoid. I wasn’t able to get to the doctor to treat it properly during Covid as they were only taking urgent cases and now it’s healed but it still sticks out. One time, a long-distance ex-boyfriend commented on it while we were video-chatting/sexting and while he wasn’t mean about it, I’ve been really self-conscious about it ever since. Do men care about stuff like that? I feel like I’m deformed, even though it’s just a tiny flap of skin.
A: Hemorrhoids are so common and affects millions of people worldwide. Most hemorrhoids heal on their own and don’t require medical intervention. They are nothing to be ashamed or embarrassed about. Unfortunately, sometimes innocent comments can have a real impact on our self-image. You will find that most people (men and women alike) do not care whether you have this tiny little piece of skin or ball in/near your anus. It does not interfere with pleasure, and it certainly is not the part a partner will be focused on. The only time a hemorrhoid is problematic with sex, is if you practice anal sex, and it ends up irritating the hemorrhoid.