Sex After Prostate Surgery

Sex after prostate surgery

And now to a topic for those with prostate cancer and their partners. This is a topic which is important and for some very emotional. What about sex after prostate surgery?

My own journey is just that, mine. What I experienced and continue to experience is unique. Nevertheless, there’s something in every person’s individual journey for each of us to take away.

Sex After a Radical Prostatectomy (Non-nerve-sparing)

I had a radical robotic prostatectomy on November 30/2020. For those reading who don’t know, a radical prostatectomy is different from a nerve-sparing robot prostatectomy. After nerve-sparing surgery, there’s a very good chance that you’ll be able to have erections again sometime in the future.

Nerve-sparing surgery is suitable for cancers that are less advanced. With advanced prostate cancer, (mine was a 9 on the Gleeson scale), nerve-sparing is not really an option. There’s a significant risk that some cancer cells will be left behind and further treatment will be required down the track.

What Can You Expect?

I’ve described in earlier posts what you can expect in general terms. Today I want to talk about the impact on your sex life.

  • It won’t be possible to have erections spontaneously.
  • There will be no ejaculation.
  • Your penis will be slightly shorter, somewhere around 10mm.

Some reading this will recoil in horror, anxiety or fear at this news. I’m aware that some men have even chosen not to have treatment because of their distaste for these outcomes. Unfortunately, the result of taking no action is death. As far as I know, that also means the end of erections and ejaculations anyway, so I figured an operation was a far better outcome.

Is this the End of your Sex Life?

Does the loss of ability to have an erection and to ejaculate have to mean the end of your sex life? The answer is a resounding no! But to have a satisfactory sex life after your surgery it requires you to shift your picture of what that looks like.

If you maintain a picture that sex is only about penetration and ejaculation, then you’ll be constantly comparing what you now have with what you’ve lost. That road leads to anger, anxiety, misery and depressing. So lets look at some information which can help and see if you’re able to develop an alternative picture.

Firstly sex is far more than the physical act of erection and ejaculation. Making love with your partner is what you do 24 hrs a day and 7 days a week. An enjoyable sex life best exists in the embrace of a loving relationship.

Procreation, (making babies), mostly does require an ability to have an erection and ejaculate, though even this is changing with new technology and procedures. However, having penetrative sex is only one part of our sex lives.

If you have a radical prostatectomy, you’ll still be able to have a great sex life and satisfy yourself and your partner. So how does it work?

The Big O

Firstly, regardless of whether or not you have an erection or ejaculate, you can still have an orgasm. It was only 24 days after my surgery that, with the help of my wife Deb, I was able to experience my first dry orgasm.

It was every bit as good as it had ever been, in fact, I would say more intense. It was a surprise because we had been following our doctor’s instructions for penile rehabilitation and not expecting an orgasm.

I had been using a penis pump regularly to prevent permanent hardening of the penis which is irreversible. We had engaged in sexual play and touch which still felt pleasant because those nerves remain intact and active, it’s only the nerves that control erection that are cut.

To achieve orgasm it’s important to be in the moment and enjoy what you have rather than what you’ve lost. If I’d been dwelling on the lack of an erection, I doubt very much if I would have achieved an orgasm.

Deb and I had agreed that we wanted to continue making love, and our sex life, albeit different than before, was always going to be a part of this. We knew we didn’t need penetrative sex to have an orgasm. After the first surprising and pleasant orgasm, it was very easy to continue to have them with the help of manual stimulation. It can be pleasant and fun to help your partner reach orgasm manually.

Erection Injections!

As part of my follow-up, I was linked up with an erection dysfunction nurse called Gill. She talked me through the next step and I began taking regular Cialis in small doses. This was not for the purpose of having an erection, but to continue with blood supply to the penis and to prevent the build-up of collagen in the penis. This causes the irreversible hardening I mentioned earlier. We also discussed the options of penile injections or penile implants so I could have erections again.

On the 5th of February, just over two months after my surgery, I had a session with Gill to learn how to inject trimix into my penis. I have to say the thought of putting a needle into my penis was very off putting. Fortunately, it’s a very small and very fine needle. You could say it is one small prick so you can achieve a large prick, though not bigger than it ever was before. Remember you still have a slightly shorter penis than before, though I believe that in time and with use, most if not all the original length will be regained.

The injections really don’t hurt much. As I have got used to injecting the trimix and have relaxed more it has become very easy to do.

Penetrative Sex Needs Planning

Here’s how we do it. If we want to have penetrative sex, I will inject trimix into my penis and we will engage in foreplay. 10 to 15 mins later the penis will become erect and harder than it ever was naturally. The erections also last longer and don’t disappear after orgasm, which is a bonus. It can take a bit of trial and error to get the dosage of the trimix right.

So yes, you can have penetrative sex but it is different than before. Holding onto what you had previously and not enjoying what you have and can do now is the road to misery and unhappiness.

The Future

So what of the future? It’s onwards and upwards! We are as close as we were before because whilst the cancer was mine, the journey is ours, and the support and love we give each other means we can have a sex life different to, but every bit as enjoyable as before.

Remember this journey is mine/ours and yours will be different, but the key to the best result is letting go of what you have lost and focussing on what you now have. The surgery isn’t the end of your sex life, it’s the start of the next stage and there is no reason for it to be any less enjoyable and successful just because it is different. How good it becomes is up to you!

Online Counselling Session

I know this journey is not an easy one and many people struggle. If you would like to book an online counselling session with me you can do that here. 

Jeff Steedman
Jeff Steedman – Riviera Counselling


11 Ways of Building Self Confidence

Truth is what we agree on anti more information comes along

When you’re confident you feel secure in yourself and your abilities. Not arrogant but quietly certain that you’re capable of handling what shows up in your life. Confidence is necessary for you to back yourself to move forward into the unknown to reach your goals and your dreams. Everyone agrees that confidence is important but far fewer people have solid advice on how to become more confident.

External events and outcomes can increase or decrease your confidence. You have no control over those externals except in the way you choose to respond. Stronger self-confidence creates better responses. So here they are, 11 ways of building self-confidence you can start implementing today. 

1. Make your Relationship with the Most Important Person in Your Life the Best it can be

William Glasser said that everything is a relationship issue. What you probably forget is that the most important relationship you have is with yourself. When you relate to anyone, including yourself, you are either connecting or disconnecting. 

Build your confidence with connecting habits
Smash your Confidence with disconnecting habits

2. Take the Best Care of your Body that you Can

When you value something you take care of it, right? Your body is the only vessel you have to experience life through. It’s a marvel of engineering but it can also cause you a lot of pain. Some of this pain is outside of your control but you do have a lot of control over the way your body looks and feels. The way your body looks and feels can add or detract from your confidence. 

Instead of taking care of your body do you have a tendency to use your body for comfort? If you’re comforting yourself with food, alcohol or vegging out you’re not caring for your body you’re abusing your body.  

You can keep doing this or you can look at the underlying causes of your stress and manage the symptoms better while you sort those causes out.

3. Meeting your Needs

You have five genetic needs: survival, power, love and belonging, fun, and freedom. Everyone has the same five needs to varying degrees. If you can meet those needs successfully you will be confident and happy. 

Enter your email address on the sidebar so we can send you our Needs Profile and Satisfaction Questionnaire. You can then see how well you’re meeting your needs and how this could be dragging down your confidence.

4. Focus on what you can Control

There’s only ever one thing in life that can you control and that’s you in the present moment. Blaming yourself for your past choices, or allowing yourself to get down for long over things that are outside of your control is waste of time.

Practice being the best you can be in everything you do then let everything else go. It’s easy to become overwhelmed by what’s going on around you. Most of this will be outside of your control. Pull your attention in around what you’re doing and focus on it fully. Bring joy and enthusiasm to your tasks and appreciate your efforts.

5. Do what Brings You Joy

Joy is the greatest currency of the universe. Feeling joyful builds confidence.  It feels great to feel great.

Doing the things that you love is usually the first thing you drop when you’re under pressure. When you do that you’re telling yourself that you aren’t as important to yourself as other people, and other things.

6. Accept what is Showing up

Accepting what is showing up in your life and learning how to deal with it successfully is an amazing way of building confidence. Unless you’re in imminent physical danger, the basis of most fear is the idea that you won’t be able to handle something that might happen. So each time that you do handle something successfully you’re building your confidence. 

7. Glance in your Rear Vision Mirror Every Now and Then

You can’t get where you want to go by staring at your rear vision mirror. That’s why your rear vision mirror isn’t very big and your windscreen, by comparison,  is huge. It does help your confidence however if you glance at where you’ve been and how far you’ve come, now and then. 

2020 – A Largely DIY Project

8. Stop Comparing Yourself

Part of having a great relationship with yourself is to really value and appreciate who you are, your unique talents, and your journey. It’s very difficult to do that if you’re always comparing yourself to other people. So STOP IT!!

9. Check your Perception

Truth is the information you agree on until more information comes along. If the information that you’re giving yourself, via your thoughts and actions isn’t working for you go out and get some different perspectives. Ask people who you trust what they think. Gather information from reputable sources and if necessary change your perception or change your behaviours until you’re in alignment. 

10. Check your Quality World Pictures

Your Quality world pictures are the ideas you have about the things that you need to be happy. Confidence is part of happiness because it takes confidence to be able to meet your needs. If you’re having trouble meeting your needs there are three things you can change: your thoughts and actions, your perceptions, or your quality world pictures. If your quality world pictures are unrealistic or unattainable your confidence will keep getting battered. You don’t have to completely wipe your dreams and aspirations but they might need tweaking. 

11. Learn how to Manage Stress and Anxiety

How to Deal with Stress and Anxiety Effectively

Stress and anxiety are a vicious cocktail when it comes to wrecking self-confidence. When you’re highly stressed your lizard brain kicks in and your lizard brain only has a couple of options: fight or flight. It developed that way to save you from physical threats. Today’s issues require the more modern parts of your brain to help you strategise yourself out of your problems. You need to think clearly and you can’t do that with old lizard brain in charge.

As always thanks for visiting and I hope this post has helped you gain some clarity over confidence-building. If you don’t already receive regular communication from us sign up for the Needs Profile in the sidebar so we can keep in touch. You can also book an online counselling appointment with Jeff below.

To a more confident you 🙂


Jeff Steedman and Deb Burns

Am I Really in Control?

In Control

Do you feel stressed and anxious because your life seems out of your control? Believing that you are ever really in control of your life is a fantasy. There’s only ever one thing in life that can you control, that’s you and that’s enough.

We often measure wellbeing against how “in control” we feel. That’s fine as long as we remember that the only thing we can really control is ourselves.

When life is peaceful, predictable, and going along nicely it’s relatively easy to be in control of your thoughts and emotions. But it doesn’t take much for that control to jump right out the window. The pandemic is one of those things that has thrown many people off course. The impact of other people, illness, or maybe even your own ambitions can throw your control of yourself off course.

Your Time is so Precious

Your time is the most precious thing you have. Without time you have nothing else. So why would you waste any of it stressing out about things that you have no control over?

The idea that your stress levels and emotions are the direct result of your thoughts, is relatively new. It’s easy to blame situations and other people for your emotions. You may even think it’s justified. But by taking responsibility for your thoughts and the emotional results of those thoughts, you’ll have so much more control over your life.

Knowing that upsetting yourself with things outside of your control is unwise, is one thing. Being able to manage your thoughts so that you aren’t upset is another.

Take Responsibility for your Thoughts

Taking responsibility for your thoughts is the first step to increasing the control you have over yourself. The next step is even more challenging because it requires consistent work. Work that ultimately only you can do.

Decide which thoughts serve you and will get you where you want to go. Hang onto those thoughts tightly. Put them up on post-it notes around your workspace or on your fridge. This is evidence that you can use to create more positive thoughts.

You may be surprised when you start observing your thoughts. They’re likely to be far more negative and critical than you expected. Sometimes you’ll want to give into them. But what will help you take control of your life is to challenge them. Challenge them with thoughts that are believable. You probably won’t be able to believe that you’re amazing at something. And there will always be people that are better than you. But you can believe that you’re good enough.

What if I’m Not Good Enough?

This is the underlying thought that undoes so many people. Don’t let it undo you. It’s a thought that won’t serve you. Keep reminding yourself that you are good enough. Keep reading your post-it notes, with all your evidence displayed right where you’ll see it. But if the thought persists, at some point, you’ll need to confront it if you want to have as much control over your life as you can.

Of course you’re good enough, everybody is. And good enough for what anyway? This thought is probably coming up for you in just one or two areas of your life. Take some time to evaluate the thought. Imagine an old-fashioned set of scales. Put this thought on one side and all the evidence you have to the contrary on the other side.

If your scales continue to tilt towards the side of “I’m not good enough,” then re-evaluate what you’re trying to do. Ask people who you trust what they think to make sure that your perception is valid. Maybe there are things you could do that would increase your confidence in yourself? Ultimately there’s no point pushing ahead with something that you have a strong underlying belief can’t work.

Pushing Forward with your Best Thoughts

The scales are a great visual reminder of what’s true for you. Maybe with more information it will no longer be true. That doesn’t matter. That’s something for the future.

Right now, if your scales tilt towards the positive evidence that you are good enough to do or have what you want, then align with your thoughts and get going. You can re-evaluate later and maybe change course if necessary. But right now, use your evidence to create more thoughts that put you in control of whatever you’re trying to achieve. If not consider one of our life-changing courses.

Life-Changing Courses from Choice Theory Online

Stress-Less Training

Deal with Stress & Anxiety Effectively
Online Stress and Anxiety Course

Feel More in Control in Just Four Days

If your feeling down and want need a pick-me-up try our new Mini-Course

Four Days to Feeling Better: Mini-Course

A Meme a Day and a Post Fresh from Deb’s Keyboard

If you have a curious mind and are serious about Self-Development sign up here and give yourself something meaning to think about each day.