Facing prostate surgery soon, worried!

Chris, I didn't understand the comment until I reread Jimmy's first paragraph again.

"I am in my late 30's and in the near future I might have my prostate removed as part of the total pelvic exenteration surgery (due to cancer in the pelvis) and am told no nerves will be spared. In light of that I have the following questions as I am quite worried:"

I don't think he has cancer in the prostate, and his surgeon doesn't know what he is to remove or leave until he gets in there.

Thanks Chris 

Regarding how natural it feels well that's a different story. The hinge effect isn't great and the "erection" won't get stronger as you get more excited so that can lead to frustration. But with practice it can work. Personally I found the intrusion (first time I tried my new girl friend nearly ran off screaming) a bit difficult but in an established loving relationship I can see it being a life saver.

Caverject worked best for me until I found the love of my life. Once I was in a stable loving relationship I found I no longer needed the heavy duty erection kit as enough natural ability remained. I realise not all prostate cancer treatment survivors are as lucky as me but there are many guys on here who one way or another are "getting it on" successfully...

One thing that is not quite clear to me though. Assuming no nerves can be saved is there still a point for daily use of the pump in the context that natural erections will never return?

Right now due to my age, and depending on my psychology, sexual urges do come often. I cannot imagine not being able to achieve an erection. Do I need to learn to ignore them? Doesn't that "frustrate" a male and creates a level of psychological tension/depression? I have already lost my ejaculation due to a previous surgery which takes some mental management in itself.

I am scared about the quality of my daily life given my life circumstances. I am not in a relationship and getting into one is going to be a tall order with all this. It would have been a lot different if I was already in one when all this started unfolding. I am now facing a potentially disastrous existence where I will survive cancer but evaporate from licking daily my unhealable wounds. How do you say to a girl you just met and you like "Hey, am a pretty good guy but I have two ostomy bags, I can't really have spontaneous sex without planning and "interventions". I also can't easily have children either unless they dig in to my testicles hoping to find viable sperm".  

Nightmares and a lot of emotional loneliness awaits.

I had 37 fractions off radiotherapy and on hormone therapy soon discovered my sex life was over  things are ok psa steady at 0.01 for nearly two years don't know if things will change when I soon come off hormone therapy if things will improve or not but I have got used to being without but don't hold much hope off things getting better good luck to anyone in the same situation 👍

After my latest appointment it has now become clearer to me that I will be having this surgery later this year.

I am very anxious of the very lonely life that awaits me post surgery. Finding a desirable/age suitable partner for someone in his late 30's will become a near impossibility unless I drop my standards a lot and begin to have no problem with dating someone 45+ along with not caring about their looks.

Before my health issues begun I had issues finding someone age appropriate because I had no desire for a family/kids and many girls of the age range I wanted had a big issue with this. I cannot imagine how difficult its going to be to find someone in the near future post surgery. I do not think I have the emotional stamina to go out and be rejected/ghosted a ton of times before I find someone. Find someone good looking? young? healthy? Unlikely..... To the advice that I recently received elsewhere "date someone within the cancer/stoma community as they are more likely to go along" the answer is no. I have my health problems/disabilities to worry about, I don't want to have to worry about my partners too. It is too much for me.

One question has arisen though. I see people using pumps when they are about to have sex and I don't understand why if injections work so well? You run to the bathroom, have your injection, and come out and all will look like normal. Why bother with a pump at all at that moment?

Lastly, I read that Caverject requires no stimulation to work but Invicorp does need sexual arousal. Are both statements true? I thought both of these drugs required no stimulation to work.

The way I have structured things in my mind is that if injections work then sex will be largely a non issue for me and my future partner and unusual/awkward moments of someone pulling out a pump will be avoided.  If this is true I can sort of relax knowing that having a colostomy and a urostomy is "on me" to look after and take care of plus I can also cover them with a special belt and they cannot be  noticed and cause grossed out feelings. Provided I manage my stomas disability and it only directly affects me and no one else then I should be OK on this front. If the penis doesn't work though then this is no longer "my problem" as it can also directly affect others.

I was under the impression that injections work for all. Do we have any statistics for how many people injections work? I will be even more devastated if even injections won't work for me. Disaster :(

Some conditions such as venous leaking mean that the blood doesn't stay in the penis and so injections are less effective.  There is also the risk of scarring from certain injections over time which can reduce their effectiveness.  Apparently this is less so with Caverject although many people get some level of pain with this.  If injections don't work or become too onerous there is the option to get an implant which some folks have got.  There is a good book on how to save your sex life after prostate cancer by Dr Mulhall which I found useful to explain the various options.

I had a prostatectomy at the end of April and have a pretty good sex life using Caverject.  It took a bit of persevering and dialling in the dose but it works pretty well.  Although have just gone on hormone therapy so will have to see how we get on with that.