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“Will I be able to maintain erections without viagra after prostate surgery? How do I stop thinking that without penetration I am ‘less of a man’?”

Patient advocate Elvin says...

Based on my work and conversations with many other men with prostate cancer, I’ve learned a few things. Always, always ask a trusted doctor, nurse or member of your medical team about things like exercise and drugs, etc. but the peer-to-peer aspects of cancer are also critical. And as a man living beyond prostate cancer, I have a lot of thoughts on the subject.

To maintain erections without Viagra after prostate surgery is dependent upon several factors. If nerve sparring surgery was undertaken – thus leaving some of the nerves in place that enable and maintain your erections – there is a high chance that after a recovery period between 2-4 years, Viagra would not be ‘essential’. However, that chance is increased when the recovery period does include regular exercising of the penis 2-3 times a week, cardiovascular exercise, and daily pelvic floor exercises.

Exercising the penis with a vacuum pump and masturbation – both for 15 minutes at a time – can bring about the early stages of penis rehabilitation (i.e. becoming what is often termed ‘semi-hard’) within six months of surgery. For cardiovascular exercise five times a week, try running, swimming, brisk walking, or anything you feel you can do healthily (and check with your doctor before starting).

Here is an excellent 2-minute instructional video on pelvic floor exercises, produced by the Continence Foundation of Australia:

If nerve sparring was not an option, alongside the above stated recovery regime, Viagra is highly advisable. In both instances described above, some people also take a daily 5mg of Tadalafil. Just double-check that this works with your other health issues.

To get the best results when taking Viagra you must be quite disciplined: start with an alcohol-free ‘light’ meal, allow an hour to digest before taking the prescribed dose (usually 100mg), and let the Viagra circulate for 45 minutes before attempting penetrative sex. When it all works, it can enable some very positive results. What you must remember though is that Viagra will only be effective if you are aroused and have a desire for sex.

Plus, before I forget, do experiment with cock rings. They can be remarkably effective in supporting and maintaining an erection.

Again, as with all prescription drugs, please ensure you check with your doctor prior to taking them for potential side effects that may negatively impact you if you have an existing condition.

Regarding “How do I stop thinking that without penetration I am ‘less of a man’?” please be aware that there are numerous ways to regain your erections: from Viagra, to injections, to surgical treatment. So please do not give up hope.

That said, there will most likely be a period when you are unable to attain and maintain an erection strong enough for penetrative sex. You will naturally be frustrated, however both you and your partner can enjoy sex that is highly pleasurable and can bring you both to a climax. Please do explore, discuss, and experiment with sex play that you may never have even thought of before, that is not solely reliant on your penis being erect. So, please do watch porn, browse websites, and of course use sex toys. Do not judge anything before you have tried it.

This is an opportunity to reignite your sexual relationships and discover an array of methods, techniques, and positions that you and your partner(s) will delight in.

To support all of the above, I highly recommend this condensed, yet extremely detailed, medical information, produced by Prostate Cancer Gibraltar.

Sex toy expert Renee says...

You probably won’t know the answer to this question until you are at that point. There are a couple of things to bear in mind though:

1. The majority of women don’t orgasm from penetration. Around 75% of women orgasm from clitoral stimulation, which you’ll do far better with a mix of hands, tongue and toys.

2. A pump and cock ring might do the job on the occasions you want an erection. (We say ‘might’ as there are no guarantees and you won’t know until you try.) The Penis Pump uses vacuum treatment on the inserted penis in order to improve penile tissue and allow more blood flow to the penis, which will increase sensitivity in the short term and if used regularly, can result in increased erection strength. Once you have used the pump, you slip the cock ring down over the shaft and sit it around the base to keep the extra blood in the penis. 

3. We have male customers in similar situations who use strap-ons for penetrating their partner. The great thing about strap-on play is that you can have as many dildos as you and your partner want – one for every day of the week – and you can keep going for as long as you & your partner want!