Saturday, 26 October 2019

ED Rehab. - The Journey Commences

I posted recently ("Paradise Lost - Vale Sir Lust") about my impotency issues, 2 years post radiotherapy for prostate cancer. In hind-sight, it was a rather depressing post, written in resignation. But I'm not the sort of person to give up without a fight.

I knew that impotence was a possibility with radical prostatectomy, but had had no warning of the likely-hood of similar effects from radiotherapy. Further, I was a bit disappointed with my urologists' response to my current condition, of only suggesting a penile implant. I wasn't ready to give up on sex completely. I wanted to know more about what medical experts had to say about ED after prostate cancer treatment. So I turned to Dr Google - a number of on-line papers on the subject are listed in the foot-notes, and sections quoted here-in.


In summary, between 50% and 85% of patients will suffer ED after treatment within 3-5 years. "The major predictors of recovery are:-
  1. age at the time of radiation: the younger the man is, the better erectile function at the time of treatment and the better the long-term function is going to be;
  2. erectile function at or before the time of radiation;
  3. type of radiotherapy causing less nerve damage of the prostate and the less amount of surrounding tissues exposed to radiation, the better the outcome;
  4. the health of erectile tissues."
"Normal erections generally depend upon 3 processes: 
  1. increased arterial blood flow into the penis by neurological initiation, 
  2. cavernosal smooth muscle relaxation,
  3. restriction of venous blood outflow from the penis.
Impairment of any of these processes can lead to ED". (Viagra works via the first two of these processes).
"If your sexual function's not what it used to be a year or two after prostate surgery, hang in there. Men who are having trouble achieving erections after prostatectomy for prostate cancer can achieve improvement in function that's sufficient for sexual intercourse more than two years later, researchers say.

"The message to patients who have erectile dysfunction -- even those who have failed to have erections after surgery -- is that improvement does occur in a substantial number of men," says researcher Jeffrey Schiff, MD, a resident in urology at the State University of New York Downstate Medical Center in Brooklyn, New York.

Overall, one-third of men with marginal erectile function and one-fourth of men with serious erectile dysfunction 24 months after surgery continue to have improvement in erectile function on follow-up visits, he tells WebMD.
The findings were reported here at the 105th annual meeting of the American Urological Association (AUA)".

Radiation Injury

Radiation affects the erectile processes via damage/injury of the nerves and erectile tissues. The ability to recover depends on the type and degree of damage. A key factor in the healing process is increased blood flow.

Recovery Factors

Major recovery factors include:-
  1. condition of ED prior to treatment;
  2. age of patient - the younger, the better recovery chance;
  3. non-smoker;
  4. non-drinker;
  5. no diabetes or obesity;
  6. controlled blood pressure and cholesterol;
Well, 5 out of 6 gives me hope.
Finally, the age of one's partner is a major factor. +1 for me - all my "buddies" are 20-30 years my junior and all with high sex-drive.

Proactive recovery recommends daily low-dose use of Sildenafil ('Viagra', a PDE5-inhibitor), use of a "cock-ring" to limit venous blood out-flow and regular ejaculations. Improvement will take from 6-24 months.

On to Rehab.

So here I am, starting rehab. I will report and track my progress on this blog conversation, monthly in 6 months. Is recovery more psychological or is physical healing the principal improvement? Let's find out. Please follow and comment if you have a similar situation or concerns.

Footnotes :-

Radiation-induced erectile dysfunction: Recent advances and future directions

ED Can Improve Years After Prostate Surgery

Treating erectile dysfunction after radical radiotherapy and androgen deprivation therapy for prostate cancer

Sunday, 20 October 2019

e[lust] 123 - Paradise Lost - Vale Sir Lust

(This post reproduced per the conditions of acceptance of a post link for publication)

Photo courtesy of Deviant Succubus

Welcome to Elust 123

The only place where the smartest and hottest sex bloggers are featured under one roof every month. Whether you’re looking for sex journalism, erotic writing, relationship advice or kinky discussions it’ll be here at Elust. Want to be included in Elust #124? Start with the rules, come back November 1st to submit something and subscribe to the RSS feed for updates!

~ This Month’s Top Three Posts ~

Bittersweet Symphony
Breast cancer awareness – check your boobs
The devil is in the detail…

~ Featured Post (Molly’s Picks) ~

Metamorphosis: Fat, Fit and In Between
Contraception- life without birth control
All blogs that have a submission in this edition must re-post this digest from tip-to-toe on their blogs within 7 days. Re-posting the photo is optional and the use of the “read more…” tag is allowable after this point. Thank you, and enjoy!

Erotic Non-Fiction

Take It To The Limit


Spank me Red

Custom Made Cuckold Porn

Thoughts & Advice on Kink & Fetish


The Image (1975): The Celluloid Dungeon

Return to CMnf

Latex for the Curious – Catsuits

Negotiating a stunt cock

Ruby Ring Piece

13 reasons why I love play parties

You Got a Piercing Where?

Erotic Fiction

Alice’s Minotaur: A Ravishment Tale

Shadow of You


The Jealous Wife

What we both want

Rugby world cup I only care about the fucking

The Red Thread


Thoughts & Advice on Sex & Relationships

Loosing My Virginity

5 things that encourage Dominance

My Happy Place is an 80s (Sex) Mansion

Sex News, Opinion, Interviews, Politics & Humor

Sex Work – How My Views Have Changed

Golden Brown

Body Talk and Sexual Health

Paradise Lost – Vale Sir Lust

My Nexplanon Implant Story: The Procedure


Saturday, 5 October 2019

Paradise Lost - Vale Sir Lust

Occasionally we read about those early teen years of discovery, perhaps of illicit liaisons. But we seldom read of the other end of life. Sure we hear of changes during menopause, and of course there is the perpetual whinging of married men saying their wives have lost their libido. Erectile Dis-function gets an occasional mention, but Viagra and Cialis take care of that.

Loss of male libido can have psychological or medicinal causes. But outright physical loss of sexual desire (lust) and function, just silently slides under the covers. 

My ED started at around 60 and I posted "Sex and Aging". But Viagra ushered in a new era for me, but orgasm/ejaculation was less, partly due to the Viagra effects. By age 65, I blogged "As Lust Fades". At 69, prostate cancer was detected -  I opted for radiotherapy, since prostatectomy was more likely to cause impotency. The treatment was a breeze and I celebrated every week of "The 39 Days".

In the 2 years since the radiotherapy, the cancer appears to have gone. But sexual function and libido have just about died. At first, it wasn't just inability to orgasm from sex, but sensitivity and feeling was declining. Add in condoms for transactional sex, the old adage of it being like taking a shower in a rain-coat, was all too true. With the prostate having been zapped, its functionality has declined so the volume of ejaculate is not much more than a dribble. Further, I have found the ED has worsened to the point where even a maximum dose of Viagra doesn't produce a workable erection. Neither porn nor masturbation can produce an erection.

The Urologist suggested that a mechanical implant could help (rod or inflatable balloon), but with no willing partner, no feeling sensations, and no orgasms, there is no point. Alas, Paradise has been lost.

Fortunately, the tongue is still in good working order. But I can't bring myself to pay $300/hr for a kiss and cuddle.

Vale, Sir Lust

Alas Sir Lust, I knew him well, a fellow of infinite jest, of most excellent fancy. He has borne me on his bed a thousand times, and now, how abhorred in my imagination it is! My ire rises at it. Here hang those balls that have been kissed I know not how oft. Where be thy thrusts now? Your gambols? Your songs? Your flashes of merriment that were wont to set the whores on a roar? No one now to mock your limp dangling?

(PS. So what happens to this blog now with the loss of inspiration? Well I still have lots of memories to draw on so I will probably defer to fictional erotic writing.)

(Click to see who else is posting Food For Though about Libido)
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