It seems appropriate, on the anniversary of the birth of the world’s most eminent environmentalist and all-round champion of all things natural – Sir David Attenborough, that I should address the large pachydermesque aspect of my recovery from prostate surgery last November. I refer, of course to the thorny issue of (send the kids to bed and whisper it softly) S.E.X.
Before you close your browser tab, legs or phone screen let me assure you there will be no graphic scenes of sex, explicit or otherwise, depicted here. If your delectations are drawn in that direction I suggest you grab one of the many million copies of ’50 Shades’ that now pollute the shelves of your local charity shop.
If, on the other hand, you want to hear how I am dealing with the emotional and relational difficulties my prostate gland removal has presented me with, read on my friend – you are in safe hands.
There are some basic facts around having one’s prostate removed. For instance, you are incapable of ejaculation during orgasm. There’s no work around, your body is rendered incapable of producing semen as the seminal vesicles are removed at the same time. You are also infertile. This wasn’t such a issue for me as I had already undergone a vasectomy many years ago. That is the complete list of things you will 100% not be able to do after surgery. There are, however other effects that will affect everyone but to varying degrees. Urinary incontinence immediately following the removal of the catheter is almost inevitable. It can be controlled over time with pelvic floor exercises and patience but you can continue to suffer a little leakage for some months. I do but they are quite predictable (strangely its when I consume a lot of liquid – who knew?) and I can take steps to mitigate the effects. The final area and, to be honest, the one I want to focus more closely on is that of erectile dysfunction (ED).
ED is probably top of the list of things that men don’t ever want to talk about, let alone admit they suffer from. I was away with some (male) friends last weekend and was asked about my recovery. As soon as I mentioned ED and the things I am doing to remedy it (details later) many of the group lost interest in the conversation. Many but not all. I did have a long conversation with one of my friends that I hope was helpful. One positive side effect is a greater feeling of freedom to talk about many elements of my health and wellbeing that I would not have previously addressed in such an open manner. Amusingly, and very openly, I do have one friend whose first question upon meeting me, once I felt sufficiently well enough to go out, was ‘so, have you had a boner yet?’. Less amusingly, perhaps, I hadn’t and still haven’t.
There are, apparently, a number of ways they can remove the prostate. I won’t go into them all but one very important distinction is in how damaging it is to the nerves surrounding the prostate, specifically nerves that control the erectile function. If you are fortunate enough that the margins surrounding the tumour(s) are large enough then they only need to take out the gland itself and, with robotic assistance, this can now be done incredibly accurately leaving everything else somewhat intact. I was in that fortunate position and so the nerves were preserved. This means that whilst I am having difficulty at the moment due to the general stress of having all that go on down there (as the doctors describe it) the prognosis is that normal service should be resumed at some point in the future. No one knows or can say when that will be (or even if) and so, in the meantime, I have to take a course of maximum strength sildenafil to try to get things moving (again as the doctors describe it). I also have a vaccuum pump thing that… well I will leave that to your imagination or you can cast it as far from your mind as you are able, I know I would.
Physically then my rehabilitation is being taken care of but what about the emotional and psychological toll, how am I dealing with that? I should say from the off it is not just I doing that work it is ‘we’ – Anne and me.
In the weeks and months immediately following the surgery any notion of physical intimacy was the furthest thing from my mind. I simply had no interest in it whatsoever. Slowly my libido returned. It was (and is) strange and a little concerning as, physically, there was still nothing going on. We have remained patient. Anne has had 2 significant operations in the past 12 years. She had a hysterectomy and then her chordoma, both very significant procedures, so we have some experience of recovery and of recovering physical intimacy. It can be difficult to address issues that have previously not been issues, things that have come naturally, and, moreover, have been areas we have not developed the language, with which, we need to address them.
“Let’s talk about sex baby” suggested Salt ‘n’ Pepa (who, I just discovered, were an American hip-hop trio and not, as I had always assumed, a pair). “I’d rather not if it’s all the same to you Salt (or Pepa or ‘n’)” reply almost every British couple in their mid 60s. It might be just us (I don’t think it is) that cannot comfortably converse when it concerns conjugal congress but we are trying. Like the rest of our relationship, it’s very much a work in progress.
What the future holds for us sexually, or otherwise, is largely unknown. We are dealing with what today throws at us and we will do the same again tomorrow. As for the elephants, we’ll leave them to Sir David, for now we are focussed on the birds and the bees.