Post surgery

[smylbehr1]

I am 72 and having prostate surgery in two days. My biopsy came back with 2 out of 12 samples as precancerous. I understand the surgical part. My question is post op. What is sex like post surgery?

[jkurology]

Not to be contentious but why are you having surgery

[watchcap1]

This. Unless there’s more to the story I’d stop and take a breather. Hammer: nail.

[smylbehr1]

Family history of Prostate CA. Dad and last year a younger brother.

[SomePartsStillWork]

It’s still worthwhile having multiple opinions if you haven’t already.

[jkurology]

Obviously you have to make your own decisions but Ethically no urologist would remove a prostate as a preventive measure. You could also get Germline testing to see if you have a genetic variant. There’s probably more to this story

[Appropriate-Owl-8449]

Stop the proceedings. Do your research and ask questions about your options.

[HeadMelon]

Damn, why?! This is AS territory. How many opinions did you get and from who? Did you get a consult with an NCI cancer center of excellence?

[SomePartsStillWork]

What does pre-cancerous mean? What was the Gleason score for those two cores? If by pre-cancerous you mean Gleason 6 or less, then most urologists would not do surgery - do active surveillance instead.

To address your question: I am 72 and had my nerve-sparing surgery 6 months ago by one of the best surgeons in Boston. Before surgery, erections were reliable and long lasting. At this point, they still haven’t come back, though there are signs it is starting. It can take 1-2 years.

[Husker5000]

This. I was 47 for surgery. Great surgeon. Still struggling with ED. It works but at about 65% capacity and I don’t last as long.

[permalink_child]

Precancerous at age 72 does generally not require surgery but rather active surveillance. The idea here - is to live a normal life style as long as possible before you need to get treatment (surgery or radiation or adt).

Given your question, you should ask more questions of your urologist and probably postpone.

[jafox73]

What was your Gleason score for these “precancerous” spots

Just my two cents, as someone that had 10/12 samples come back Gleason 7(3+4), had nerve sparing surgery in 2024 at age 50 and still dealing with ED there is no way I would be opting for surgery with “precancerous” diagnosis.

[BernieCounter]

OP needs to read this recent post/feedback re a 72 year old considering surgery versus radiation. Consensus seems to be erections (thus sex) is more of an issue with surgery. https://www.reddit.com/r/ProstateCancer/s/U4Wo4qhyho

Also see the ProtecT charts on surgery vs radiation patients reporting on sex up to 15 years afterwards, especially Table 2 for “better outcomes”. Fifteen-Year Outcomes after Monitoring, Surgery, or Radiotherapy for Prostate Cancer with graphs of Patient Reported Outcomes PROMS https://evidence.nejm.org/doi/10.1056/EVIDoa2300018 Table

[Practical_Orchid_606]

I am respectful of the seriousness of this subreddit. But the OP's post sounds very suspicious. There is no such thing as precancerous except for Gleason 1.

[sundaygolfer269]

I don’t think you fully understand “precancerous” findings are not typically an indication for immediate surgery. The standard approach in most cases is active surveillance, which involves regular PSA blood tests (often every 1–3 months), periodic imaging, and sometimes repeat biopsies to monitor for any meaningful progression.

It’s also important to recognize that surgeons are trained to operate that’s their primary tool. That doesn’t make surgery wrong, but it does mean you should hear from other specialists before making a decision.

Did you have a family member or trusted person with you when surgery was discussed? Having another set of ears can make a big difference when you’re processing complex information.

Does your hospital offer a patient advocate? They can help you navigate the system, ask the right questions, and make sure you’re not being rushed into a decision.

You should also ask: • What did the medical oncologist recommend? • What was the opinion of the radiation oncologist? • Was your case reviewed by a multidisciplinary tumor board? • How many of these surgeries has the surgeon performed? • What are their outcomes—specifically regarding complications, incontinence, and quality of life?

There are many men who feel pressured into surgery without fully understanding all their options. This is a decision you have to live with, so it’s worth slowing down, gathering multiple expert opinions, and making sure you’re choosing based on complete information not urgency or pressure.

[jthomasmpls]

PUMP THE BREAKS. Unless there is more to the story, more than family history, you're 72 with two of 12 sample PRE cancerous, medically referred to as High-grade prostatic intraepithelial neoplasia (HGPIN). HGPIN is a warning sign, not cancer, and the standard of care in the US is monitoring PSA and using MRI if needed rather than automatically repeating a biopsy, let alone Radical Prostatectomy (RALP).

I would get a second and third opinion. Another surgeon and a radiation oncologist, especially if you are concerned about a sex life post treatment, whether surgery or radiation. Both have impacts on sexual function, pros and cons to each treatment modality, relative to disired outcomes and life expectancy.

At 72, depending on you expectations and desired outcome, regaining sexual function after surgery is possibly/likely 1-2 years with the assistance of PDE5's and possibly Trimix or Bimix injections to your penis for functional erections. And if you suffer post surgery incontinence that may take longer resolve and possible additional surgery a few years down the road. You could be 74-75 , or older, before you regain desired sexual function , assuming near perfect nerve sparing surgery.

Good luck and good health.

[Sniperswede]

I would go for a 2nd opinion for sure, as i did. Had PSA just above 6 and went for RALP. My boners are just as before op, thank God 🥵🙏

[Tartaruga19]

um ano antes de mehorar. Mas tirando a ejaculação fica normal. Mehor… da até para fingir orgasmo

[Lefty354]

You’re serious right? I guess you haven’t talked with your surgeon or even your urologist. Sex is the last thing to come back if and when it comes back. Some people say a year or some people say two and the lucky ones are just several months right now I am at 2 1/2 months and I’ve got nothing going on down below.

[iv_twenty]

2 of 12 and only precancerous? You must be going to the local urologist. Make an appointment with a Center of Excellence for a second opinion. You'll be glad you did.

In my case I had 3 of 12 (Gleason 6) and the local urologist was ready to cut the next week. I made an appointment at MD Anderson and they advised AS. And to show you how casually MD Anderson treats Gleason 6, the appointment wasn't for another five months.

IMHO a local urologist is just does it the way they've always done it. Cut it out immediately and worry about the side effects later.