In our third and final installment we are going to discuss the simple changes to your sexual routine that can help after prostate surgery. These techniques can be used with or without the use of medications for erectile dysfunction.

One of the most important things to remember is that after prostate surgery, your husband’s subsequent sexual difficulties can originate from physical or psychological issues, or a combination of the two. Many males feel less of a man after surgery and there is a period where he may wonder if his pride and joy (his penis) is ever going to perform again. Slowing things down and focusing on new methods of arousal will address all of his concerns. Make sure that he is medically cleared for sexual activity.

First Things First
After surgery, most men will take longer to become aroused. This is a great opportunity to try something you may not have done in a while. You may have to romance him to help him feel sexy again. Does he like lingerie? How about giving him a strip tease or a lap dance? How about putting on an adult film?

Now that you are communicating better, use your new verbal skills in the bedroom. Walk him through what you want to do sexually—most men are very literal in their use of language and sexy talk is a big turn on. Remind him of how much you love having a sexual connection and that you want him just as much as before. Reassurance during times of stress goes a long way!

The next step is simple if you have been following our advice. We are always adamant about making sure the female is pleasured first, having at least one orgasm before progressing to intercourse. This is important for her because after climaxing, she will be more lubricated and her body will be more accommodating for penetration. She will also enjoy intercourse infinitely more if she is well lubricated. After prostate surgery, it’s important for a husband to focus on his wife’s pleasure because watching her get turned on and bringing her to climax is visually stimulating! He can feed off of her arousal and focus on the growing passion.

What Next?
Once she is satisfied, he should be getting excited. It is very important to remember that most men post surgery may need a lot more direct genital stimulation to build and maintain an erection. Using plenty of water-based lubricant or a sexual enhancement cream, she should begin massaging his penis in long strokes. Communication here is key. Ask him if it feels good, does he like the pressure and the tempo? As he becomes aroused, start talking sexy, asking if he likes that. Some men may also enjoy the combination of oral and hand play to stimulate the head of the penis, where most of the nerve endings are located. Use your mouth to stimulate the head of the penis while you use one or both hands to stroke the shaft. The urethra is very sensitive, so stroke over the tip of the penis with your mouth or fingers! Many men like to have their balls touched and licked too. This will help him stay aroused as he gets hard.

The choice of what to do now is yours. Some men may want to climax this way, from oral and manual stimulation. Others may want to attempt to move on to intercourse. Regardless of which direction you choose—and if he is having trouble maintaining his erection—try sliding a cock ring over the penis and rolling it to the very base. This soft ring (usually made of silicone, hard plastic or leather) will help trap the blood flow in the penis, keeping him harder longer. Some have bullet vibrators in them for him and her to add extra sensations that many find different and fun. If you don’t have a cock ring, either you or your husband can grab the base of the penis with your fingers and pinch-off the blood flow.

Ready For Intercourse
While we usually are not big fans of the missionary position, it has a few advantages for men post prostate surgery. The biggest one is that gravity is on your side, helping draw blood into the penis and keep it there. We would recommend putting a couple of pillows under her hips, so she is a little closer to him and tipped upward, so his strokes have a shot of hitting her G-spot during intercourse. During intercourse, keep your strokes short and at an active tempo. Deeper thrusts are used to calm down the urge to climax and that’s not what you want here. Constant stimulation to the shaft of the penis keeps the blood in the penis since the muscles of the shaft are engaged.

If you are in the middle of intercourse and you begin to lose your erection, don’t worry; simply use your fingers to grasp the base of the penis (either one of you can do it), preventing blood from escaping. Stay inside your spouse with the head of the penis in the outer third of the vagina so that she can squeeze with her vaginal muscles to help keep him erect and make love: kiss and stroke each other all over and enjoy the journey instead of focusing on the destination. This whole body stimulation and feeding off of each other’s passion should help your erection to rebound and lead you to orgasm. The second great position for keeping the blood in the penis and for keeping access to her clitoris is "doggy style." Try it and see if it works as well for you as the missionary position.

For those of you that are having serious trouble getting hard enough for penetration, use a cock ring or form a ring with your fingers (as described above) to get just hard enough to enter her vagina in the missionary position. This is called "the soft entry technique" and you maintain the erection with your fingers around the base of the penis. Continue thrusting as we described, focusing on the pleasurable sensations and the pleasure you are giving your spouse. Erections will follow your mental focus, so stay locked on the pleasure and let your passion flow through you.

The Future and Beyond
Bear in mind that after prostate surgery, a man’s orgasm will be different. It will probably be dry (no ejaculation) and it may feel different. Don’t concern yourself with comparing your historic orgasms to the ones you will have today and tomorrow. Embrace the way things are and enjoy the ride! You will find that while things may be different, sexual pleasure can be yours again with a little more attention to detail and a lot of communication. Implementing erectile dysfunction drugs may be helpful, since they help increase blood flow to the penis.

We hope these tips help all of you and your spouse in dealing with post-prostate surgery issues. If you continue having difficulties reconnecting sexually, consider meeting with a marriage counselor who specializes in sexual issues or a sex therapist. Remember, great sex in marriage is about celebrating a great love affair. As we age and our bodies change, sex changes and we may need to adapt. With creativity, patience and love, any challenges can be overcome and bring you closer. Celebrate your love sexually, no matter what that looks like now, and your relationship will be stronger for it.

RELATED ARTICLES
Reconnecting Sexually After Prostate Surgery
Part 2: Reconnecting Sexually After Prostate Surgery

Dr. Joni Frater & Esther Lastique are the founders of www.SexEdBootcamp.com and the authors of "Love Her Right: The Married Man’s Guide to Lesbian Secrets for Great Sex!"