sexual health information for men with cancer · the penis is stimulated, a message is sent to...
TRANSCRIPT
Sexual Health Information for
Men with Cancer
Sym
ptom
Man
agem
ent
2
Table of Contents
The Male Reproductive System
5 Managing Erection ProblemsVacuum Erection Devices . . . . . . . . . . . . . . . . . . . 9
Oral Medicine for Erections. . . . . . . . . . . . . . . . . 12 Penile Injections . . . . . . . . . . . . . . . . . . . . . . . . . 15 InflatablePenileProsthesis. . . . . . . . . . . . . . . . . 19 EnjoyingSexWithoutaFirmErection . . . . . . . . 23 ExternalPenileProsthesis . . . . . . . . . . . . . . . . . 25 Questionstodiscusswithyourpartner . . . . . . . . 27 Whatoptionsareyouwillingtotry? . . . . . . . . . . 28
29 Managing of Incontinence and Leaking UrineHowtodopelvicfloorexercises . . . . . . . . . . . . . 30
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3
The Male Reproductive System
Thisinformationwillhelpyouunderstandhowthemalereproductivesystemworks(beforetreatment)andsomeofthewordsyourdoctororhealthcareprovidermightuse.
Aman’sgenitals(thepenisandscrotum)areoutsidethebody.Thescrotumcontainsthetesticles,whichmakespermandtestosterone.Whenamanejaculates,spermtravelsthroughatube(vasdeferens)totheprostategland.White,milkyfluidcalledsemenisaddedandittravelsdowntheurethraandoutthepenis.
Whenamanhasavasectomy,thevasdeferensiscutandtied.
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What is testosterone?Testosteroneisahormonethataffectssexdriveandinterestinsex.Thetesticlesmakespermandtestosterone.Sometestosteroneisalsomadebytheadrenalglands.
Testosterone normally decreases as men get older. Testosteronecanalsodecreaseforashorttimeifamanisdepressed,stressed,sick,orgetshurt.
Testosteronereplacementisatreatmentforlowtestosterone.Ifyou’vehadtesticularcancerandhadoneorbothtesticlesremoved,askyourdoctorabouttestosteronereplacement.
Will cancer treatment affect my testosterone? Somecancertreatmentsstopthebodyfrommakingtestosterone.Forexample,androgendeprivationtherapylikeEligard®,Casodex®,orhavingthetesticlesremovedcandothis.Ifyouhavequestionsabouttestosteronereplacement,talktoyourdoctororhealthcareprovider.
Youdon’tneedtestosteronetohavesex,butitdoeshelpyougetaroused,haveanerection,andhaveanorgasm.Menwithouttestosteronecanstillhavesex,butitcanbechallengingwithalowsexdrive.Whentestosteroneisdecreased,manymenaren’tasinterestedinsex.
Sometimesmenstopbeingsexualandsometimestheyevenstopbeingaffectionate.Thiscanhappenbecausetheycan’thavesexorbecausethey’velosttheirsexualdesire.Ifthishappenstoyou,rememberyourpartnermightstillbeinterestedinsexand/orbeingaffectionatelikehuggingorcuddling.Yourpartnermightnotsayanythingaboutthisbecauseheorshedoesn’twanttoputpressureon you.
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Somecouplesaren’taffectediftheydon’thavesex.It’simportanttotalkaboutsexorotherwaystobeintimatesoyouknowhowyourpartnerfeels.Yourpartnermightwanttotalkaboutwaystobesexualorheorshemightbeokaywithnothavingsex.
Therearewaystoimproveyoursexlifeandbeintimatebylearningmoreaboutimprovingyoursexualdesireanderections.
Managing Erection Problems
What is an erection? Whenamanhasanerectionbloodflowstothepenis,whichmakesithard.Manymenhaveerectionproblems(erectiledysfunction,impotence)astheygetolder.
Someoftheseproblemsinclude:• troublegettinganerection• thepenisisn’tashardasitusedtobewithanerection• erectionsdon’tlastaslongastheyusedto
Mencanstillhaveorgasms,eveniftheydon’thaveanerection.Duringsexualtouchingorstimulation,amancanstillhaveanorgasm,evenifthepenisisn’thardenoughforintercourse.It’snormalformentohavedifficultywitherections on occasion. Erectile dysfunction gets more common as men get older.
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What happens during an erection?Theprostateglandhasabundleofnervesaroundit.Whenamangetsturnedon(isaroused)orinterestedinsex,orthepenisisstimulated,amessageissenttothesenervesthatmakesbloodflowtothepenis.Thetissueofthepenisislikeasponge,whichcanabsorbblood.Whenthisspongytissuefillswithblood,thepenisgetshard.
Whenmenhavepelvicsurgeryorpelvicradiation,thesenervesareoftendamaged.Aftersurgery,thenervesmightbebruisedorinflamed.Thesenervescanheal,butit’saslowprocessthatcantakeupto2years.Ifthenervesarecut,theywon’tgrowbacktogetherandthedamageislikelypermanent.
Mencanstillenjoyhavingtheirpenisorgenitalareastimulatedandtheycanstillhaveanorgasm,eveniftheydon’tgetanerection.Cancertreatmentsdon’tdamagethenervesthatcontrolorgasmsorfeelingsinthepelvicareaandpenis.
What causes erection problems?Erectionproblemscanbecausedby:
• bloodvesselproblems• nerveproblems• heartdisease• diabetes• smoking• cancertreatmentsinvolvingthepelvis,suchaspelvic
radiationtherapy,orpelvicsurgery• depression,anxiety,orstress• drinkingtoomuchalcohol
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Chemotherapycanalsoaffecttheabilitytohaveanerectionbecauseitcanaffectsexualdesire.Ifthishappens,sexualtouchingmightbeneededbeforeanerectioncanhappen.Ifyou’rehavingtroublewithyourinterestinsexorerectilefunction,thinkabouterectionsinadifferentway—asaresponsetosexualtouch.Erectionsmayhappenwithsexualtouchinginsteadofontheirownwhenyouthinkaboutorfeeltheurgetohavesex.(Formoreinformation,seethe Low Sexual Desirebooklet).
How does an orgasm happen?Whensomenervesarestimulated,itgivesthebodyafeelingofpleasure.Forexample,whenthepenisistouchedinasexualway,amanfeelspleasure.
Manypeoplethinkejaculationandorgasmarethesamething—theyaren’t.Sometimesaftersurgeryorpelvicradiation,someofthenervesaredamagedandsomeofthenervesaren’t.Evenifnervesaredamaged,amancanhaveanorgasmwithouthavinganerection.Thisisbecausethenervesthathelpamanfeelpleasurearedifferentthanthenervesthatcauseanerection.
Iftakingpartinsexualactivities,likestimulatingthepeniswithahand,andyourpenisisn’thard,it’sagoodideatousealubricant.Ifyoudon’t,thefrictioncanbepainfulandyoumightnotenjoyitasmuch.
Iftheprostatehasbeenremoved,amancanstillhaveanorgasm,buthewon’tejaculate.Thisiscalledadryorgasm.Somemensaythatthequalityoftheorgasmisdifferent,butmanymensayit’sjustasenjoyable.
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What is ejaculation?Menejaculatewhentheyorgasm,whichcausesfluidtocomeoutofthepenis.
Ifmenhavehadtreatmentforprostatecancer,theytypicallynolongerejaculatesemen.Theglandthatmakestheliquidpartofsemenisremovedduringsurgery,andisdamagedduring radiation.
Anorgasmisdifferentthanejaculation.Formostmen,thesehappenatthesametime,butamancanhaveanorgasmwithoutejaculating,whichiscalledadryorgasm.Ifamanisunabletoejaculatesemen,thenitmeansheisinfertile.
If I have trouble with erections, are there treatments?Therearemanywaystotreaterectiledysfunctionincluding:
A. Vacuum Erection Devices
B. Oral Medicine for Erections
C.Penile Injections
D. PenileProsthesis
E. SexWithoutaFirmErection
F.ExternalPenileProtheses
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Vacuum Erection DevicesA
Vacuumdevicesarecylinder-shaped,externalpumpsputoverasoftpenistomakeithard.
How does a vacuum erection device work?Youusealubricanttocreateasealbetweenthecylinderandtheskin.Whenyoustartpumping,theairinthecylinderisremoved.Thiscreatesavacuumaroundtheoutsideofthepenis.Thepressurepullsbloodintothepenis,whichmakesitswellandgethard.
Oncethepenisishard,putarubberretainingringonthepenisbeforeyoutakeoffthepump.Thisisnotharmful.Youcanleavetheringonforupto30minutes,butnolonger.
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What if I want an erection longer than 30 minutes? Ifyouwanttohaveanerectionforlongerthan30minutes,youneedtotaketheringoffforafewminutessothebloodflowsnormally.Afterafewminutes,usethepumpagaintomakethepenishardandputtheretainingringbackonfor30minutes,butnolonger.
Will the erection look normal?• Theskinofthepenismaylookdarkerorblueand
mightfeelcool.• Theerectpenismightmovemorefromsidetoside
thannormal.• Thepenismayhangerectfromthebodyinsteadof
standinguperect.Sometimesthismakesthepenisslipoutduringintercourse.Youandyourpartnermightneedtoadjustthewayyouthrustduringsex,ortrydifferentpositions.
• Somemengetafirmererectionifthedeviceisusedafterforeplaythatmightstimulateapartialerection.
• Itwon'tchangehowtheskinonthepenisfeels,ortheabilitytofeelanorgasm.
• Manymenfindthattheringclosesofftheurinarytube,whichmeansthatnofluidcomesoutduringanorgasm.Ifthishappens,itwilllikelydripoutwhenthering is removed after sex.
Are there side effects when the vacuum device is used? Whenyouuseavacuumdevice,youmightgetmildbruisingonthepenis.
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Where can I buy a vacuum device? It’sagoodideatobuyamedicalqualitydevice.Youcanbuythemonline.CallPsychosocial&RehabilitationOncologyinCalgaryat403-355-3207tolearnmoreaboutusingvacuumdevices.Youcanattendateachingsessionwithstaffinthisdepartmentandalsoaccessthedevicefromthere.
Tips for Using a Vacuum Device• It’simportanttohavesupportfromyourpartnerif
youchoosethisoption.It’salsoagoodideatohaveforeplaywithyourpartnerbeforeandafteryouusethevacuumdevice.
• Practiceusingthedeviceforafewweeksbeforeyouuseitforsexualactivity.Ifyouhavequestions,callthemanufacturer—there’susuallyanadviceline.
• Youcanbuymanydifferenttypesofrings.Trydifferentonestofindoutwhatyoulike,whatyou’recomfortablewith,andwhatsizeisrightforyou.
• Thinkaboutaskingyourpartnertohelpyouusethedevice.
• Beforeintercourse,warmthepeniswithawarmclothorhandmassage.
• Talkaboutandmakesureyourpartnerunderstandsthatyou‘restillattractedtohimorher,eventhoughyouneedthedevicetogetanerection.
• Trysomeforeplayonyourpartnerafteryouusethedeviceandbeforeyoustartintercourse,sothatsexualexcitementstayshigh.
• Somepartnersfeelcomfortabletouchingthemselveswhileyouusethedevicetostaysexuallyexcited.
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Oral Medicine for ErectionsB
Therearetypesofmedicinetakenbymouthforerectionproblems,whichinclude:
• Viagra® • Cialis®• Levitra® • Staxyn®
How does medicine taken by mouth work for erections?
Amantakesapillbeforehewantstohaveanerectionforsex.Thepillsworkbyincreasingachemicalthathelpsbloodflowtothepenis.Ittakesatleast30minutestowork.Mostmedicationslastupto4hours,exceptCialis®whichhasboththedailydoseversionandalsoalongeractingpillthatcanlastfor48hours.
Thesetypesofmedicinehavenoeffectonsexualdesireorinterestsotheerectionwillnotjusthappenonitsown.Afterthepillistaken,themanneedstogetsexuallyexcited(mentally)andstartforeplay(suchastouching)togetanerection.Thesetypesofmedicineworkforabout7outof10men.
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Checkwithyourdoctororpharmacistbeforeyoutakeanytypeoferectionmedicine.Don’ttakeerectionmedicineifyoutake:
• nitratemedicine(suchasnitroglycerin)forheartdisease
• alpha-blockerstolowerbloodpressureandtreatenlargedprostateglands
Will oral medicine work for me? • Ifyou’vehadothertypesofcancerthanprostateand
somedegreeoferectiledysfunction,pillsmighthelp.Youmightneedtotakethemlong-term(orforweeksormonths),untilyoucangetanerectionagainonyourown.Confidencecanplayabigpartwitherectilefunction.Ifyoudon’tbelieveyou’llgetanerection,youmightnotgetone.Sometimestakingerectionmedicinehelpsmakeyoumoreconfidentandisonlyneededshort-term.
• Oralmedicineforerectionsusuallyworksbestformilderectionproblems.Talktoyourhealthcareproviderifyouhaveanyquestionsabouterectionproblems.
• Ifyou’vehadyourprostateremoved,thesetypesofpillsmightnotworkforyouinthefirstyearaftersurgery.Theymayworkforyouifyoursurgerywasanerve-sparingprocedure.Thepillsmayworkbetterafteraman’snaturalerectionshavehadtimetorecover—about12to24monthsaftersurgery.
• Ifyou’vehadradiationforprostatecancer,thepillsmighthelpatfirst,butmaynotworklong-term.
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What are the side effects of erection medicine? Sideeffectsmayinclude:
• headaches• flushingintheface• upsetstomach• yourvisiongoingblueforashorttime(Viagra®only)• youreyesbeingsensitivetolight• nasal congestion
Don’teatheavy,high-fatmealswhenyoutakethistypeofmedicinebecauseitmaynotworkaswell.Ifyouhaveanyquestionsaboutthemedicine,talktoyourdoctororpharmacist.
Where can I get erection medicine? Youneedaprescriptionfromyourfamilydoctororoncologist.Thesetypesofmedicinearenotusuallycoveredbymostbenefitplans.Talktoyourinsurancecompanytofindoutaboutyourcoverage.
Tips for Taking Erection Medicine
• Trythemedicineafewtimesbecauseitdoesn’talwaysworkwellthefirsttime.
• Ifyou’vehadpelvicsurgery,askyourdoctorhowlongyouhavetowaitbeforeyoutrythistypeofmedicine.
• Tellyourpartneryou’retakingerectionmedicineandthatit’ssafeforyoutouse.Don’ttrytohideit.
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Penile InjectionsC
Amancangetanerectionwhenmedicineisinjectedintotheshaftofthepeniswithaveryfineneedle.Thismedicineisonlyprescribedbyspecialists(usuallyurologists).Notallmencanusethesetypesofmedicine.Talktoyourdoctortoseeifthey’rerightforyou.Thesetypesofmedicineinclude:
• prostaglandinE1likeCaverject®orEdex®(mostcommon)
• phentolamine
• papaverine
Ifyou’vehadprostatecancer,bladdercancer,colorectalcancer,orsurgeryorradiationtothepelvis,thistreatmentmightbethebestoptionforyou.Injectionscanworkevenifyou’vehadtheprostateremovedandthenervesthatcauseerectionsaredamaged.Ifyou’vehadsurgery,usuallyjust a smalldoseofmedicinewillgiveyouafirmerection.Ifyou’vehadradiation,youmightneedahigherdosesincesomeofthebloodvesselsmaybedamaged.
How do the injections work? Amaninjectsthemedicineintohispenisabout 10to15minutesbeforehewantstohaveanerection.Themedicinemakesthepenisswell(withoutphysicalstimulation)bycausingbloodtoflowtothearea. Withforeplayorwhenamanisexcitedaboutsex,theerectionwilllikelygetharder.Theerectionusuallyhappenswithin10to15minutesoftheinjectionandwilllast30 to 60 minutes.
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Theerectionmaynotgodowncompletely,evenafteran orgasm. If the erection lasts longer than 2 hours after the injection, call your doctor right away. If you can’treachyourdoctor,gotoanurgentcarecentreoremergency room.
Theideaofinjectingmedicineintothepenismightnotsoundappealing,butmostmensaythepainisn’ttoobad. Yourdoctorwillteachyouhowtodotheinjectionandthefirstonewillbegivenatthedoctor’soffice.It’sveryimportanttodotheinjectionthewayyourdoctortaughtyou—onthesideofthepenis,towardsthebottom.Theneedleisputrightintothepenisata90°angle.
Onlyuseinjectionneedles1timeandthenthrowthemaway.Youcanbuyneedledisposalcontainersatadrugstoreoruseanoldbleachbottletostorethem.
https://edpostprostatehelp.wordpress.com/treatment-options/penile-injection/
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Ifyou’rehavingtroubleinjectingyourself,thinkaboutaskingyourpartnertolearnhowtodotheinjectionfromyourdoctor.Youcanbuypenileauto-injectors,whichmightmakeiteasier.Ifyouareinterestedinthis,talktoyourdoctororhealthcareprovider.
Themedicinemustbestoredinthefridge,whichmakesithardtouseifyou’retravelling.
What are the side effects of the injection? Themostcommonsideeffectsoftheinjectionare:
• achinginthepenis(feelslikepinsandneedles)• aburningfeelinginthepenis• bleedingattheinjectionsite,whichcancausea
bruise—topreventthis,pressfirmlyontheinjectionsitefor5minutesaftertheinjection
Long-termeffectsarerare.About3to10menoutof100developscarringonthepenis.Mildscarringmightfeellikesmalllumps,butseverescarringmightmakethepeniscurvewithanerection.
What if my erection lasts longer than 60 minutes? Anerectionwillrarelylastforlongerthan4hours,butwhenitdoes,it'scalledpriapism. If your erection lasts longer than2hoursafteryou’vehadsex,seeadoctorrightaway.Thismighthappenifthedoseofmedicineistoohighforyou. Don’t increase your dose of medicine unless your doctortellsyouto.Don’tinjectmorethan1timeaday.It’sbesttowait48hoursbetweeninjections.
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Where do I get the medicine? Youneedaprescriptionforthemedicineandyoualsoneedahealthcareprovider,suchasaurologisttoteachyouhowto inject it. You need a referral from your family doctor or oncologisttoseeaurologist.Thesetypesofmedicinearenotusuallycoveredbymostbenefitplans.Talktoyourinsurancecompanytofindoutaboutyourcoverage.
Tips for using the injection
• It’simportanttohavesupportfromyourpartnerifyouchoosethisoption.It’salsoagoodideatohaveforeplaywithyourpartnerafteryougivetheinjection.
• Iftheinjectiondoesn’tworkwellthefirsttime,waitatleast48hoursandtryagain.
• Alwaysusethedoseofmedicinethatyourdoctortells you to.
• Mendon’tusuallysaytheneedleistoopainful,butsometimestheerectionitselfmaybepainful.Ifyouhavepainusingtheinjectionsandit’swithinthefirst6monthsaftersurgery,youmaywanttowaitafewmonthstotrytheinjectionagain.Itwilllikelyhurtlessthelongeritissinceyouhadyoursurgery.
• Talkaboutandmakesureyourpartnerunderstandsthatyou‘restillattractedtohimorher,eventhoughyouneedtheinjectiontogetanerection.
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What if I’ve tried different types of medicine and they don’t work?Ifyou’vetrieddifferenttypesofmedicinetohelpwitherectionproblemsandtheyhaven’tworkedwellforyou,thereareotheroptionsincluding:
• inflatablepenileprosthesis(IPP)• sexwithoutafirmerection• penispump/vacuumerectiondevicewithrubber
retaining ring
Inflatable Penile Prosthesis (IPP)D
AnIPPisapumpsystemimplantedintothepenis.Surgeryisneededtoputthepumpsystemin.IPPsareinflatedsothey’reerectforsex,anddeflatedsothey’resofttherestofthetime.
Thereare2companiesthatmanufacturetheseimplants.Theycomeinself-contained,2-pieceor3-pieceversions.Themorecomplextheimplant,thefirmerandlargertheerectionwhenit’sinflated,andthesofterandmorenaturalthepenisiswhenitisn’tinflated.However,themorepartstheimplanthas,themorelikelyitistobreakdown.
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Togetanerection,amanpressesonasmallpumpthatmovesfluidintothecylindersinthepenis.Thepenisdoesn’tdeflateafterorgasmuntilareleasevalveispushed.Youcan’ttellifsomeonehasapenileprosthesis,unlessyouseethesmallscaronthebottomofthepenis.
How does the IPP work? AllIPPsaresimilar.Theyallhave2cylindersandapumpsystemthatareputinthepenisandthesurroundingarea.Whenthey’reempty,thepenislooksandfeelssoftandhangsdown.Whenthey’refilledwithfluid(salineorsaltwaterthatstaysinthepumpsystem),thepenisgetsbiggerandhard.
Therearedifferentkindsofpumpsystems,buttheyallworkthesameway—fluidispumpedintothedevicetomakethepenishard.TheIPPmakesanerectionthat’sjustlikeanatural erection.
http://www.soc.ucsb.edu/sexinfo/article/erectile-dysfunction-causes-symptoms-treatment
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Manymensaythesizeoftheerectionisshorterthanwhat’snormalforthem.Thisdoesn’tusuallymattertotheperson’spartneranditdoesn’tusuallyaffectapartner’sorgasmwithintercourse.
Ifthisisaconcernforyouandyourpartner,trydifferentsexpositions.Forheterosexualcouples,trywiththewomanontopasitincreasesfrictionagainsttheclitorisandmakesiteasiertohaveanorgasm.Forsamesexcouples,it’ssafetotrydifferentpositionstostimulatethepartner’sprostate.
What can I expect with an IPP?• Whentheprosthesisisn’tinflated,thesoftpenisisa
littlefullerthannormal,butitlooksthesame.• Itdoesn’tchangehowtheskinofthepenisfeelsora
man'sabilitytohaveanorgasm.• Amanstillejaculatesandpassesurinethesameway.• Onceaprosthesisisputin,amanwillneverbeable
togetanerectionwithoutinflatingit.• Iftheimplantisremoved,themanwon’teverbeable
tohavenaturalerections.
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Who can get penile prostheses? IPPsareusedforhealthissuesthataffecterectionproblemswhentherearenoothertreatmentoptions.Onceaprosthesishasbeenputin,amancan’thaveanerectionwithoutit.Thismeansitwon’tworkformenwithstress-relatederectionproblems.It’sbesttogetcounsellingforthesetypesofproblemsorjustgiveittime.
Ifamanhashadaradicalprostatectomyforprostatecancer,heneedstowaitatleast2yearsbeforehavingsurgerytogetanIPP.Thisistoseeiftheabilitytohaveanerection will recover.
What are the side effects of the implant? • Implantsworkwellabout9timesoutof10.About1in
100menhavemechanicalproblemswiththeIPP(forexample,partofthedevicespringsatinyleak).Theseproblemscanoftenbefixed.
• Menrarelygetaninfectioninthefirstfewdaysaftersurgery(about2outof100men).Ifthishappens,theIPPhastoberemoveduntilitheals.
• It’sbesttochooseasurgeonwhohaslotsofexperienceputtinginIPPs.
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Enjoying Sex Without a Firm ErectionE
Manycoupleskeephavingsex,evenifthemancan’tgetafirmerection.Peoplecanstillhaveorgasmswithcaressing,oralsex,orothertypesofstimulation.
Thinkabouttryingasextoy,suchasavibrator.Avibratorworkswellifyou’retiredorifyougettiredusingyourhandstostimulateyourpartner.Youcanalsoliefacingyourpartnerandrubyourgenitalsagainsteachotheroruseavibratorbetweenyou.Makesuretouseagoodlubricanttomakeitfeelgoodanddecreasepainfromfriction.
Tips for Using an IPP • It’simportanttohavesupportfromyourpartnerif
youchoosethisoption.It’salsoagoodideatohaveforeplaywithyourpartnerbeforeandafteryouusetheIPP.
• TellyourpartneryouhaveanIPP.Don’ttrytohideit.• Don’tusetheIPPuntilyou’rehealedfromyour
surgery.Yoursurgeonwilltellyouwhenit’sokaytohavesex.
• ThinkaboutgettingyourpartnertoinflatetheIPPaspartofforeplay.Beforepenetration,warmthepeniswithawarmwashclothorhandmassagewithalubricant.
• Talkaboutandmakesureyourpartnerunderstandsthatyou‘restillattractedtohimorher,eventhoughyouneedthedevicetogetanerection.
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Manypeoplethinkthatsexwithpenetrationistheonlywaystohavesex.But,mostcouplesusetouchingandcaressingaspartoftheirroutine.Whencouplescan’thaveintercoursebecauseoferectionproblems,manygiveuponsex,butotherscontinuetohavesexinotherways.Thinkabouttryingsomethingnew. Thereisnoriskwhenlearningtoenjoysexwithoutafirmerection.Somepeoplemayfeelthisoptiongoesagainsttheirreligiousbeliefsorvalues.Ifthisisaconcernforyou,talktoyourhealthcareprovider.
Where can I buy sex toys? Youcanbuysextoysatsexpositiveadultstoresoronlinesuchas:alittlemoreinteresting.com,pinkcherry.ca,oramazon.ca.
Tips for Having Sex without a Firm Erection• Trydifferentwaystocaresseachotherthatyou
haven’ttriedbefore.Trythingsmorethanonceiftheydon’tworkwellthefirsttime.
• Makesureyouunderstandyourpartner’sbody,andwhereandhowtheyliketobetouched.Mostwomenliketohavetheclitoristouchedandcaressed.Talktoyourpartneraboutwhatyoulike.Beopentotryingnewkindsoftouch.
• Ifyouoryourpartnerhasahardtimereachingorgasm,thinkaboutusingavibratorwhenyouhavesex.
• Addinnewwaystoincreaseyourexcitementlikethinkingaboutasexualfantasyorreadinganeroticstorytoeachother.
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Researchshowsthatmanypeoplefindusingexternalprosthesesforintercourseverysatisfying.Thisoptionmightnotberightforeveryone.
Todothis,adildoandpelvicharnessareused,whichyoucanbuyatadultsexstoresoronline.Thedildositsintheharnessjustlikeanerectpenis.Thepelvicharnessholdsthedildoon,rightabovethesoftpenis.Thecouplecanthenhavepenetrativeintercourse.
• Usealubricantwhenstimulatingthepenisbyhandorwithavibrator.
• Thinkaboutmasturbating(onyourownorwithyourpartner).Thiscanhelpyouknowhowyoulikebeingtouchedbest.Sometimes,thiscanchangeaftersurgeryorcancertreatment.Talkabouthowyouliketobetouchedwithyourpartner.Also,anythingthatincreasesthebloodflowtothepenishelpskeepthetissuehealthy,includingmasturbation.
External Penile ProsthesisF
http://www.lovelifeandintimacy.com/
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Getintoapositionjustlikeyouwouldforregularintercourse.Thrustjustlikeyouwouldforpenetrativesex. Yourpartnercangetpleasuredirectlyfromthistypeofintercourse,butyou’llneedtobestimulatedwithyourpartner’shandtofeelpleasureinthepenis.
Ifthesoftpenisiscaressedwiththepartner’slubricatedhand,themancanhaveanorgasm.Havingthepenisstimulatedandthepelvicmovementswithintercoursecanmakeitpleasurableforthemanwearingtheprosthesis.Manymensaythisfeelsjustlikeregularsex.
How does this type of sex work? Withtherightstimulationandthemusclememoryofpelvicmovementsduringsex,apersoncanactuallymakethebrainthinkit’shavingpenis-in-vaginasexorpenetrativeintercourse.
Therearenoriskswiththistypeofintercourse,butsomepeoplemayfeelthisoptiongoesagainsttheirvaluesoreventheirreligiousbeliefs.Ifyouhavequestionsorconcerns,talktoyourhealthcareprovider.
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•
Possible questions/topics you can discuss with your partner:
• Howdowefeelaboutusingorexploringerectileaidsand/orsextoys?
• WhatshouldwedowhenyougetarousedandIdon’t?• Areyoucomfortablewithoneofusreachingorgasm
eveniftheotherdoesnot?• IsitokayifIbringyoutoorgasmthroughtouchingor
oralcaressingevenifIdonothaveafullerection?• Whatkindsoftouchingdoyoumostenjoynow?• ThesearethekindsoftouchthatImostenjoy
now……..
Tips for Having Sex with an External Penile Prosthesis
• Talkabouttheseideaswithyourpartneraheadoftime.Makesuretotalkaboutyourcomfortlevelandworriesyoumighthave.
• Makesureyouandyourpartnerarebothwillingtoexploreanewwayofbeingsexual.
• Gotothesextoystoretogetherorgoonlinetogethertobuytheseproducts.
• Useawater-basedlubricantforstimulatingasoftpenis.
• Trydifferentpositionsforsextofindwhat’smostcomfortableforyouandyourpartner.
• Beopentotryingnewthings.Evenifyoudecideyoudon’twanttotrythemagain,you’vebondedwitheachotherovertryingsomethingnew.
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What options are you willing to try?
OptionHow willing are you to try it? (Circle one)
How willing is your partner? (Circle one)
Why?
Non-penetrative sexual activity (touching, oral sex)
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Experiment with sex toys
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Oral medications
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Vacuum erection device
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Penile injections
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Inflatable penile prosthesis
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
External penile prosthesis with harness
1=willing to try2=unsure3=not willing to try
1=willing to try2=unsure3=not willing to try
Other
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Managing Incontinence and Leaking of Urine
What is urinary incontinence?Urinaryincontinenceistheaccidentalreleaseofurine.It’scommonforpeopletolosesomebladdercontrolaftertreatmentsforcancerofthepelvis,suchasradiationorsurgery.Thiscanbeembarrassinganddisruptdailyactivities.Evenifyouhavegoodbladdercontrolduringtheday,youmightstillhaveincontinencewhenyousneeze,cough,orlaugh(stressincontinence).What causes stress incontinence?Stressincontinencehappenswhenthemusclethatholdsthebladder’soutletclosedisn’tstrongenoughtoholdbacktheurine.
How is incontinence treated? Therearetreatmentsforincontinenceandwaystohelpyoumanageitathome.
How long does incontinence last?Afterpelvicsurgery(e.g.,forprostatecancer),manymenhaveincontinenceforatleast3months.It’susuallybetterafter6months.Incontinenceusuallygetsworselaterinthedaybecausethemusclesinthepelvicfloorgettired.
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What is pelvic floor physiotherapy?Exercisesyoucandotostrengthenyourpelvicfloor.Whenthemusclesinthepelvicflooraretightened,itshouldfeellikeyou’retighteningthesamemusclesyouusetostoptheflowofurineorpassgas.Itfeelslikeyou’reliftingthescrotumupandinward.Whenthemusclesarerelaxed,itshouldfeellikewhenyourelaxtopassurine.Pelvicfloormusclestrengthisanimportantpartofbladdercontrol.Strongpelvicmusclescanhelpdecreaseincontinence,helpthebladderholdurinewhenyoufeeltheurge,andmakehardererections.Ifyoudopelvicfloorexercisesregularly,incontinencemaygetbetterafteracoupleofmonths.Ifsymptomsdon’tgetbetter,seeyourdoctor.Forinformationonfindingaphysiotherapistnearyou,visit:physiotherapyalberta.ca.
How to do pelvic floor exercises:
1. Emptyyourbladderandgetintoasittingposition.2. Tightenyourpelvicfloormusclesasstronglyasyou
can,thenletgo.Itshouldfeellikeyou’reliftingorpullingthatareaup.Don’ttightenthemusclesinyourstomachorbuttocksanddon’tholdyourbreathwhileyoudothetightening.
3. Holdthetighteningfor3seconds,5seconds,or10 seconds. Hold it only as long as you can fully holdit.It’sbettertodoafewreallygoodtighteningexercises,thanmanythataren’tfullytightened.
4. Repeatthis10times.Themoreyoupractice,themoremusclestrengthyou’llbuildup.Ifyoukeepdoingtheexercises,eventuallyyou’llbeabletoholdfor 10 seconds.
5. Trytopracticetheseexercisesduringtheday.Youcandotheexerciseswhilesitting,standing,lyingdown,orwalking.Yourmuscleswillgetstrongerifyoudotheexercises3to5timeseveryday.
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How do I manage incontinence and sex?Somecouplesstrugglewithurineleakingduringsex.Theseideasmighthelp:
• Layatoweloutonthebedbeforesex—ifurineleaks,thetowelwillabsorbit.
• Keepawarm,wetclothnearyouforeasycleanupifneeded.
• Rememberthaturinedoesn’thaveanygermsinit,soitisn’tharmfulifitleakswhilehavingsex.
• Tryhavingsexintheshowerorbath.• Useanerectionring(likethekindusedwithavacuum
erectiondevice)tohelppreventleaking.• Evenwhenmenhavegoodcontrolofthebladders
duringtheday,theymightstillleakurinewhentheybecomearousedorhaveanorgasm.
What if my incontinence isn’t getting better? Somemenwithseverestressincontinencemightneedsurgery.Yourdoctormightwantyoutowaituntilafteryourcancertreatmentstohavesurgery.Manydoctorsrecommendwaitingatleast1yearbeforehavingsurgeryforincontinence.Yourdoctorwilltellyouwhatsurgeryisbestforyou.
Thedifferenttypesofsurgeryforincontinenceinclude:• artificialsphincter• urethralbulking• bulbourethralsling:aslingisputundertheurethrato
supportitandisattachedtomuscleorthepubicbone• electrical stimulation
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SymptomManagement|SexualHealthInfoforMen|Prov|2016|B0082
DevelopedbyDr.L.Walker&Dr.J.RobinsonandapprovedbymembersofOASIS(OncologyandSexuailty,IntimacyandSurvivorship)
Cancer Patient Education