The Possible Struggles of a Male Urostomate

The Possible Struggles of a Male Urostomate

Here is a post written by a gentleman with a urostomy for the gentlemen with urostomies about impotency and how you can work around this. Thank you, Trevor Harvey, for your honest and raw account on a subject I would not do it justice

 Birds do it bees do it even educated fleas do it lets do it lets make love 2

Sadly it has been taken away from us; that have had a Prostatectomy along with our Cystectomy. They now call it Erectile Dysfunction [yet another politically correct statement to blight our lives] actually for us it should be ERECTILE NON  FUNCTION. But wait they tell us there are solutions to the problem, that help is available!

Some things are over forever; if we have not pre-empted or been warned in advance and asked for our sperm to be frozen in a sperm bank, we are never going to be fathers again, for most of a certain age this will be of no great consequence. However, any young person intending to be a father must consider this aspect of the outcome. It is not that we can not manufacture sperm anymore only that we can no longer ejaculate.

So why can't we obtain an erection on demand as before? Providing the blood flow was good before the prostatectomy was performed [and this is what is meant by Erectile Dysfunction with those not having this surgery] and providing the blood flow has been left intact, there is no reason why an erection isn't possible.

The prostate is a very complicated organ, the size of a large walnut with the urethra travelling through the centre. To make it easier to understand, the prostate is like an electrical junction box with many wires {nerves} entering and leaving to do many complicated functions. When the prostate is removed not only do the messages from the brain not get to the intended parts to give instructions and create the intended functions the communications stop short where the surgery finished.

The potential ability to obtain an erection we should still have [barring any problems mentioned previously] an erection itself is quite a simple mechanism. Blood flow under pressure into a sponge-like material is what is required, called Spongiosum this runs the full length of a penis [It does look like a natural sponge] Anyone with rudimentary knowledge of hydraulics will understand the principle, it's a bit like lifting the bucket on a mechanical digger, that uses oil under pressure to do the lifting. During surgery to remove the prostate the ability to allow this flow under pressure to be maintained and not draining back out, has been removed, here basically the problem lies.


After the initial recovery period our thoughts might turn back to our loving relationships, of course, this has not gone away, but the fulfilling aspect is likely to be problematic. Although penetration is not to be taken as the whole answer, as even a flaccid penis is capable of some of the feelings we had before and a loving relationship should give the desired effects.

My advice is do not rush to put things right as you may be very disappointed with the results and you may have to put up with a diminished sense of feeling, which may improve over time. While the feeling may well improve over time it might never be the same as before, this is partly due to the fact that ejaculation is no longer possible and this was a part of the feeling we had before this surgery.

However when ready make an appointment with your GP and ask to be referred to the ED clinic. Most hospitals have one, just remember GP's have heard it all and seen it all so no need to be embarrassed to ask for this help.

I have seen many claim to have had "nerve-sparing" this may well have started in the USA where additions can be put on the medical bill to increase the overall cost through medical insurance. A lucky few may in fact still have the ability to have an erection afterwards, in some cases such as Neo Bladder/Indiana Pouch that can still be connected to the urethra and prostate retained, this may happen if Cancer is not the reason for the surgery.

However the statistics reveal of the Nerve Sparing Surgery performed only some 30 % of men will have function of some kind and may still need help, this may be less severe than in others that have a Prostatectomy, but nothing can be guaranteed.

1) I do not know when they will learn at these clinics but in the first instance, you will probably be given a letter to take to your GP requesting a prescription for Tadafil {cialis}. Most people will refer to it as Viagra, this was the first drug to be marketed and the name has generally stuck. This drug is as the "blurb" says to relax the blood vessels in the penis so that it increases blood flow. 

*As explained when I started this piece WE ARE NON FUNCTIONAL not dysfunctional and therefore blood flow is not generally our problem, keeping it in place IS the problem*

There are warnings with all medication, and this is no different read the leaflet that comes with these pills as it does come with side effects. I believe the dose has been altered from the original one tablet a week to a daily dose of a lower dosage.  

2) There is an injection which is self-administered, which I believe has very good results or some, the name was once VIRIDAL DUO but this may have been updated several times. I personally dismissed this out of hand since I have an aversion to needles. 

Most drugs can have side effects and believe that anyone with Sickle Cell Anaemia and other problems must not take this method. Sorry for the lack of information on this, but if it appeals to you then you must ask about it .

3) There is a sort of suppository [small pill?] that I believe can be offered by some ED clinics which can be administered down the urethra. This seemed a good method to me until it was explained "The urethra is like a hose pipe and has to be waterproof  so the urine is not reabsorbed" We do not prescribe from this hospital as the success rate is low because of this non-absorption.

There are also creams advertised in various men's magazines; I believe these do not work either for the same reasons.


Many jokes have been made about pumps to help with erections over the years; usually by the uneducated who believe the whole situation is something to joke about, which it is not. We that have had surgery to save our lives and Prostatectomy has been involved will know the difficulties that follow.

If the other methods mentioned are not to your liking or in many cases do not work the vacuum pump method will certainly work. Some find it difficult to use and while it is not an instant erection solution that used to be our norm, with a little practice and following of detailed instructions it can guarantee a good result.

So how does it work: unlike what would be our normal function of blood being pushed into the penis under pressure [see explanation above] the vacuum pump has the opposite effect of drawing blood into the penis. The clever thing about the device is that it has an additional ring [a bit like a thick rubber band] which when the penis is engorged and erect the ring placed on the penis stops the blood from flowing out again. Success! 

It does, however, come with a warning that you must not fall asleep with the ring in place as this can cause damage if left for long periods.

So how can you get one? You must ask your GP for a referral to the ED clinic in your area, you will be seen and assessed probably after being given Tadalafil first [as I said they will not learn!] You will be seen by a male operative from the company involved SOMAerect who will instruct you on how to use the device, don't be embarrassed this may be your last shot at success if all else fails. 

This is no back street device and is manufactured to excellent standards, I believe in the USA, they can be purchased privately and cost £200+ if so desired, by visiting this site.

I will finish with a true story as told by a lady at a Prostate Cancer meeting; Husband comes into the bedroom naked wearing new shoes.  She says "That thing [his penis] is looking at your new shoes," He says "But aren't they nice shoes?" After a moments thought she says "Maybe so, but pity you did not buy a new hat!"

Trevor - Guest Post Impotency and Urostomy

Thank you for sharing your experience Trevor and offering possible solutions for other men in your situation. Do you have different experiences or solutions? Please let me know!

Written by : Rachel Jury

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