39 movements over the looser skin works and is effective. A U shaped vibrator can be used up and down the penis with the gentle end on the glans. The man may experience arousal leakage which can go on to become climacturia (leaking of urine with climax ). As the external sphincter strengthens, this leakage diminishes. Should the man be uncircumcised the foreskin needs to be brought towards the body to expose the sensitive glans. Touching the undamaged dorsal nerve along both sides of the penis helps to stimulate sensation. ORAL SEX This is known to be the most successful partner stimulation and therefore men without partners are disadvantaged. Stimulation around the glans of the penis and just under the penis works extremely well. Oral sex is also done on the scrotum, this is known as T-Balling. Like the anus, the nerves to the scrotum are not affected by prostate surgery, and this area is therefore a useful tool for enhancing excitation to a weaker area. It is further stimulated by cold and if the partner has touched or sucked on an ice cube, sensation is enhanced. Each testicle can in turn be given its own oral sex. As one famous woman said “you just kiss it until it gets well”. POSITIONAL SEX Genitalia against genitalia. Here the couple can “play” with a non or partial erection, trying to use gravity to their advantage. The penetrating partner stands or kneels at the edge of the bed or the missionary position. The most successful position is the “hot dog sausage in the hot dog roll” - while spooning the partner, the accid penis is moved in a well lubricated vulva. The female partner can gently touch the glans, thus combining hand work and positional sex. Conclusion Dealing with erectile dysfunction after prostatectomy requires communication, knowledge, love, trust and respect. Powerful gold dust to be put in the cauldron. Here is a chance for couples to rediscover and reinvigorate their relationship. For the couple that may not be able to experience penetrative sex again, this is an alternate way of having an intimate relationship. UROLOGY, URO-ONCOLOGY AND SEXOLOGY UPDATE
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