I'll just lay the big card on the table right up front. I'm scared....I've been to war, been in gunfights, fought hand to hand for my life, run for my life and hunted the most dangerous creatures on the planet. All of that being said, I'm genuinely terrified of losing my sex life....and thusly I'm here asking for input from experienced prostate ca survivors.

I have a medical background (OR and ER Nursing) but it is dated. In my time (90s), a TURP meant the end of a sex life....or at lease enjoying the pleasure of erection and orgasm. In the last year, I was first flagged for having a high PSA, that lead to a MRI which had a concern for a RT transition zone PI-RADS 4. This triggered a biopsy which pulled 14 specimens and returned a completely negative result. All good, clear of cancer.......Then we did the 6 month follow up in January where my PSA is still climbing. Now over 6...not super high but still higher than the 4.8 that got this started. In response to this, they sent my biopsy samples out for a methylation study with a result of positive methylation on one of the 19 samples....not from anywhere near the original area of concern that was in the initial MRI. They say that there a a 19% chance of something showing on the next MRI and a 6% chance of finding something on the "next Biopsy"...(FUCK YOU..that Biopsy felt like they were shoving a hot iron up my #$shole so not sure I'm doing another one of those without much higher MRI confirmation.)

All of the backstory out of the way, I am in my own head about possibly having to have my prostate removed. Dad and Brother both had their out and CA runs in the genetics. I love sex...love my sex life with my Wife and am not ready to give it up.

Can those who have been through this please let me know what the real world expectation of a sex life, including enjoying orgasm, is after having a prostatectomy? I get the standard clinical jargon re: expectations of function dependent..yadda yadda.... I want to know the real deal from those who have been there and done that.

Thank you