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A Radical Prostatectomy is a major operation which entails the removal of the prostate gland, a section of urethra which runs through the prostate, the seminal vesicles, and tying-off the vas deferens, along, generally with a margin of other tissue surrounding the gland. The bladder has to be 'purse-stringed' back down in order to reattach the urethra, and an 'anastomosis' is created at that point. The surgery generally destroys one of the sphincter muscles which control urinary retention, and incontinence is a common side effect, along with the impotence created by the removal of the erectile nerves, and possible injury to any remaining nerves, as well as penile arteries and other musculature. It takes a fairly long recovery period before any normalcies return.
Because the prostate is what produces the semen, losing ejaculatory capabilities is a given for this surgery, and possibly the TransUrethral Resection of the Prostate (TURP), or TransUrethral Needle Ablation of the Prostate (TUNA) procedures as well. Those are done by going in throught the end of the penis, and are far less impacting, and much more minor procedures than the radical operation.
The general understanding is that the term "radical" is employed when cancer is present. In rare cases, open prostatectomy is conducted for BPH, the benign enlargement of the prostate that interferes with urnination. It is my understanding that open proastatectomy for BPH is only done when the prostate has grown to an abnormally large size and TURP would be dangerous.
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If you have taught your child all the rules of ‘stranger danger’ you have protected him/her from a 1% chance of being sexually abused. This leaves your child vulnerable to the most likely sexual child abuse offender, family members or other trusted adults. 80% of children are sexually abused by a family member, 19% are abused by someone the child knows and trusts. The other little known statistic is the frequency of sexual child abuse. David Finkelhor and Dianna Russell’s research reveals 62% of girls and 31% of boys will be sexually abused by age 18. Unfortunately this statistic is considered low due to the difficulty in gathering data through surveys or reporting agencies.
For many decades we have screamed, ranted, condemned, demanded and enacted legislation to punish sex offenders to little avail. The news media and magazines have joined in the campaign to illuminate the problem after the damage is done. As a result of the media’s incessant coverage and hype of ‘strangers,’ we have come to believe if we teach our children about ‘stranger danger,’ we have thoroughly protected our children from this horrific crime.
The first response we form when hearing of sexual abuse or incest is denial. ‘I don’t have to be concerned about that in my community. That would never happen in my family.’ The unbelievable reality is that a person who sexually abuses children may seem very average and ordinary to the world. Furthermore, we find sexual abuse and incest even more difficult to believe or accept when the person we like, admire, love, and/or marry is the perpetrator of the abuse. Tragically, the unwillingness to accept the facts concerning sexual abuse perpetrators leaves children vulnerable to becoming victims and increases the likelihood that they will be abused. To understand how sexual child abuse is perpetrated by the person we least suspect one needs to have a comprehensive definition of sexual abuse.
“Traditionally, incest [sexual abuse] was defined as: sexual intercourse between two persons too closely related to marry legally--sex between siblings, first cousins, the seduction by fathers of their daughters. This dysfunctional blood relationship, however, does not completely describe what children are experiencing. To fully understand all sexual abuse, we need to look beyond the blood bond and include the emotional bond between the victim and his or her perpetrator. Thus, a new definition has emerged. The new definition now relies less on the blood bond between the victim and the perpetrator and more on the experience of the child. Incest is both sexual abuse and an abuse of power. It is violence that does not require force.
Another is using the victim, treating them in a way that they do not want or in a way that is not appropriate by a person with whom a different relationship is required. It is abuse because it does not take into consideration the needs or wishes of the child; rather, it meets the needs of the other person at the child’s expense. If the experience has sexual meaning for another person, in lieu of a nurturing purpose for the benefit of the child, it is abuse. If it is unwanted or inappropriate for her age or the relationship, it is abuse. Incest [sexual abuse] can occur through words, sounds, or even exposure of the child to sights or acts that are sexual but do not involve her. If she is forced to see what she does not want to see, for instance, by an exhibitionist, it is abuse. If a child is forced into an experience that is sexual in content or overtone that is abuse.
As long as the child is induced into sexual activity with someone who is in a position of greater power, whether that power is derived through the perpetrator’s age, size, status, or relationship, the act is abusive. A child who cannot refuse, or who believes she or he cannot refuse, is a child who has been violated.. (E. Sue Blume, Secret Survivors).”
There are two types of sexual abuse approaches—overt and covert.
Overt sexual abuse is openly sexual and apparent. Although there may be an attempt to deny that it is abusive, there is no attempt to hide the fact that it is sexual in nature.
Covert sexual abuse is more insidious. Thus, identifying it is harder, because the sexual nature of the action is disguised. The perpetrator acts as if she/he is doing something non-sexual, when in fact he or she is being sexual. The betrayal then becomes two-fold. The child is not only abused, but also tricked or deceived about the act. In this dishonesty, the child is unable to identify or clarify his/her perception of the experience. The unreal or surreal sense that accompanies any sexual abuse is intensified when the child is tricked into disbelief. Thus, the child doubts his/her perceptions and feelings and believes that there is something wrong with him/herself because he/she feels terrible. To make matters worse, everyone around her/him discounts signs of the abuse, because we don’t want to believe someone with a sterling public image would do such a thing. Thus the child feels crazy, as if she/he is the one with the problem.
One example of overt sexual abuse whereby the perpetrator disguises his actions and those present are in denial about what is transpiring is exemplified by the incident a client, who is a sexual abuse survivor, reported seeing. Her father (her perpetrator) kissed his granddaughter, her one-year-old niece on the pubic area after her niece finished her bath. Her sister, the child’s mother, the child’s grandmother (wife of the perpetrator) were present. “My sister and mother (the child’s grandmother) laughed and I got sick to the stomach. Am I over reacting,” she asked. Obviously, her sister and mother are unaware of the definition of sexual abuse. Except for the fact this woman was in therapy she would not have considered it sexual abuse either.
An example of covert sexual abuse by someone we least expect is exemplified by a 39 year-old woman who came to me after having a severe panic attack. During our investigation as to the root cause of the panic attack she revealed she had been ‘fondled’ when she was nine by a family friend. “He helped me on with my coat at a family gathering. As he adjusted my coat onto my shoulder, he fondled my breast.” This type fondling is often times referred to as ‘coping a feel.’ No matter the label, it is sexual abuse and causes damage. Women know how icky it feels when a man ‘cops a feel.’ Can you imagine what it would feel like for a nine-year-old, who has no information to comprehend and emotionally resolve what she experienced?
Another example of covert sexual abuse by someone you least expect was told to me by my client, Rickie (not his real name). He remembered being held by his mother’s best friend in the water at the beach when he was six, while his parents sat on the beach. Fully protected from view by the water, she fondled his penis. This was not the end of the sexual abuse. When Rickie was 15 years old, she enticed him to have sex with her at her home while he waited for her son, his friend to come home. The second incident of her sexual abuse of Rickie was overt.
There are six key techniques to abuse-proof your child.
•Avoid spanking your child—spanking is a body boundary violation. Perpetrators target children who have had body boundary violations because they are less apt to protest any unacceptable body boundary violations, are more compliant with adults and are less apt to tell. You can avoid your child from falling prey to these cunning perpetrators by doing everything to avoid making your child a target.
•Avoid touching your child in erotic areas—buttocks, chest, thighs, etc. Perpetrators state they use familiar touch (rubbing the child’s legs, buttocks or hugging/kissing) to desensitize the child before using touch which is sexual in content and intent. If your child is unaccustomed to being touched in erotic areas, he/she will protest immediately. Protesting will either thwart the perpetrator or alert anyone nearby that something is awry.
•Teach your child self-protection by teaching him/her to protest violation of body boundaries or unwanted touch beginning at age two.
•Practice and teach your child good body image.
•Practice and teach your child to TELL YOU EVERYTHING, NO SECRETS FROM MOMMY and DADDY.
•Practice and Teach Appropriate Suspicion—Trust your intuition, (a.k.a Sixth Sense)
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This is a thought on the study of Home and Away Games, The Best Team Always Has the Advantage. Predators and Prey; The Hunters and The Hunted. Recently Rumsfeld asked his brightest commanders to come up with strategies to combat Islamic Extremists Terrorists. Here is an idea. Set up a couple of Humvees, which would drive at normal speed a head of a van, which had interior 1" steel walls. Drive the Humvees in front and use remote control to draw fire. Put mannequins in the Humvees. And a Big America flag to piss them off. The van will have SWAT Team Special Forces. When the humvees are shot at stop them and the van unloads and surrounds the area from the rear and special forces shoot each one between the eyes, cut off the heads stick them on the posts out front of the houses where they were found and just get back into the van and drive around again.
Hunt the terrorists like the prey that they are. Turn the tables. The hunters become the hunted. The hit and run games of the past turn into a simple way to draw fire as a marker of you’re immediate and next target. At night sneak around in fatigues with special teams. Gore-ill the Gorillas. Use UAV helicopters to get in close a spook them. Use ELF to put them to sleep. Use RF to make them piss. Pull out all the stops to kill them. The triangle is not our Devils Triangle it is their place to meet Allah. Let them come to the triangle in large numbers from throughout the region and slice and dice. To fight this war we need to be the hunters. Play to win, get serious and let the boys have some fun, they have been practicing urban warfare for months on end, they are ready to rock and roll, the weather is going to get more livable, so after Ramadan and Christmas let's load the place up with the toughest son's of bitches in this country. The tough guys, Special Forces, the guys who know who they are and who know how to win. Hunt them down one by one. Mercilessly. They want to fight, show them hell on Earth. Cut throats, cut off their penis, shove it in their mouth and decapitate. I bet things change real fast. They want to fight and live in the year 3000 BC, show them what they are missing.
This hit and run sissy stuff cannot be tolerated. If you want to win a war you have to take the will of your enemy out of the group. Let's do it. We need several hundred such plays as the one described above to deploy, like a football team, mixing up the plays, different each day, different special teams, different methods all with one idea in mind, the goal line. I am sorry if some people reading this think it is too extreme, I believe weak people succumbing to political correctness while our guys get picked off and lawyers determine targets is just dumb. I suppose the enemy is lucky that I am not in charge. There would be hovering apache helicopters over the horizon, just waiting lines up and armed to the hilt and we would be running these plays and hunting like big cats in the night, all night, every night, every holiday, every second, day and night, no rest for the enemy, until every last one is slaughtered. No mercy, no prisoners, no bull sh_t. Of course the Democratic Presidential hopefuls would be so disappointed in me. But let's get real here. The war is over, these people just don't get it. Jihad? G-Wizz? It might be time to start sending some of these heads back to the countries where they are coming from. Cruel and Unusual?
We should never fight evil with our hands tied behind our backs. This hide and seek, hit and run, drive and crash needs to turn into pray and pay, lead and be-head from the air and land. Get tough and win. This rhetoric of oh no what do we do now on TV is ridiculous. Either we have the balls, brains and Braun or the liberal anti-American guest stars on the nightly news are right. Which is it? A fighter pilot has rules, in war they are different. "Never give a sucker an even break, take the advantage and cheat." So far this is what they are doing. Yet those are our rules of engagement and conflict. We are letting them run our plays and sitting around wondering what we should do? The political correctness has gotten out of hand and into the battle area. How can this be? How can we have done this to ourselves? Shoot back, hunt them down, and attack. We have all the advantages, use them. Just a thought, a single perspective and observation. What do you think?
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Top Questions of our Time Series: Sex
Slam bam thank you Ma’am or Mr.? That’s some people’s method and it works for those who mutually agree they want a quick fix. But for most people this is not the method of choice. So, why is it that this is so prevalent? The reason for this could be that American culture is simply not accepting of sexuality in general and that is why sexuality leaks into what many consider to be ‘shadow’ areas, such as pornography, strip clubs, and prostitution. Carl Jung, one of the founding fathers of psychology, would definitely label sexuality as the shadow side of our culture. For most people who watch or visit these areas, it’s not something they discuss with their acquaintances or even their family and friends. In fact, the actual act of having sex with a person is not discussed too openly in our culture. Alfred Kinsey was one of the first and most famous people to openly discuss this cultural issue in public. Sure, sex is flashed in our faces on TV shows, movies, and advertisements, but few people actually openly discuss the act of having sex with another person.
For whatever reason that is, this is an article that is going to discuss one of the top questions of our time: What is a great way to have sex, even for those who are inhibited. I am going to explain a term, I am certain I am not the first to use it, or explain concepts like it, however, I have not seen the term before. That term is Mindful Sex. Mindful sex involves slightly slowing down in every aspect of the act of sex, from creating the setting, to the foreplay, to the actual act of sex, whatever you consider that to be. The following is the gist of it:
Setting:
This part is not necessary if the act of sex is spontaneous in any given moment. If it is not spontaneous, sometimes it is a good idea to set the setting. When creating the setting, whether you are lighting candles, putting on music, or preparing special lingerie, moving slightly slower than you usually would. As you move slower begin to pay attention to your senses. If you are lighting candles, notice what you are lighting it with, is it a match, a lighter? Notice what the flame looks like, how it moves, does the candle have a smell, if so, take a moment to inhale it. If you are setting up special lingerie, take a moment to feel the lingerie. Is it made of silk? How does the silk feel? Are you spraying perfume/cologne on it? Take an extra moment to inhale that. You get the idea, with anything you are doing, move slightly slower and take a moment to pay attention to what you are seeing, hearing, smelling, feeling, and tasting. You do not need to think about any of this, just notice your sensations. If you notice you are thinking about something, notice that and then simply bring your attention back to what you are sensing. By moving slightly slower you have the opportunity to do this and in return make the process more meaningful and enjoyable.
Foreplay and Sex:
Some people consider foreplay to be sex, some consider intercourse to be sex. So I am putting them together because these ideas apply to both of them. There are many aspects to foreplay and sex and different people will have different variations on what they like. The tragedy of it all is that most people, having not felt free to discuss sex in public and they have only relied on what the media has influenced them to think about how sex should be. While they’ve had sex, they have never freely explored it on their own. Some people like to start out with oils and massage, some people like to start out with kissing all over the body, while others are into more fetish areas such as acting out a fantasy of being ruled over by a dominant figure of some kind (e.g., dominatrix). As far as fetish goes, this goes as far as our imagination can take us.
As you practice Mindful Sex you will give yourself the chance to discover what it is that you really like and you will begin to feel more comfortable communicating that to whomever you are having sex with, even if that person is yourself (i.e., masturbation). Here is the gist:
As you begin to practice mindful sex, it is important to remember one thing: Whatever it is that you are doing, do it slightly slower than usual. This does not mean go in slow motion, it means just go slightly slower than you would think to go. As you move slightly slower, you give yourself the opportunity to really be there in that moment and notice things that you may not have noticed. If you are giving a massage, you get to feel how the person’s skin actually feels, is there a scent to the oil? If so, inhale it. If the oil is edible, take an extra moment to lick it and truly taste it in your mouth. Look over your partner and take a moment to take in all the little nuances of the person’s body. By slightly slowing down, you also allow yourself to relax a bit, and this not only helps in making this a richer experience, but also helps reduce anxiety if that is an issue (e.g., being overly sensitive or premature ejaculation).
You can apply this in every moment of sex that you find yourself in. For example, when you are giving oral sex, go slightly slower and notice the smell and taste involved, feel the texture of the other person, is it soft/rough? What does the person’s vagina or penis look like? As you go slightly slower you’ll find that it is not so difficult to notice these things and it will draw you deeper into the experience and give you the gift that you have not been privy to experience in the past.
Ofcourse, you can apply this to intercourse as well. No matter your gender or sexual orientation, there is often some sort of sexual intercourse involved. It is important to let your partner know that you want to go slightly slower this time in whatever way you feel comfortable communicating that. As the intercourse begins, notice the sensations you are feeling. All parts of you are experiencing sensations from your head to your penis or vagina to your feet. If you find yourself thinking about something, notice that you are thinking about something and gently bring yourself back to your sensations. If you find yourself judging your self or the other person, just notice that you are judging and gently bring yourself back to your sensations.
Gifts:
Paying attention to your sensations may also broaden your horizons on things you want to do. Maybe you notice that while having intercourse that you are not tasting anything so you decide to taste your partner by kissing or licking him/her. Maybe you want to smell your partner more to bring in that sensation. Maybe you open your ears and begin to hear what the sex you are having sounds like. Maybe you’re now noticing for the first time what other areas of your body are being touched during intercourse besides your penis, vagina, or nipples. You might just discover an erotic area of your body that you had not noticed before (e.g., back of the knees, toes).
Having mindful sex is simply a teaching and a suggestion. If a spontaneous act of aggressive sex comes out and it is not a slightly slowed down process, than that is Ok too. This is simply an opportunity to broaden your awareness about yourself during the act of sex and deepening the richness of your experience. Of all things we have to experiment with on this planet, this is surely one of the top. So, responsibly, go off and try this out, have fun, and broaden your horizons! You may just find that sex is a far more sensual and sacred experience than you had previously imagined.
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Same sex relationships aside, which have their own sources of wonder, the relationship between a man and a woman is so intriguing and amazing because we understand so little about the opposite sex.
A man hears about another man's penis being cut off and goes into paroxysms of distress in empathy for the victim. Upon hearing the same news, most women simply wince but have no visceral reaction. A woman hears about a rape and reaches out to the victim in pain and empathy. Even the most non-violent and liberal male has a tendency to think that it's no big deal: "Well, it's not like she was killed or anything."
The divide is that our experiences differ, our anatomies and our relationship with our physical attributes differ, and our perceptions of our interactions with the world differ. In a sexual sense, men give and women receive. In traditional societies, men act and women accept. Despite the rise of feminism and the cultural equality of women, many physiological disparities remain.
The strangeness of each other's physical makeup is a significant portion of the tension aroused in a male-female relationship. The alien nature of the partner's anatomy is an unending source of fascination and delight. Men can spend hours looking at their mate, or watching pornographic movies, in a total obsession with female attributes: breasts, vagina, clitoris, anus, and labia. A woman sees such body parts as something best hidden, despite the delight they may bring when aroused. Women are in awe of a man's ability to wax and wane as his levels of desire change. A woman can seduce a man but rape is virtually impossible.
A woman worries about the size of her breasts whereas men accept a variety of sizes and shapes, all equally appealing. A man worries about the size of his penis whereas a woman is less concerned with size than how the appendage is used.
For two such different creatures to enter a permanent fulfilling relationship, a great deal of exploration is required, both in terms of understanding the other as well as understanding the self. Mutual exploration can become a vessel that explodes the level of intimacy enjoyed.
It starts with communication - the discussion of oneself and what is arousing on a personal level. Such an exchange of personal turn-ons can then evolve into the identification of what new techniques, positions, or approaches may be mutually exciting. Each partner may have very different ideas of what they would like to try.
In an atmosphere of trust and devotion, almost anything can be valuably experienced once. Try to work out a loose schedule that allows each partner to implement a new technique once in a while. Afterwards, a discussion of whether the new activity was satisfactory can ensue and the partners can decide whether to eliminate it, use it as an occasional change of pace, or incorporate it as part of their standard routine.
The key is to mutually accept the exploration, agree to honest feedback about its utility, and establish a standard of equality in the partners taking turns in suggesting new techniques with an acceptance by the other of implementation on a trial basis.
Because of the uniqueness of our physical attributes, what works for one may be counterproductive for the other. Just the exploration of new techniques, in itself, forces the partners to focus on their sexual activity and can generate a more intense intimacy because of that new awareness and concentration on the act of making love.
