Leakage with Sex

[MGKB]

I had radical prostatectomy 5 years ago. I have urine leakage with sex. (known as "climacturia"). My doctors have suggested a few possible fixes including surgical implants like a "sling", an "artificial sphincter" and a couple of other options. Has anyone else experienced this situation, and if so, how did you sucessfully resolve it? Thanks!

[Tall_Allen]

A few tips I've picked up from support groups:

• Restricting fluids for a few hours before sex, especially coffee, tea, Coke, alcohol and fruit juices

• peeing before sex (sit down and rock around or in the shower - whatever it takes to fully empty the bladder)

• a constriction band around the base of the penis (also helps maintain erection)

• lay down on your back and don't change position

• use a condom

• get rubber sheets, and just enjoy water sports

Unfortunately, I suspect that ED meds (like Cialis) may make it worse.

[MGKB in reply to Tall_Allen]

Thanks!

[jacro]

While I agree that it is uncomfortable to lose the exacting control of one’s bladder with all the stimulation that is occurring during sex, I believe that issue alone would not be enough to warrant another surgery, assuming one’s regular bladder control to be otherwise OK. More practice and Kegel exercises will also help.

[MGKB in reply to jacro]

Thank you!

[RMontana]

I had the same problem. What works for me is a Cock Ring or a Bo-Tie...either one you can get on Amazon (like anything else), or you can buy at Walmart I think. Again it works for me and I recommend you try that before any surgery.

For me the Sling wont work as I have had sRT (salvage) radiation. When I asked whether the AUS (artificial urinary sphincters) would work for me my URO told me it would not. I have USI (stress incontinence), but a very mild level of leakage. The AUS appears to be most effective in bringing men with Diapers to Pads not taking them from Pads to being completely dry...that is what I was told and what the research I see tells me. I have been searching for other sources but so far that is what I know. So if you have had radiation the sling may not be for you. If you dont have any leakage, other than at climax, then the AUS may not work either...check it out before you do any surgery. Here are some links that I have posted on this issue. Rick

healthunlocked.com/advanced...

healthunlocked.com/active-s...

PS the other surgical solution that I am looking at is the ProAct...I like this implant as you control the pressure placed on the Urethra and therefore hopefully prevent scarring/ erosion of its walls...I am still on the fence as to whether I will proceed with any of this or just live with the leakage...again, dont know if you even have this other problem, other than with Climax...Rick

[MGKB in reply to RMontana]

Thanks Rick, for the thoughtful response and sharing the detailed info you have! I really appreciate it! You've done your homework!Michael

[Don_1213 in reply to RMontana]

Exactly the same conclusion I came to.. I inquired from Boston Scientific (who makes everything urinary) about who the best NY doctor for the sling or AUS was. Turns out (not a surprise to me) to be a urologist at Columbia Presbyterian. I arranged initially for a video consultation with him, and we discussed the options. He also asked that I come in for a scope of the urethra/bladder. So I did - and afterward we had what I considered a quite productive talk.

His thinking was - the sling with a patient who had radiation (me, 83Gy) had about a 25-40% chance of being successful. It had a 60% chance of making things worse. He would only consider doing a sling IF I agreed if it didn't work if an AUS was then installed.

I pointed out my age - and that the AUS might be great now, but in 5 years (I'd be 83) I didn't want to have to ask someone to pump me open because I was too debilitated to do it myself. He understood immediately. ("hey, com'mere.. squeeze my balls, I gotta pee.." wouldn't go over big I think..)

SO - since I'm at the point where I can go all day with the same pad, and can go all night without waking up to pee - that we just observe it for now. So that's what I'm doing, and it seems to be very slowly getting slightly better.

And as TA pointed out - a restrictive band (these are available on-line, Amazon has an amazing selection of them, with same-day delivery for some) does help in several ways, and may enhance the experience since it's sorta kinky too.

BTW - this did have one very productive outcome - the Columbia/Presbyterian doctor was outstanding IMHO. He listened and he explained his thinking based on his experiences. He's also a professor of medicine at Columbia Medical School. So he's now my urologist. My experiences with local urologists has been not good - getting me in and out of their office and making certain they had the billing information seemed to be their primary concern. In the case of ALL the MD's I've seen at Columbia/Presbyterian (Weill/Cornell) - their concern has been very evident - it was about the patient. One very obvious difference - all the C/P MD's have shared their email address with me, and said write whenever I have a concern. The local doctors email address is a deep dark secret, and their offices don't like you speaking with the doctor if it's not billable.

[j-o-h-n]

Easy Peasy,,,,,,,,,,,,Just pull out at the right time and pee into a handy bottle which your partner can hold steady for you. Holding the bottle steady is a must!!!

Good Luck, Good Health and Good Humor.

j-o-h-n Tuesday 05/30/2023 3:18 PM DST

[MGKB in reply to j-o-h-n]

Thanks!

[Arrayscout]

Daily series of pelvic floor exercises. Kegel etc. This is a must.

Limit fluid intake prior to, esp bladder irritants.

Fully empty bladder.  Sit, relax pelvic floor.

Avoid sudden movements in bed.

Tighten down a bit on pelvic floor during orgasm.

Sex in shower works too!

[MGKB in reply to Arrayscout]

Thanks! Good advice, I thought about the shower too, worth a try!

[jeffersonsam99]

Better to wear condom in your reproductive organ before going to start the intercourse performance.

Better to avoid drinking liquid items for three to fours hours before starting the intercourse performance.

Doing body massage will relax your mind and boosting your mood to more concentrating on your intercourse performance.