Urination and arousal

[Dreamweaverman]

Hey All, I was responding to one of the members on here and decided to post this in case others have had the same experiences. I am only 2 months out from surgery and I am already getting worried/frustrated. I have been jerking off as advised by doctor, But the semi hard-ons feel less satisfying. Orgasms feel great but my knee-jerk reaction is to look for some type of semen.smh... Lastly, the urination when getting turned on is crazy! I had such an embarrassing experience the other day when I uncontrollably squirted all over my BF's shirt. I wanted to crawl under a rock from the shame. Still get really surprised by all this, and although I have supportive loving relationships, I sometimes just long for the pre PC self.

[Tall_Allen]

It's called climacturia, and it is fairly common. I hope you are also using a pump - it can help with the size loss. Trimix injections a couple of times a week, too. The lack of semen takes some getting used to.

[Dreamweaverman in reply to Tall_Allen]

Hey Allen, when did you start pump and trimix? I went to the urologist a couple weeks ago and he threw me out...lol He told me to give it time. I am really missing my erections.

[Dreamweaverman in reply to Tall_Allen]

also any recommendations for pump?

[Tall_Allen in reply to Dreamweaverman]

I never lost erectile function, but I did not have surgery. John Mulhall advocates beginning penile rehab as soon as the catheter comes out - size loss starts early. You can also take on-demand ED meds. you can get a pump in any porn store or online.

amazon.com/Saving-Your-Sex-...

[Dreamweaverman in reply to Tall_Allen]

Oh ok, I was just asking if you preferred a particular pump brand, but since you never lost function you probably wouldnt know. I wasnt worried about size stuff, as I have always felt blessed in that area...LOL. But should I be? I will be in Chelsea later today and will check on some different brands.

Thanks again, you are an amazing asset on this site.

[Tall_Allen in reply to Dreamweaverman]

If you're in NYC, you might want to arrange a consultation with John Mulhall at Memorial Sloan Kettering.

[Dreamweaverman in reply to Tall_Allen]

Just watched a bunch of videos and contacted his office. Hopefully, I will get an appointment. Thanks again Allen. You are extremely helpful.

[DanWinters in reply to Dreamweaverman]

I purchased the medical grade lump recommended my my doctor. Hurt like crazy. Only because the soft Scrotal protector was too flimsy. Sucked mu nuts into the tube. One method is to put the edge more firmly at the bottom of the cock. I am 8 weeks out. The 2 pumping session I went a little too fast and had some frenulum swelling. Not as bad as you see in those pumping porno films. But I did go to the adult store and bought a 19 dollar one and I actually like it a lot better. Also bought a little less tight cock ring for the base. Didn’t hurt quite as bad. It is a whole new journey. I just warm people. I may Pre on you. I am not going to give up. The feeling of the pump is great but it is good to see a hard on. It does swell the head. A little more than I would like.

[Hidden in reply to Tall_Allen]

Sorry to contradict, I used a pump and was told that the cheap ones you can get online or in porn shops aren't up to it. Luckily I was able to get a proper medical device for free, (although its actual cost was about 150 GBP). I also got training in using it e.g. a 20 minute session twice a day, every day inflating and releasing several times each session. This is for rehabilitation not for sex!

I confirm that the best available evidence suggests starting on PHE5 inhibitors as soon as the catheter's out. Might be a good idea to start on the "on demand" versions as they are a higher dose. When spontaneous erections start re-occurring, you could switch to lower "daily" doses e.g. tadalafil 5mg.

[Tall_Allen in reply to Hidden]

Experts are steering men away from daily dosing and to on-demand dosing because daily Cialis stimulates easier peeing - not an effect one wants when struggling with incontinence.

[Dreamweaverman in reply to Tall_Allen]

Omg Allen, I have been urinating a lot lately and was wondering if I was drinking too much water. It’s definitely the cialis. I’m gonna try and stick with it until I get an erection. Thanks for the info.

[Tall_Allen in reply to Dreamweaverman]

Here's the evidence:

"In preoperatively potent men, nightly sildenafil 50 mg impaired urinary health-related quality of life more than on-demand use in the early months after nerve-sparing RP, independent of effects on urinary continence."

ncbi.nlm.nih.gov/pmc/articl...

Cialis, Viagra and Levitra have similar urination stimulatory properties.

[Hidden in reply to Tall_Allen]

I find this a bit misleading. I read and believe that the "On demand" dose of sildenafil is 50mg. There doesn't seem to be a "daily dose" version. In the study you refer to the "nightly dose" is identifed as 50mg AND the "on demand" dose also as 50mg.

"The “nightly” group (n = 50) received nightly 50 mg sildenafil dosing, the on-demand group received 50 mg sildenafil,"

I guess the difference in this study is that the daily dose is just taking it more often. In this scenario, if you take the on demand dose they refer to twice a week, you get 100mg a week. If you take it every day then 350mg. Since any drug effect/side effect is dose independent the more you take the better/worse it is.

What this study seems to be recommending is don't take sildenafil

every day.

Tadalafil however is 10mg for the on demand dose and 2.5 for the daily dose i.e. a quarter of the amount. In the same scenario, if you took the on demand dose twice a week that's 20mg a week, if you take the daily LOW dose every day that's 17.5mg a week = less.

Notwithstanding the results of the study seem quite clear i.e., don't take too much PDE5s in the early months which is not something I recommended anyway. "Might be a good idea to start on the "on demand" versions - ". Perhaps I should have added "but not every day".

I don't think it logically follows from the study referred to that guys shouldn't start on Daily "low" dose Cialis on the grounds of adverse effects on incontinence. However, because of it's low dose, it might not be effective enough for soemone who isn't fairly well on the way to spontaneous erections.

As for evidence of daily low dose Cialis causing urinary problems after surgery, I can't find any. I have read that it is sometimes used for treating the symptoms of BPH by making peeing easier, which in itself is not advisable immediately after surgery.

I also find that it's recommended, not simply for facilitating erections but because it helps repair the damage caused by surgery.

That makes it a bit of a trade off - less risk of incontinence (no evidene) against greater risk of ED or vice versa.

[Tall_Allen in reply to Hidden]

Daily Cialis got FDA approval for treatment of lower urinary tract symptoms. That's not something a man who is suffering from incontinence wants.

This meta-analysis found that the differential on-demand vs nightly effect on erectile function differed among the ED meds: " On-demand treatment with PDE5Is was significantly better than daily treatment in recovering drug-assisted EF...Avanafil used on-demand was the most effective PDE5I in recovering drug-assisted EF. Whereas tadalafil was equally effective when used both on-demand and daily, vardenafil significantly improved drug-assisted EF recovery only when used on-demand. "

onlinelibrary.wiley.com/doi...

I think many urologists would support on-demand use for the first 6 months or at least until there is good recovery of continence, and then switching to nightly use or a combination of nightly and on-demand.

[DanWinters in reply to Hidden]

My doctor has me on daily 20 mg Sildinafil and adding to total of 100 mg if I feel I may have encounter. I have been adding 40 mg once and 40 mg later if I think I am going to have sexual activity. Of course no erection. Bit more of a floppy lengthening, which is better than the turtle it wants to be after the surgery.

[Hidden in reply to DanWinters]

Hi I guess the issue with dailky sildenafil IMMEDIATELY post op is that it might make incontinence worse. When did you start taking it and how long are you post op now.?

I hope the floppy turtle turns into more of a snake at some point.

Have you tried using a pump?

[DanWinters in reply to Hidden]

With the sildinafil I get about a floppy 6. With stimulation. With the pump I can get normal 7.5. And maybe close to 8 not not a feel good one lol. Well I take that back feels good to see it that way again I am 8 weeks out today. I also decided to get a circumcision at the same time ( just because. I worry about hufeom when I get older ) so that has been strange also

[Hidden in reply to DanWinters]

Is that inches? It's how stiff it is that counts. Sorry to say it'll never be as good as it was before. At 8 weeks post-op it sounds like you're doing OK. You can expect improvement up to 2 years.

[VL54]

I'm with you my friend, I feel the same, I miss my pre PC self, I miss my morning wood and the sensation of releasing fluid. The desire is always there. Hang in there and keep on loving.

[DK1347 in reply to VL54]

I can relate, especially the lack of semen, I knew it would be this way but I miss the feel, aroma and even the taste.... sorry to be so graphic; oh I’d like to be in my 30’s again!

[VL54 in reply to DK1347]

I agree, the 30s and 40s were great. I wish there was a prostate transplant, I would love a 20 something prostate, LOL.

[Bcgkelly]

I’m being told to take it easy as well and give my body time to heal. I got a pump after 3 months and just started Caverject injections two weeks ago. I got a pump from a Company that supplies medical pumps called imedicare. I have been told that the ones sold online can be dangerous as they have no restrictions. The injections have been ok to give. Very small needle and no pain but it takes a few weeks to build up to the proper dose that will give you a solid hard on but not too much that causes problems. I’m very frustrated at the time it’s taking to recover. Will be six months in November and am using a thin pad each day also suffering from fatigue. When the fatigue hits the incontinence gets worse again.

[Dreamweaverman in reply to Bcgkelly]

Thanks for info Bcg, I just ordered pump you recommended, and have an appointment with a specialist recommended by Big Allen. Will keep you posted. Love this site and the support!

[JimVanHorn]

I had a strange experience. I was on Eligard injections for 6 and 1/2 years and stopped injections in June, 2018. For 2 months I would get and erection every times I tried to urinate. But you cann't urinate with an erection. So I would wait 10 minutes and do something else and then finish my urinating. My Urologist said this is normal and that I was making Testosterone again and after 8 weeks all was well again.

[DanWinters]

As far as Pre Pc self. I wish I had been more active. And yes long for it.

[billy1950 in reply to DanWinters]

Dan,

Have had radiation 13 yrs. ago. Still can get it up but no semen...and no pump. Somewhat satisfied ...as much as possible!

Billy

[Hidden]

Sorry, there's no cure for climacturia. I believe there's a surgical procedure where a section of vein is joined up with the urethra to make it longer, but it can cause more problems than it prevents. Besides which I've been stitched (proverbally) so many times already I wouldn't want to choose being stitched up that particular way! There are things you can do to reduce it. Don't have sex standing up!

(Did you ever?)

[Skiotter]

I'm 10 yrs out and while it's not as big a deal as it was --Are you happy to see me or is that a squirt-gun in your pocket?-- I still leak a bit just thinking about a hot guy. Haven't used pads since 3 mos after DaVinci surgery, so general incontinence is not the issue.

I am single and wank to porn pretty much every day. I get it up well enough, and didn't used to shoot pee all the time. I've begun squirting on ejaculation pretty much every time the last year. I'm allergic to Cialis and haven't used sildenafil much. Get a better reaction with Chinese "viagara." None of them seem to work in the moment with a real guy. Tried a few times to get a wank-to-porn date to see how it goes, but they've fallen through.

I really do miss that feeling of getting hard and not worrying about peeing my pants.

Is it too late to start with a pump? It wasn;t suggested as part of my rehab 10 yrs ago.

bill