Questions about intercourse and incontinence after prostate surgery

Pee. Wait 10 minutes & pee again ("double-voiding", apparently. They have names for everything).

Empty your bladder as much as you can, 2 or 3 times beforehand.
Seems to be working for me.
Also... limit liquids. I don't drink anything after 7:30pm.

In terms of devices specifically for this problem, have a look at Urostop.
Cheap, sounds good, but never tried it.

As long as it has been since your surgery it is unlikely you can resolve the urine leaking problem. They say that after a year incontinence is unlikely to improve.

You have 3 choices, two of which won’t work if you have radiation on the prostate bed in the future.

Without radiation you could get the sling or ProACT device put in. Either of them should stop the leaking, but the ProACT device would probably work better.

If you do need salvage radiation in the future then the AUS (artificial urinary sphincter) device is the answer. I am having one put in April 2 because of problems like you describe, though mine is worse. It works quite wall, do a search on this forum (at the top level ), others that have had it put in have commented about it. You can also search for ProACT to see comments about it.

In June I will be 3 years since prostatomy, I to leaked urine during sex including orgasim but rarely have any leaking now during sex. It was probably at the 2 year mark when it was to the point I am now. So hopefully you to will improve up to the two year mark. I still have minimal leaking daily, one pad a day only 1 to 2 teaspoon in 24 hours. But not during sex anymore except for maybe to raid exception. Feb 11 going in for advance xp sling. Then possibly ipp in to summer, still deciding about that.

@jeffmarc I think that @bueller68 is talking about climacturia, not incontinence per-se. I am in a similar situation, but unfortunately without independent erections yet. @bueller68, have you looked into rings?

@topf
He was also talking about using a pad at times, That sounded like stress incontinence which does get worse over time.

Does the leak a little when he coughs or sneezes or does stressful activities?

@jasonfarmer I got IPP and AUS implants a year ago. I couldn’t be happier. A total quality of life changer.

I had AUS and IPP implants done a year ago. They are total quality of life changers. If you want to be able to have satisfying penetrative intercourse without any leakage, talk to your doctor. I had both implants done at the same time and had only minimal pain, swelling or bruising. I did not need narcotics for pain and was leading a normal life within days, although I had to wait several weeks before actually using them.

If incontinence doesn’t resolve itself, a good alternative is an incontinence clamp. A urethral stricture caused by “demon” radiation made the decision to get an AUS complicated. I discovered the clamp while I pondered my options and found the clamp to be so efficient and practical I stuck with it. Worn 18-20 hours a day, with one Tena max pad with no discomfort or onerous effects on penile circulation.

@topf Hello, I would tend to agree with this gentleman about the diagnosis being actually closer to “Climacturia!” However, I began to have something similar about 12-18 months this after my successful RALP in October of 2022.
When my wife and I started to engage in some fireolay, a clear liquid would drip from my penis. Not a lot of volume but more than one would feel comfortable with. It also changed the mood of our ensuing sexual encounter and sexual intercourse.
Having a damp cloth nearby for a quick clean up worked well and after the initial and only discharge stopped, that was it for the moment,
I did some research and found that there is something called “AROUSAL INCONTINENCE.”
It’s not actually urine but a combination of several fluids released by some of the organs related to your prostate area and surgery etc.
It was just a bit sticky but not too much. It was totally clear in color. Did not have any smell or odor. It was just weird and totally un expected. No physician or any other research I had done prior to my PALP procedure, (which was quite significant), never mentioned or discussed this kind of incontinence.
It was only after the fact and my personal experience if it that led me to do a deeper search and research on the subject. It has mostly gone away now but sometimes comes back.
It usually occurs as my erection gets firm enough for sexual intercourse and I start to get very sexually aroused in anticipation of being sexually stimulated and having various forms of sex with my wife.
I use TRIMIX a good deal of the time as my natural erection normally only gets me to about 80% of the stiffness and harness I need for reliable penetration. For those of you that don’t have any success with “ED PILLS,” I strongly recommend that you speak with your Urologist and try it. As a result, I know that I will be able to produce a nice firm erection whenever I want it after about 5-10 minutes following my penile injection.
The needles is very similar to what a diabetic would use for insulin.
Obviously, I prefer the totally normal erection without using the TRUMIX when I get it but it’s not reliable and I never know when it will occur. The TRIMIX is always reliable.
Best wishes.

@philipsnowdon Nearly there... this thing gets so complicated.

Urine during arousal - arousal incontinence
Urine during climax - climactruria
Thicker, clear liquid during arousal - Cowper's gland. That's normal.

Although the prostate & seminal vesicles are removed, the Cowper's gland stays.
So if you've had that before, you'll continue to experience that - maybe a little less often.

So much to get used to. If I'd only stuck to my original plan... if the biopsy confirmed cancer, I was just going to identify as a woman.
Dammit. Missed my chance.