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Questions about intercourse and incontinence after prostate surgery

Posted by bueller68 @bueller68, Jan 29 11:51am

Hello all, I was so glad to find this page before my surgery and immediately post surgery, we (Wife and I) gained a lot of information here. Hoping that I can once again find answers here.

I am having issues with urine leaking with both vac pump erection therapy (less) and with sexual stimulation (more). Small amounts, but more than I (and especially my wife) are comfortable with.

I am looking to hear from members if this was something that was/is something you dealt with? What you did to (Hopefully) overcome this and how long to expect this to take...of if it is still an issue longer into recovery?

Back story. Nerve sparing PR on Feb 10, 2025. Successful surgery with good follow-up. In the monitoring phase on the CA part of the process. I had return of erection (first erection at 6 weeks post surgery) very early and the doctor and staff were very pleased. Started with vac pump therapy at 8 weeks post and this greatly increased erection frequency and strength both with and without bands. Incontinence in general was significant and ended up doing pelvic floor PT which was beneficial as well. Overall I am doing well (still mentally taxing with CA, but trying not to think about that aspect). Still wearing a guard pad, but not needing the thicker pads and have gone without a few times. I think that the guard is more mental now than necessary.

As a couple, we have had (and continue to have, given the circumstances) a great sex life. My wife has always been "fun" and we enjoyed a lot of "things". I especially desire oral stimulation but given the leakage, my wife is not keen on this...very understandable. I have struggled to climax with intercourse since recovery, and the times I have, there is an even greater volume of urine that is released. The climaxes have been very intense, but are few and far between which was never the case before surgery.

So, sorry for the long post...

My Questions...
Common?
What exercises other than Kegels which I am doing, were helpful?
Any OTC tools or products other than condoms (Sensation is decreased enough already)?
More aggressive options (surgical, medications that slow urine production/release?

Thanks in advance for any help you all might have...

Interested in more discussions like this? Go to the Prostate Cancer Support Group.

Profile picture for robertcukor
robertcukor | @robertcukor | Feb 2 4:58pm
In reply to @philipsnowdon "@topf Hello, I would tend to agree with this gentleman about the diagnosis being actually closer..." + (show)
Profile picture for philipsnowdon @philipsnowdon

@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.

Jump to this post

@philipsnowdon
Do you find that the Trimix injections are quite variable in their outcome ? I can have the occasional not very good result at certain injection points, despite using the same dose ?

REPLY
Profile picture for philipsnowdon
philipsnowdon | @philipsnowdon | Feb 2 9:46pm

Hi Robert, thanks for your question. Yes, I too have experienced what you’re describing while using the same dosage of TRIMIX. For whatever reason(s), injections on my right side seem to consistently work better and are more consistent. I do my best to move the injection sites around as much as possible to avoid any buildup of unwanted scarring. I have more physical dexterity and consistent injections when using that side.
My own personal observation is that some injections and ensuing development of whatever quality of erection I get will vary from time to time.
As I shared earlier, I still have a strong sex drive and would prefer to get a natural erection
that gets and remains form
firm enough to enjoy sexual intercourse for as long as I used too prior to my successful “nerve sparring” RALP Procedure in October of 2022.
I think just like certain times and days prior to experiencing post surgical ED. Some days your erections are just firmer and last longer.than others.
Getting back to your original question. It’s very important that you inject the TRIMIX into the desired location for the best results. If the medication is not delivered to the intended target as well as it should, it simply won’t work as effectively intended! Admittedly, sometimes in my rush to enjoy sexual intercourse with my wife. I will “miss the mark” so to speak with my injection.
I find the better and more accurate the medication is made, the better it performs. I’ve also started to use TRIMIX a little less to resist the small amounts of discomfort that can sometimes happen. Again, I relate that again more to “missing the mark!” Additionally, if I can produce a strong enough erection organically, it feels better all the way around. Granted, rarely as strong and firm enough a ms a “TRIMIX INDUCED” erection!
However, I am truly grateful for TRIMIX because I have the confidence to know that even if my mind, emotions and desires are all ready for my wife to have wonderful sex etc. My once trusty penis is not. Thank you, TRIMIX to always coming to the rescue when I need it! My wife prefers a nice strong erection and I want to make sure she has it. I prefer it as well because it allows one more creative in my lovemaking skills. Without TRIMIX, I just wouldn’t be able to consistently provide that for us. I hope you find the above both helpful and informative.
GODSPEED

REPLY
Profile picture for jasonfarmer
jasonfarmer | @jasonfarmer | Feb 3 9:41am
In reply to @philipsnowdon "@topf Hello, I would tend to agree with this gentleman about the diagnosis being actually closer..." + (show)
Profile picture for philipsnowdon @philipsnowdon

@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.

Jump to this post

@philipsnowdon I to can get natural erections up to maybe 80% no way of knowing how long the last usually not long enough. I use Trimix 99 % of the time it just is a much better experience feels better. I stoped using left side to painfully. I not have an appointment set up with Doctor to see if I am willing to do the IPP . Have you every considered the IPP?

REPLY
1 reply
Profile picture for philipsnowdon
philipsnowdon | @philipsnowdon | Feb 3 10:42am
In reply to @jasonfarmer "@philipsnowdon I to can get natural erections up to maybe 80% no way of knowing how..." + (show)
Profile picture for jasonfarmer @jasonfarmer

@philipsnowdon I to can get natural erections up to maybe 80% no way of knowing how long the last usually not long enough. I use Trimix 99 % of the time it just is a much better experience feels better. I stoped using left side to painfully. I not have an appointment set up with Doctor to see if I am willing to do the IPP . Have you every considered the IPP?

Jump to this post

@jasonfarmer Hi Jason,
Thank your for your comments and inquiry regarding your experience with TRIMIX and my opinion(s) on the “IPP”
Firstly, like many things in life, I appreciate choices.
When it comes to treating ED more effectively, then the more the better.
I try not to ever rule out anything. However, as long as TRIMIX remains a viable option for me I will continue to use it. However, if the TRIMIX no longer provided me with the desired results I wanted I would consider utilizing an “IPP” in some iteration.
Hopefully, my natural erections will improve. It’s very strange that I can obtain a nocturnal erection at full strength that lasts long enough to enjoy plenty sexual intercourse. At the very least, this proves that my penis and ability to obtain a usable, accountable and even a long enough lasting erection for a natural and satisfying erection is in good shape. It also proved I can have an enjoyable sexual intercourse experience with little to no worries about effectiveness and length of time I can rely upon it to perform as desired.
I wish you the very best in your continuing quest, (as I am) to improve your own abilities to obtain the strength and the reliability of your erection.
Best wishes,
GODSPEED
Phil

REPLY
Profile picture for bueller68
bueller68 | @bueller68 | Feb 8 11:54am
In reply to @topf "@jeffmarc I think that @bueller68 is talking about climacturia, not incontinence per-se. I am in a..." + (show)
Profile picture for topf @topf

@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?

Jump to this post

@topf
Rings are beneficial but climax is "elusive". good for penetration and size with the pump and rings is "noticeable"...

As to the incontinence, that is 99%better. I still wear a guard pad, but is dry most days.

REPLY
1 reply
Profile picture for bueller68
bueller68 | @bueller68 | Feb 9 3:28pm
In reply to @bueller68 "@topf Rings are beneficial but climax is "elusive". good for penetration and size with the pump..." + (show)
Profile picture for bueller68 @bueller68

@topf
Rings are beneficial but climax is "elusive". good for penetration and size with the pump and rings is "noticeable"...

As to the incontinence, that is 99%better. I still wear a guard pad, but is dry most days.

Jump to this post

Also, after reading about the Cowper's gland, I believe this may be a substantial part of my issues... I will be asking my provider at my April appointment.

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