Firm Tech Ring for Climacturia and Arousal leakage

I think the term you would want to search on is "venous leakage" or "venous leakage erectile dysfunction." Here is the first link that popped up on google https://www.american-hospital.org/en/treatment/venous-leak-embolization
Vacuum erection devices often come with an assortment of such rings, which can also be bought separately. The goal is to take an engorged penis, place the ring as close to the base as possible to sustain the engorgement, and then remove it before it causes damage to the penis, but after enjoying the presence of such engorgement.
There are a couple downsides... 1) the penis extends into the body below the skin and the ring cannot be placed below the skin, and 2) since the blood flow is cut off, it quickly becomes cooler and the penis also becomes bluer as the oxygen is depleted. Of course, the third downside is if you leave it too long.... Well, don't do that.
Sizing and amount of stretch are important and personal, but some rings also have tabs or auxiliary rings to help with application and removal.

I’m familiar with the problem as I have experienced both and am 2 and a half years past RP. I was never told about this by any medical professionals. In fact the consequences of my treatment choice was down played if anything. I’m thankful to be cancer free at this point but my quality of life has taken a hit. Personally I would hesitate and probably not spend that much on that product. It’s a lucrative industry (ED and related products)
Just my opinion. Best wishes.

I have a few thoughts on this.

First, Climacturia and Arousal Leakage are real things which I started to experience a few months after my prostatectomy. I first noticed it when I was still working on controlling urine leakage and thus quite conscious of anything which would trigger a spurt. That happened on occasion when I would hug my wife! Not a little back tap, but a full-body, prolonged squeeze. It was NOT due to pressure on the bladder, but rather associated with a warm feeling of love. Then I noticed it when trying to masturbate to orgasm, which I had begun as part of my penile rehabilitation. Simultaneously, I heard about it on "The Penis Project", a podcast from Australia about recovering bladder and sexual function from radical prostatectomy. Here are a couple of links I found:

https://youtu.be/Xl_hLKWRGGg?si=BYdCNhmsrk-5kA1K
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7705983/ (Their literature review showed an estimated 30% prevalence after RP.)

Six months ago, I bought a Firm Tech, the more expensive model with an internal sensor designed to detect nocturnal erections. I was interested in whether my penile rehab was working to help me regain the natural blood flow which they provide. (I'm happy to say they have returned.) The key point here is that the Firm Tech is NOT like other cock rings in that it can be worn for extended periods of time, e.g., all night. It is softer, more pliable than other rings.

Now, why might the Firm Tech help with climacturia? What follows is my own speculation - I have no data or scientific studies to verify this theory. Why does climacturia happen? And why doesn't it happen with the prostate in place? During orgasm, the sperm have to be pushed out of the tubes which carry them from the testes eventually to the urethra and out of the penis, along with the the prostatic and seminal fluid in which they are suspended. That happens because of smooth muscle contractions in vessels like the urethra, seminal vesicles, vas deferens, and prostate. With a prostate, urine as kept nicely in the bladder, and only the urethra might have a few drops in it, which would not be noticeable along with semen. But after RP, the bladder can more easily leak urine into the urethra, and with the automatic orgasmic contractions still occurring, out it comes. The Firm Tech is "firm" enough to squeeze off the urethra (which runs on the underside of the penis), so it theoretically can stop *most* of the orgasmic urine loss.

I've found that not only emptying the bladder, but milking the penis afterwards to get out those last few drops, helps greatly reduce or even eliminate the climacturia.

@richardblackman, good question. Tagging you to make sure you saw the informative, helpful posts from @trusam1 @bfg1, as well as @spino's.

@richardblackman @trusam1 I just (finally) looked at the site you both mentioned. It is definitely interesting. The tone puts me off a bit, and I find it a bit incredible that 1/3 of all men (US maybe?) have a ring of this sort (although I guess I'm included as several came with the vacuum erection device I recently ordered.) Nonetheless, maybe I'll buy one. Certainly the idea of getting data on something that I'm supposedly treating through one or more interventions (smooth muscle tensioning) is attractive. And compared to surgical interventions, it seems rather pedestrian for sure. But I do find myself continually wondering whether this is something I should keep treating or something I should just accept as a loss and move on. For now, I am erect by injection or vacuum erection and unaware of much nocturnal activity, and I am now a month past 2 years out from RALP.

I believe the original post and what you are referring to are two different issues.

The original post is talking about urine leakage during arousal/sex and the ejaculation of urine during an orgasm (climacturia). This has occurred to me as well.

The rings placed at the base of the penis used with vacuum devices help to prevent venous leakage out of the penis to keep the penis erect.

I don't have/know a fix for the urine leakage. Limiting fluid intake for several hours before sex and urinating right before would be practical solutions. Adding a ring at the base of the penis to compress the urethra may help as well.

I will be interested to read the comments from those who have experienced this.

retiredoc I am in your boat it seems, having had RALP surgery and still experiencing the bad side effects. My wife has no desire to be the recipient of climacturia, so most of my experience is with masturbation in an attempt to rehabilitate my penis. I use the VED to gain an erection, slide the ring down and work towards an orgasm. If the ring is on, no climacturia. On the rare occasion I attempt this without the ring, I do experience leakage. However, as my incontinence has improved with time, so has the leakage during masturbation. It is much less than months ago. One last note, if the ring is on during the whole process, upon its removal, there is some leakage then.

I am currently on month 14 of an 18-month ADT treatment plan after having spot radiation treatment for a lymph node at Mayo. Most days, I only have a little incontinence when I do strenuous activities, but it's manageable with no pad. However, certain things make it worse including alcohol (the night when I am drinking and the next morning), too much coffee/tea/caffeine, any type of relaxation medication (like a sleeping pill or muscle relaxer), generally drinking too many liquids, and being tired magnifies all of these contributors. I mention these because they also contribute to leakage after using Trimix. This is something I have not discussed with my wife, but try to hide after intercourse (I'm sure she knows, but it is an awkward conversation), so I try to have intimacy in the afternoons or at other optimal times, which really makes a difference in controlling the problem. Lastly, I find if I use too much Trimix, the problem can be worse with urine materially dripping out afterwards. My urologist recommended a "cock ring" as he put it, but I have been unwilling to try. I hope it gets better after ADT. I wish you the best of luck.