Urine leakage during sexual activity

Posted by edo @edo, Aug 16, 2023

I had RP in March 2022, BCR in Sept 2022 and 28 SBRT treatments in Jan-Feb 2023 with ADT. Now that the ADT has left my system (thankfully) I am able to feel stimulated and enjoy sexual activity again. That is the good news. The bad news is that when I am getting aroused, if my girlfriend touches my genitals, I dribble some urine. It is not a large volume but it destroys the mood momentarily. I always void myself before engaging in sexual activity so I am surprised by this leakage. The leakage does not last too long and we are able to continue but it is disconcerting. I do not leak urine normally during the day so I'm wondering what is causing this problem. Has anyone experienced something similar? If so, how did you deal with it?

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tomf | @tomf | Aug 17, 2023

Certainly this is a touchy subject ( pun intended) because Americans are so unlikely to discuss sexual topics with strangers. Forgive me if I offer too much information here. I had RALP in February and will admit to impotence ever since. I have been prescribed generic Viagra and use a VED for penile rehabilitation at the suggestion of my urologist/surgeon. The pump produces an erection suitable for sexual activity. I have been able to masturbate but do experience climacturia, which is urine leakage during orgasm. It is common after a prostatectomy according to my doctor. My wife is not pleased with this possibility so I have experimented with the constriction ring that came with the VED and it successfully keeps me from leaking during orgasm. I have to convince her it will work during intercourse. Fingers crossed. You may want to try it.

web265 | @web265 | Aug 17, 2023

"climacturia" ? Knew there had to be a medical word for it. "leaking during sex" just wouldn't look good on a medical chart...LOL.
Song coming to mind "Let's talk about sex, baby...lets talk about..." well, you get the idea.
Thanks for posting this, coming up on the end of my ADT meds (well sort of, another 8 mos) and was wondering myself. I have been able to have a weird sort of erection / climax where I get semi erect for a few seconds, dry orgasm or leak urine a little and that's that. I haven't used the ED meds, yet...
I'm hoping that once the ADT meds clear my system a little, I'll get more of my "groove on" but was wondering how to manage the leakage. I was thinking condoms. My docs never mentioned the VED.

I don't think I care enough about sex to have any surgical options, but, that may be the ADT meds talking. I'm all for any other options though.

In all seriousness, please keep us posted!

spino | @spino | Aug 17, 2023

https://www.amazon.com/Saving-Your-Sex-Life-Prostate/dp/0980064961 by John Mulhall discusses this in some detail. "edo": Your situation is more complex because you have had multiple treatments, not to mention that you have a past history of course as well, so I won't try to summarize :-). There is transient urine leakage as the nerves recover after surgery or radiation, and also possible permanent nerve damage, so Mulhall's summary may be helpful to discuss with your [sex*] doctor if you have one, or if not, then with your partner anyway.
*Mulhall also points out that many or most MDs, urologist or primary care, are uncomfortable discussing sex in the first place.