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Orgasm after RP

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Posted 5/19/2024 7:39 PM (GMT 0)
Hi-

I am 2 months post RP and continent however I still leak a little urine when orgasming which I know is considered normal. Does anyone have completely dry orgasms and if so was it from the start or did it just gradually get to the point of being completely dry ? I should also mention that the orgasms are without an erection.

Post Edited (Whatprostate318) : 5/19/2024 11:53:35 AM (GMT-8)

Posted 5/19/2024 10:44 PM (GMT 0)
Not unusual, I was leaking a little urine with orgasms after my surgery. After radiation, I leak a little more, unless I make sure I empty my bladder before the deed is done.

As far as erections, what are you doing to help in that area? Meds, pump, injections? anything? It's still early, it can take time to improve. I was getting erections soon after surgery, but TBH, they are not as easy to come by now as they were then (8 years ago) and I often orgasm without one.
Posted 5/20/2024 6:10 AM (GMT 0)
Everyone is different....But I too leaked urine.
Posted 5/20/2024 11:56 AM (GMT 0)
The first orgasm some weeks after surgery was like a fire hose which surprised me. My continence was fine so not exactly sure what was going on but missing the prostate check valve is pretty obvious when you think about it. Like everything else, it was mainly retraining and got better over time so maybe 98%. Still leaks a little which is influenced by state of bladder at the time. Guaranteed to have an issue if fully hydrated.

Steve says “everyone is different” but I suspect this is pretty common with surgery patients. The “new normal” is a proper description of life after surgery.
Posted 5/20/2024 5:19 PM (GMT 0)
The medical term for leaking urine during orgasm is climacturia and unfortunately it’s rarely discussed. It’s very common for more than 50% of men when their prostate is removed. It can also occur in some BPH procedures. It is the result of removing one of your involuntary sphincters that is located in the prostate. This sphincter’s purpose is to shut down urine flow during sex. This involuntary sphincter is the same one that makes it hard to pee when a man is sexually excited. Since it’s gone it may help to have an empty bladder prior to sex. It may also help to strengthen your remaining voluntary sphincter. When modern radiation is used as a monotherapy to treat PCa the urinary tract typically does not see a damaging amount of radiation to this sphincter.
Posted 5/21/2024 2:10 AM (GMT 0)
In my experience, Terry is correct in all regards. I mentioned it to my urologist and pretty much got a nod that it is a new normal. What I would like to mention is that I have an AUS and the pressure on the bladder during that “event” exceeds the holding capacity of the device or the extra blood flow in that area slightly distorts the cuff allowing a leak, or both.
Posted 5/21/2024 1:36 PM (GMT 0)
Vince… I wonder how much of the ‘new normal’ is discussed prior to surgery by the urologist. BTW, the information I posted earlier is mostly from discussion with one of the guys I cycle with. We were both diagnosed at the same time as low risk Gleason 6. He opted for a very poorly run ‘active surveillance’ program at the VA. His cancer was finally and unsuccessfully treated with surgery and later radiation. He has an AUS placed and continues on ADT. He’s a poster boy for what can go wrong in a poorly run active surveillance program.
Posted 5/21/2024 4:00 PM (GMT 0)
My urologist did not get into the details quite that far. Lots of discussion about incontinence and ED but I do not recall any discussion about "climacturia". In fact, I do not recall reading about it anywhere either until I looked it up. There were general incontinence discussions about "leakage" when straining, etc but not specific to the event.

I also had a temporary issue after my biopsy with "retrograde ejaculation" which is an orgasm with the contents going back into the bladder vs. coming out front. I was really surprised and found all about it pretty quickly. Uro says that it is rare from a biopsy but no worries, all will be ok.

Conclusion - The "new normal" is not fully described but the main issues were covered in depth. I also thought full recovery from surgery was underestimated and I was not back to normal in a month. I was lucky and had hardly no incontinence after the catheter was removed so I was cocky at 2 weeks but it was months before my "normal" returned in full.
Posted 5/28/2024 5:05 PM (GMT 0)
Sex was unfortunately a big part of my thoughts for a long time.
I didn't act on it that often but had my share of partners sometimes serious relationships often just sexual friendship.
Wow has that worm turned!
Thankfully I'm not at all ruled by the drive and secondly, PCA, radiation, diabetes and back surgeries have reduced (pun intended) my urges.
I'm married and my wife is understanding and I think at 71 we are both over the overwhelming drives.
I'm sure Cialis and testosterone are somewhat helpful but honestly I just don't care about the sex drive.
Maybe TMI but in case it helps, I do "take matters into my own hand"
This is maybe every two weeks. Instead of the old fire hose, it's more of a trickle but still somewhat satisfying. I'm assuming the act is somehow physically beneficial

Glen
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