Starting on nooky (a little rambly)

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New Member

Date Joined Feb 2009
Total Posts : 8
   Posted 3/16/2009 12:01 PM (GMT -6)   
We (my 40-years-sweetie and I) had the post-surgery follow up with the doc last Friday, 7-1/2 weeks after surgery. As noted below, PSA is great - evidence so far is the little dragon is gone, gone, gone (yes, I know I'll have to watch regularly forever).

Continence has improved dramatically in the last couple of weeks. I'm still wearing a pad during the day, but down to about one "spurt" per day, small quantity, usually caused by getting out of bed or stepping forcefully and not thinking about squeezing as I do. I'm able to walk longer distances - which was a problem at first, couldn't go a block without needing to pee. Saturday, I walked all the way downtown (1/2 mile), including a digression of two blocks to thank the police officer for pulling over the idiot who failed to stop as I was crossing in a crosswalk; went to the video store; went to the library; came home; and peed just because it seemed safer than not.

OK, says the surgeon, you can check those two off, now it's time for erectile function. I'm prescribed one Viagra, twice a week, wait 20-30 minutes, then go at it (this is not the language he used, but is more or less the tone in which it was delivered). When I raised questions of urine release during orgasm, he minimized it, saying, "it's sterile." When I had asked earlier whether my internal sphincter had been removed, compromised (permanently), or just thrashed (won't know for a while how it's functioning), he also minimized that, saying there's no evidence that the internal sphincter is necessary for continence.

First off, my wife and I are both more than a little grossed out about the idea of me peeing into her. Second, at this stage in our lives (60's, with my wife seven years post-hysterectomy), it takes a while to get rolling anyway.

I understand everyone's history is different - but is urinating during orgasm always a lifetime thing, or does it fade away in some cases?

Any G-rated suggestions welcome (this being a public forum and all).
Age 60 at diagnosis, robotic laparoscopy January 20, 2009 at Univ. of California San Francisco
Gleason 4+3 (from pathology), T2A, tumor growing into wall but not extending beyond
Last pre-surgery PSA 4.4
Post-surgery PSA at six weeks 0.01 - looks like it's gone!

Regular Member

Date Joined Oct 2005
Total Posts : 489
   Posted 3/16/2009 12:38 PM (GMT -6)   
No doubt others will mention this (and too bad your Doc did not know or mention this). If you are on the bottom when you orgasm you are less likely to squirt since the urine will be pooling away from the bladder exit.

This also goes for a simple JO too. Standing up you'll get urine, lying down on back when you orgasm, you likely will stay dry.

One other idea also is to use a penis ring or two (even on a natural erection) since that'll hold back the flood and also help keep you harder maybe. At early stages the rings might be a necessity anyways. And of course always pee as much as you can beforehand -- but that will never be enough to stop completely any spurts unless lying on back.

Goooood Luck!
Age 58, 192lbs, 6'4", 57 at DX, PSA Aug2008 7 4 ... June2007 4.7 (BPH + LUTS)
Biopsy Nov2008 1 of 12 cores 5%, Gleason 3+3 - Sona showed 140+ cc (110 grams post op) prostate size.
open RP surgery 02/03/9, Nerve sparing both sides, 1 day in hospital, Day 4 first BM,
Post-surgery Pathlogy Report - All margins clear - No Invasive spread - no change in Gleason score.
Cath out on 2/18/9, passed a STONE within hours. To be analyzed by doc.
Using pump (encore) daily since catheter out -- Viagra and Levitra samples now and then (no effect).
03/06/09 Started Levitra 20mg rehabbing.

James C.
Veteran Member

Date Joined Aug 2007
Total Posts : 4462
   Posted 3/16/2009 12:46 PM (GMT -6)   
My experience:
As I became more familiar with what it took to hold back/clamp down the urine, I was able to stop almost all episodes of it. You gotta have time for the brain and the nerves, along with the battered bladder to figure out how to work together again. Continence is a good start, but you will really learn the feelings and how to control it by being involved in the act of stimulation, orgasm and control. Whether you learn this by yourself, with help from the wife or during full intercourse, it will be a learning process to figure it out. If it really becomes an issue, then using a condom has been recommended here, as well as using a small sized penis ring to hold the urine back until after sex. All this is dependent on that Viagra working, of course..... tongue I hope it does right out of the chute....
James C. Age 62
Co-Moderator- Prostate Cancer Forum
4/07 PSA 7.6, referred to Urologist, recheck 6.7
7/07 Biopsy: 3 of 16 PCa, 5% involved, left lobe, GS 3/3=6
9/07 Nerve sparing open RRP- Path Report: GS 3+3=6 Stg. pT2c, 110gms, margins clear
16 mts: ED- 50 mg Viagra 3X week, pump daily,Trimix .35ml 2X week continues
PSA's: .04 each 3 months

Ralph Alfalfa
Regular Member

Date Joined Nov 2008
Total Posts : 469
   Posted 3/16/2009 8:29 PM (GMT -6)   
Dear Bill,
I had surgery one day before you and our outcomes are very similar. Continence,ditto. Our 34th anniversary around the corner, and the urine thing. I've found that if you urinate before activity that the chances, as well as the amount, are greatly diminished. Kind of kills the spontaneous side of the act, but that is soon forgotten, as long as you two have been together. My wife asks, "Did you pee?" No problem. It takes some time to get the full control back and time, I believe, is what we have with a PSa of zero. Good luck and if no one else has said it, welcome to the zero club.
 Dx: October,27(the day after my birthday)
 Psa 14.5
 Gleason:(4+3) 7 T1c
 Bone scan:Negative
 Cat scan: Negative
 Biopsy: 4 of 12 positive, left side, pre-cancerous on the right.
 Confined to prostate.
 DaVinci Jan. 19th, No lymph node involvement, all margins clear.
 8 week PSa <0.01

Regular Member

Date Joined Oct 2007
Total Posts : 300
   Posted 3/16/2009 8:38 PM (GMT -6)   
I'm about 14 months out and the urinating during foreplay and orgasm has diminished to nothing at all.
It was very discouraging to my partner and I.  I didn't know at the time if this would be a permanent part of my life.  I couldn't find any info as to whether it would go away on it's own or if there was any treatment available.  It is called "climacturia", and a lot of us here on the forum have dealt with it.  I think as the bladder heals things kind of go back to normal.  Remember, two of the three sphincter muscles are gone with the removal of the prostate.  Give it some time and I think it will resolve itself.  Good luck.
Age 65
Diagnosed 10/12/07
PSA 6.3
Biopsy 18 core samples, 2 positive <5%
Stage T1a Gleason 6 (3+3)
LRP  1/29/08
Gleason 7 (3+4)
1 positive margin (.3cm)
4/16/08- Started Bi-mix injections 
5/15/08- 1st Post-Op PSA 0.07 Undetectable
8/11/08 -2nd Post-OP PSA 0.02 Undetectable
8/15/08- No more pads as of today  Whoopee!!!
11/13/08- 3rd post-op PSA 0.02 Undetectable
03/02/09- 1 yr. post-op PSA .09 Undetectable

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