The Unspoken Side Effect: Coping with Climacturia After Prostate Treatment

What To Do When Urine Meets Ejaculation

Many individuals are aware that urinary incontinence is a common issue for men following prostate cancer treatment. Fortunately, this is typically temporary and can be addressed with time and dedicated pelvic floor training such as Kegel exercises. However, what often goes unnoticed is another prevalent side effect known as climacturia and arousal leakage.

Climacturia involves the involuntary leakage of urine during ejaculation, while arousal leakage refers to urine being present during sexual excitement. Like general incontinence these issues can improve over time, yet there are instances where it persists, resulting in distress for some men.

The exact cause remains unknown, though there are a few theories. It could be related to injury or changes in the urethral sphincters following treatment. Some suggest a connection to a reduction in penile length, but evidence indicates that penile rehabilitation with devices like vacuum pumps can mitigate this.

Many men associate difficulty urinating with a strong erection and mistakenly link their post-prostatectomy erectile dysfunction to urine leakage. It's crucial to clarify that climacturia is unrelated to erectile dysfunction; they are simply common post-prostatectomy side effects.

It's essential to remember that climacturia and Arousal Leakage are usually harmless and often temporary. However, they can have a significant negative impact on one's psychosexual well-being. Approximately half of patients report experiencing some level of distress due to these symptoms, leading to reduced sexual satisfaction, higher rates of depression, and increased anxiety.

The level of bother is the most significant issue. If it doesn't bother you, there's no problem; some individuals even derive pleasure from it (as seen in practices like "golden showers").

Research from 2020 indicates that the prevalence of Climacturia falls within the range of 21–38%. While it may not be bothersome for most, it can be deeply impactful for some men. For example, 36% of patients in one study reported avoiding intercourse entirely due to Climacturia. The concern about how one's partner perceives the issue is a source of distress for many, including those in long-term relationships.

Now that we understand what Climacturia is and that it has a name, let's explore potential solutions. Several treatment options are available, some less invasive than others. As a general rule, it's advisable to try conservative approaches during the first 12 months post-surgery. If the problem persists, surgical intervention can be considered.

Treatment Options:

1. Emptying the bladder before sex: This works for some but not all, as some men still experience leakage despite using the restroom immediately before sex.

2. Change position: Engaging in sexual activities while lying down or standing can reduce pressure on the bladder.

3. Tension loop/lasso (commonly known as a "cock ring"): Placing a soft elastomer loop over the penis before sex can compress the urine channel and prevent incontinence during orgasm. 

4. Pelvic floor training (Kegels): These exercises are crucial for overall continence and can help reduce Climacturia while improving orgasm quality and intensity. Consult a qualified pelvic floor physiotherapist who specializes in men's health for proper guidance.

5. Surgical management: Procedures like a male urethral sling or an artificial urinary sphincter have shown positive results in curing persistent Climacturia. Consult your urologist for more information.

In my clinical practice, I typically recommend pelvic floor training, bladder emptying, and the use of a tension ring/loop as initial approaches. However, what truly excites me is the groundbreaking innovation introduced by the FirmTech performance ring. This device has proven to be a game-changer for individuals grappling with these challenges.

My experience with the FirmTech performance ring has been genuinely impressive. The feedback that I’ve received from clients is that these rings have demonstrated comfort for both the wearer and their partner, enhancing theirs overall intimate experiences. Unlike some alternatives, they can be comfortably worn for extended periods, making them conducive to maintaining intimacy without concerns about discomfort or disruption.

Another great aspect of the Firmtech Performance Ring is its ability to strike the perfect balance between managing Climacturia and ensuring optimal penile health. Not only does it effectively reduce urine leakage during moments of excitement, but it also allows for adequate blood flow, ensuring that the penis retains a healthy pink hue and warm sensation.

Climacturia can significantly affect a man's quality of life, as well as that of their partner(s). Unfortunately, it's a poorly recognized side effect of radical prostatectomy, despite its substantial impact. As you journey through life after prostate cancer treatment, it's crucial to keep learning and discover the array of solutions within reach. While climacturia and arousal leakage can be tough hurdles to overcome, there's a path to a better, more comfortable intimate life with the support of innovative options.

If you or someone dear to you is facing these challenges, take heart in the knowledge that there's hope and help available. Don't hesitate to explore the possibilities presented – it's a step toward a future filled with brighter, more satisfying moments and a renewed sense of control over your intimate life.

To dive deeper into this topic, consider tuning in to the episodes available on The Penis Project

For more information about the author and services offered visit: