Well — this is a sort of progress, one hopes!


According to the abstract of a newly published paper by Krouwel et al. in Urology (“the Gold Journal”), we now have formal evidence that most urology residents in at least The Netherlands feel that they receive insufficient training in the management of men with erectile dysfunction. The abstract concludes (rather bluntly) that:

Current urology residency does not pay sufficient attention to sexual communication skills and sexual dysfunction. The residents require more knowledge about and more practical training in sexual counseling. Findings support efforts to enhance the education of urology residents regarding prostate cancer treatment-related sexual dysfunction.

One wonders what the results would have been if the same questions had been asked of urology residents here in the US. Perhaps the American Urology Association should carry out the relevant survey here!

7 Responses

  1. My concern is the solution will lead to future burnout. The prime need besides knowledge is time; vote for PA or nurse concentration.

  2. I’m curious about squirters. What fluids are squirted by males and females during foreplay? I have had prostate surgery with incontinence the only lasting problem.

    Gordon, age 79

  3. Mike:

    You are right. The solution is not necessarily for every urologist to have to spend hours with every patient. The solution is to have a system that allows the urologist to help the patient through the use of appropriate resources — a well-informed, skilled nurse or PA who listens and is a good communicator is certainly part of a way to solve this particular problem.

  4. Dear Gordon:

    The two most common fluids excreted during during foreplay and sexual activity by men who have undergone prostate cancer surgery are fluid from the Cowper’s gland (a pre-ejaculatory fluid that can still be secreted and excreted during foreplay for example) and urine (commonly excreted at or close to orgasm through a process known as climacturia).

  5. Thank you for the reply. I recently had climacturia during orgasm which wet the sheet through the towel. Other times I’ve sprayed on my wife during foreplay.

  6. Gordon:

    While it may not be ideal, the simplest way to address this problem is to use a condom.

  7. Among the suggestions I’ve heard from men who deal with this are to limit fluid intake (especially caffeine and fruit juices) before sex, empty bladder as completely as possible first, and use a constriction ring during sex (which helps maintain erection as well).

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