Can’t climax, so who should I talk to about it?

I, m36, cannot climax during sex without stimulation of my prostate. This has been going on for a couple years now, and the last two times my partner and I have been intimate I have had to stop before I could climax because she is getting too sore.

In order to have a chance a climaxing, I basically have to, as we call it, “get marinated” by drinking my 2 liter water bottle and letting my bladder get full. Then, once I’m almost ready to pee my pants, I’ll USUALLY have enough pressure on my prostate that I can achieve climax, though not always.

I AM able to achieve climax through self stimulation, using the same method, but it takes FOREVER (feels like it). I honestly think I’m starting to get carpel tunnel from it, which sounds utterly ridiculous.

I know our bodies change as we get older, so I just chalked this down as one of those changes. But it’s gotten to the point where it’s beyond annoying, and I want to do something about it, but what?

I got a vasectomy last year and brought it up to the urologist. He basically brushed me off, and I have no desire to go back to him or his office.

What type of specialist could I see for something like this?

Is this a problem you have had and have had treated? If so, what did you do?

I’ve considered toys to address the issue, but I’m afraid that would just be a temporary fix, and I’m looking for something more long term.

For background, I’m on medication for a prolactanoma that makes me super horny and more susceptible to addiction (pretty sure I’m addicted to sex/masturbating, which is incredibly frustrating).

I’m 5’8” and I’m down to 180lbs from 200. I still have a bit of a dad bod, and could probably drop another 20. I know fat can cause health issues, but I don’t think I’m carrying enough excess weight for that to be a problem.

I don’t run it work out, though I’ve been meaning to start once a few work projects are finished. In the mean time, I work some low end construction, and it’s not uncommon for me to be on my feet all day and lifting heavy items.

Finally, I love my partner and am incredibly attracted to her. While I’ve definitely developed some kinks she’s not entirely into, she’s working to expand what she’s comfortable with, and I have no problems with her, her personality, her body, etc etc etc. in other words, it is NOT a her problem, so please don’t suggest it. It’s a me problem, and I’m addressing it as such.

Thank you.