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Herman & Wallace Blog

Male urinary incontinence with sexual activity post-prostatectomy

The latest Journal of Urology reports on a single-center prevalence study of urinary incontinence during sexual activity that occurred in men following prostate cancer surgery.

Nearly 1500 men were surveyed to determine the post-operative prevalence of urinary incontinence (UI) with sexual activity and stress UI in the absence of sexual activity. The participants completed the UCLA-PCIpre-operatively and again at 3, 6, 12 and 24 months following surgery. All men had been treated by the same surgeon. 12.1% of men reported major bother from urinary incontinence with sexual activity at 24 months post-operatively. Of these men, more than half of them also experienced significant bother from stress urinary incontinence. Interestingly, more than 10% of men who did not report stress incontinence did report leakage with sexual activity. The take home point: men can have leakage during sexual activity even if coughing, laughing, golfing, transitional movements are leak-free.

The study concludes that treatment of the problem requires further research. While that is true, you can find some wonderful patient education materials related to post-prostatectomy pelvic muscle awareness and strengthening on physiotherapist Grace Dorey's website. One such resource is "Living and Loving After Prostate Surgery."It is so helpful to be able to direct patients to such resources that speak candidly about issues of urinary and sexual function for men.

Another terrific resource for the pelvic rehab therapist is Grace Dorey's textbook, Pelvic Dysfunction in Men: Diagnosis and Treatment of Male Incontinence and Erectile Dysfunction. You can also attend the Pelvic Rehab Institute's next Male Course, in which topics of male sexual health, pelvic pain, and urinary dysfunctions are discussed. Check out the course listing for upcoming dates.

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