Between the Sheets - May 2022

QUESTION FROM PROSTATE CANCER SURVIVOR:

Ever since my surgery (laparoscopic prostatectomy with the DaVinci robot) I leak urine during sexual activity/oral sex. This is NOT sexy and I don’t know what to do about it. I need help!

RESPONSE FROM DR. ANNE KATZ:

This is not an uncommon occurrence and most men find it very distressing. The sphincter, which is the valve that keeps the bladder closed, is damaged or destroyed when the prostate gland is surgically removed. The muscles of the pelvic floor have to take over that function during sexual activity. Especially during orgasm, the muscles of the pelvic floor ‘let go’ or contract, which can cause leakage or outright gushing. While a towel under you and/or your partner is an obvious band-aid solution, it doesn’t get to the root of the problem; and, of course, a towel is not going to help much if you are leaking during oral sex.

Although urine is sterile and cannot harm you or your partner, loss of urine during sexual activity can be embarrassing and can have a major negative impact on sexual satisfaction and quality of life. There’s no need to suffer in silence. A visit to a knowledgeable pelvic floor physical therapist, or physiotherapist, can be very helpful. The American Physical Therapy Association is the official organization for physiotherapists in the U.S. Search for a physical therapist on their website at https://bit.ly/2mwByW6. But be sure to confirm that any physical therapist you are considering has expertise in pelvic floor physiotherapy, as this is not included in basic training programs.

Originally published in the November 2018 Hot SHEET newsletter.

Do you have a question about sexual health or intimacy? If so, we invite you to send it to ZERO. We’ll select questions to feature in future Between the Sheets columns. Please email your question to: bts@zerocancer.org.