QUESTION:
I HAD PROSTATE CANCER WITH A RADICAL PROSTATECTOMY AS TREATMENT. SINCE THEN I FEEL LIKE I’M PEEING DURING FOREPLAY. IT’S SO EMBARRASSING! WHAT SHOULD I DO?

ANSWER:

One of the potential side effects of radical prostatectomy is a condition called urinary incontinence. It’s a broad term used to describe the inability to control urine, but it comes in a number of varieties. What it sounds like you have is something called stress incontinence, or SUI. This occurs when pressure on your bladder from activities like coughing, laughing, sneezing, exercising, or, in your case, sexual activity, causes the leakage of urine.

Stress incontinence is the most common type of incontinence after prostate surgery, so it’s not surprising that you may be experiencing it. It’s usually caused by problems with the bladder sphincter, which is the valve that keeps urine in the bladder. Unfortunately, prostate cancer treatments can damage this value or the nerves that keep it working. (1)

While surgical techniques have improved significantly in recent years, SUI remains a frequent side effect, with reported rates that range from 5% on the low end to 48% on the high end. (2) Timing can also play a role in the symptoms you’re experiencing; shortly after radical prostatectomy, about a third of patients complain about urine leakage, but that number usually drops to fewer than 5% of people once they’re a year out from their operation. (3)

Fortunately, SUI is very treatable. Some of your options include pelvic floor exercises, biofeedback, transcutaneous electrical nerve stimulation, external magnetic stimulation, and penile compression devices. (4) In fact, there are so many quality, proven options that you should reach out to a physician straight away. There’s no reason why you should have to live with this condition any longer than necessary.

The NAFC Ask The Doc series provides answers to some of our reader’s most common questions from a group of experts in the fields of urology, pelvic floor health, bowel health, and absorbent products. Do you have a question you’d like answered? Click here to Ask The Doc!

1. https://www.cancer.org/cancer/prostate-cancer/treating/surgery.html
2. Bauer, R. M., Gozzi, C., Hübner, W., Nitti, V. W., Novara, G., Peterson, A., … & Stief, C. G. (2011). Contemporary management of postprostatectomy incontinence. European urology, 59(6), 985-996.
3. Peyromaure, M., Ravery, V., & Boccon‐Gibod, L. (2002). The management of stress urinary incontinence after radical prostatectomy. BJU international, 90(2), 155-161.
4. Wilson, L. C., & Gilling, P. J. (2011). Post‐prostatectomy urinary incontinence: a review of surgical treatment options. BJU international, 107, 7-10.