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Sexual Incontinence Needs Attention, Researchers Say

Nov 21, 2017

Based on their review, the researchers noted the following:

  • Between 2% and 10% of women experience sexual incontinence, with higher rates for women who already have another type of incontinence.
  • Men often have sexual incontinence after radical prostatectomy, the surgical removal of the prostate gland. For example, one study in the review found that 20% to 64% of men had climacturia after this surgery. Some men find that their continence improves over time, however.
  • Scientists aren’t sure exactly why sexual incontinence happens. One possible explanation involves damage to important nerves, particularly the pudendal nerve, which plays roles in both genital sensation and urinary function. Such damage can occur through pelvic surgery or childbirth.
  • Many men and women with sexual incontinence avoid sexual activity because they feel embarrassed, unattractive, or anxious.
  • Sexual incontinence can affect partners and relationships, too. But some people felt their partners were more bothered by it than those partners actually were. In fact, one study found that some men didn’t know their female partner had leaked urine during sex. In the same study, 84% of the women said that their sexual incontinence was a problem, but only 35% of their partners agreed.
  • Men who have sex with men may be more bothered by sexual incontinence and need to make adjustments, especially if they engage in oral sex. (The reviewers found no studies discussing women who have sex with women or heterosexuals and oral sex.)
  • Doctors and patients often don’t discuss incontinence during office visits. The authors suggested that doctors provide relevant information in office waiting rooms or conduct simple screenings.

There are several ways to treat sexual incontinence, the authors wrote. Some are behavioral, like emptying the bladder before sex, wearing a condom, placing a tension loop at the base of the penis, or using a dental dam (a barrier method sometimes used during oral sex). Patients may benefit from pelvic floor physical therapy, which strengthens pelvic floor muscles for better urinary control. Medications and surgery are other options.

Treatment of sexual incontinence may improve sexual satisfaction for both patients and partners, the authors added.

Resources

Sexual Medicine Reviews

Melissa H. Mendez, MD, et al.

“Contemporary Review of Male and Female Climacturia and Urinary Leakage During Sexual Activities”

(Full-text. Published online: September 20, 2017)

http://www.smr.jsexmed.org/article/S2050-0521(17)30097-5/fulltext

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