Arousal Incontinence a Concern After Prostatectomy

Arousal Incontinence a Concern After Prostatectomy

Arousal incontinence – urine leakage when a man is sexually aroused - is common after radical prostatectomy, researchers report in the Journal of Sexual Medicine.

Radical prostatectomy (the surgical removal of the prostate gland) is a frequent treatment for prostate cancer. After surgery, men might experience sexual issues, like erectile dysfunction and climacturia (leakage of urine during orgasm). However, less is known about arousal incontinence.

The research team sent questionnaires to 226 men who had undergone radical prostatectomy within the previous 24 months. The men’s average age was 64 years.

Half of the men said they had had arousal incontinence at least once since their surgery. For most of the men, the problem started within the first three months after prostatectomy.

About 39% of the men were experiencing it at the time of the study. Eleven percent said they’d had arousal incontinence in the past, but no longer did. Among this second group, 50% said that the situation had gotten better within seven months.

About three-quarters of the men said physical stimulation led to arousal incontinence. For 25%, urine leakage happened when they were psychologically aroused, too.

Arousal incontinence didn’t happen with every sexual encounter, however. For 57% of the men, it occurred less than half the time they were having sex. Most men said the amount was a tablespoon or less.

The authors explained some similarities between arousal incontinence and stress urinary incontinence, which happens when there is pressure on the bladder. People with stress urinary incontinence often leak urine when they cough, sneeze, laugh, or physically exert themselves.

Both types of incontinence are more likely to occur when a man’s pelvic floor muscles are relaxed. For a man with stress urinary incontinence, this might be when he is tired. Similarly, a man’s pelvic floor muscles relax when he is aroused.

Treatments for arousal incontinence are still being studied, the authors said. “In our practice, we recommend the use of a variable tension ring in men who are significantly bothered by [arousal incontinencehttps://www.jsm.jsexmed.org/article/S1743-6095(19)31443-2/fulltext" style="margin: 0px; padding: 0px; border: 0px; font-style: inherit; font-variant: inherit; font-weight: bold; font-stretch: inherit; font-size: inherit; line-height: inherit; font-family: inherit; vertical-align: baseline; color: rgb(145, 188, 64); text-decoration: none;">https://www.jsm.jsexmed.org/article/S1743-6095(19)31443-2/fulltext

Jimbo, M., et al.

“Prevalence of Climacturia in Patients with History of Definitive Therapy for Prostate Cancer”

(Abstract. January 2020 – Supplement 1)

https://www.jsm.jsexmed.org/article/S1743-6095(19)31599-1/fulltext

MedlinePlus

“Stress urinary incontinence”

(Reviewed: January 23, 2018)

https://medlineplus.gov/ency/article/000891.htm