Incontinence during sex is a long-lasting problem for roughly one in eight men who've had a prostatectomy, a study of more than 1,400 patients has found.
Although the urine leakage resolved for some men over time, 36% of them still had the problem – called climacturia – two years after surgery. And 12% called it a major bother.
"I think that it's something that is under-appreciated, because if you look through all the discussion, everything is always about erectile dysfunction after prostate surgery,” said Dr Herbert Lepor, an urologist at New York University.
"We overlook some of the other issues that are relevant to overall sexual function," said Dr Lepor, who led the new study.
Another urology group had a different outcome
His group looked at responses to questionnaires from 1,459 men who had radical prostatectomy between 2000 and 2007.
He performed all the surgeries himself, without using a robot, but said he believes the incidence of sexual incontinence would not differ after robot-assisted procedures.
The findings, published online in the Journal of Urology, suggest urination issues may be a bigger deal than suggested by earlier studies.
Another urology group reported that only one in 20 men said they were significantly bothered by incontinence a year or more after prostate surgery. Whether the discrepancy is due to questionnaire differences or other factors is unclear.
Few men reports leaking problem after surgery
The term climacturia was coined in a paper in the Journal of Urology by Dr Neil Fleshner at the University of Toronto and his colleagues.
Dr Fleshner told Reuters Health he's surprised by how few men report the problem after prostate surgery. Surgeons typically remove a sphincter muscle in the neck of the bladder that shuts off the flow of urine during an orgasm.
"I do tend to tell our patients prior to surgery that this could happen," Dr Fleshner said.
Exercising the pelvic muscles might help
Surgery can help relieve incontinence in some men who develop the problem after prostate removal. So, too, might exercises that strengthen the pelvic muscles, although the benefits of such rehabilitation are unproven, Dr Fleshner noted.
Dr Lepor said he and his colleagues were a bit surprised by how common sexual incontinence was in their study.
"I think it's something that those of us who perform radical prostatectomy should be aware of in terms of counselling our patients, and also in terms of finding ways to treat this if it ends up being a problem," he said.
(Reuters Health, August 2011)