Trouble controlling the flow of urine (urinary incontinence) or flow of faeces (faecal incontinence) is a common side effect of treatment for cancer of the prostate, bladder, bowel and penis, or of the female reproductive organs. The pelvic floor muscles that affect bladder and bowel control also affect sexual function and arousal. Having bladder or bowel issues can make you feel embarrassed and impact your sexuality, but there are ways to manage symptoms.
Incontinence can be temporary or permanent. For advice and suggestions on managing incontinence, call the National Continence Helpline on 1800 330 066, or visit bladderbowel.gov.au.
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Tips for managing bladder and bowel issues
- If you have a catheter for draining urine, tape the tube to your skin, remove the bag and insert a flow valve or stopper before having sex.
- Use plugs designed for rectal use if you have faecal leakage.
- Learn how to exercise your pelvic floor muscles. See video below for instructions.
- Wait at least 2–3 hours after a meal, and empty both the bowel and bladder before having sex.
- Cover your bed with large, fluffy towels.
- Women only: talk to your doctor about whether oestrogen inserted into the vagina as a cream or tablet could improve things. This may not be an option if you are having hormone therapy.
- Try positions that reduce pressure on the bladder such as being “on top”.
- See a pelvic health physiotherapist for advice.
How to exercise your pelvic floor muscles
To identify your pelvic floor muscles, try stopping your urine stream for a couple of seconds while emptying your bladder. You use your pelvic floor muscles to do this. Pelvic floor exercises should be done several times a day.
The technique is the same for men and women (watch video above).
- Start by relaxing all of your pelvic floor and tummy (abdominal) muscles.
- Gently lift your pelvic floor muscles up and hold while you continue breathing normally. Try to hold the contraction for up to 10 seconds. Relax your muscles slowly after each hold.
- Repeat the exercise up to 10 times, with a rest of 10–20 seconds between contractions. Relax your pelvic floor muscles completely during the rest periods.
Listen to our podcast on Sex and Cancer
Helena Green, Clinical Sexologist and Counsellor, inSync for Life, WA; Anita Brown-Major, Occupational Therapist, Thrive Rehab, VIC; Karina Campbell, Consumer; Nicole Kinnane, Nurse Consultant, Gynae-oncology Services, Peter MacCallum Cancer Centre, VIC; Jessica Medd, Senior Clinical Psychologist, Headway Health and Concord Hospital, NSW; Chris Rivett, 13 11 20 Consultant, Cancer Council SA; Kath Schubach, Urology Nurse Practitioner, President – Australia and New Zealand Urological Nurses Society (ANZUNS), VIC; Prof Jane Ussher, Chair, Women’s Health Psychology, Translational Health Research Institute (THRI), School of Medicine, Western Sydney University, NSW; Maria Voukelatos, Consumer. We would like to thank the health professionals, consumers and editorial teams who have worked on previous editions of this title.
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