Sexual Considerations After Urinary Diversion

Leaking urine during sex can be an issue. You may have had a urinary diversion as part of your cancer treatment, and this can come with special considerations. Urinary incontinence can be expected after surgery. You may have an ostomy or ileal conduit. Whatever the case may be, it is important to remember that unless you have an infection, urine is sterile and will not harm your partner. 

Cancer cells in your urine could not harm your partner either. However, if you are actively receiving radiation or chemotherapy treatment, please consult your oncology provider prior to having sex. 

Tips for Coping with Urine Leaks 

  • Make your bed with a waterproof sheet, bed pad, or towel in between the sheet and mattress pad. If you have a leak, you can just throw the top layers in the wash.  

  • Use a disposable pad that sticks to a fitted sheet and can be thrown away after each use.  Some come in different sizes, depending on how much urine needs to be absorbed. 

  • If you are concerned about urine odor, and you plan to have sex in the next few hours, avoid eating foods like asparagus or fish that give urine a strong odor. 

  • When you are getting back to sex for the first time after cancer treatment, you may want to try sexual activity in the shower or in a big bathtub. Just be careful not to put yourself at risk of slipping or falling. Be aware that sometimes a lot of exposure to hot water can also increase the risk of urine leakage from an ostomy faceplate. 

  • When you start a new relationship, consider discussing urinary incontinence or having an ostomy with your partner before being intimate. While some may find this awkward to address, it can take away the dread of a "surprise". 

  • Leakage is more likely to occur during penetration than during gentle external caressing or oral sex. However, if you tend to leak urine at orgasm, you may want to warn your partner to stop oral sex and substitute hand caressing when you are close to your climax. 

  • If you have an ileal conduit or continent ostomy, empty urine from your appliance or catheterize yourself before sex to minimize the chance of a leak. 

  • You can get pouch covers made of soft or colorful fabrics to wear during sex. Some people also get smaller-sized pouches to wear for sex, but they need to be emptied more often. 

  • Special stretchy belts to cover an ostomy appliance or panties with a pocket for it can reduce the chances the faceplate will leak or separate during sexual activity. 

  • Avoid positions in which your partner’s body rubs against your ostomy faceplate. Some women place a small, firm pillow above the faceplate to support the partner’s weight. 

If you are struggling with a leaking ostomy or urine leakage during sex, please reach out to an Iris Oncology clinician or get expert help from a pelvic certified physical therapist or a Wound, Ostomy, & Continence (WOC) nurse.