Sexuality

Bladder or bowel control issues can have an enormous impact on sexuality and the way you feel about yourself. Any leakage, fear of leakage, fear of odour, wearing continence pad or need to find a toilet may change how you feel about yourself sexually. It may also affect how you behave, including how you dress, socialise and engage in sexual relationships. You may find you restrict your movements outside of the home, avoid intimate relationships and alter your clothes to try to disguise any wetness, staining or sign of a continence pad. Your choice of clothing can be an outward expression of your sexuality.

If your partner needs to assist you with your continence care, including personal care, this may also have an impact on your sexuality and your intimate relationship. If this is impacting on your relationship, you should be talked about with an appropriate health professional, such as your doctor or clinical psychologist.

When you live with incontinence, this can have physical and emotional impacts.  This can include fear of intimacy, concerns over leakage or soiling during sex, concerns over how to manage continence products during sex, painful sex, bladder spasming or catheter bypassing during sex.

These impact or concerns can lead to you avoiding situations of intimacy, withdrawing from existing relationships, avoiding new relationships and suppressing your sexual desires.

You need to know you are not alone in these feelings and that help is available.

Try to empty your bladder prior to sexual intimacy. Be prepared by protecting the bed, such as with a mattress protector and/or a bedpad, and have towels and washcloths ready. You could also discuss your fluid intake with your doctor, including the types of fluids you are drinking. Speak to your doctor, pelvic health physiotherapist or nurse continence specialist about what you are experiencing and what treatment is available to help manage it.

A catheter can be removed prior to sexual intimacy and a new one inserted. This may not be possible for many people. For men, a catheter can be taped to the shaft of the penis, allowing for an erection. If friction is a concern, a condom may be worn over the catheter and penis, and water-based lubricant used for lubrication. For a women, a catheter can be taped to the upper thigh during sex to keep it out of the way.

If your partner is in good health, it is unlikely that they would be at increased risk to the organisms or bacteria associated with a urinary catheter. If there is any doubt, encourage your partner to wash themselves and pass urine after intercourse and drink plenty of fluids.

Having a catheter in place should not affect an erection or ejaculation. An erection starts through a combination of mental stimulation (thinking) and sensory stimulation (touching) responses which leads to increased blood flow into the muscles of the penis. It is possible that anxiety may affect the 'thinking' responses. If you experience difficulty, it is important to find out the exact cause of the erectile dysfunction or impotence and this may mean a referral to a urologist. Sometimes, however, a catheter can have the opposite effect and cause spontaneous erections due to the friction.

Certain types of ongoing infections can produce strong or offensive smells. Make sure any signs or symptoms of a urinary tract infection are investigated and treated. Drink well to try to avoid having concentrated urine which may have a strong odour.

A leg drainage bag may be covered or put out of the way. It is a good idea to talk to your partner before sexual intimacy about the equipment you use so that they know what to expect. Sometimes a catheter can be temporarily sealed off and the leg bag removed with a catheter valve used instead.