There is a substantial body of clinical evidence on how urinary incontinence affects women's sex lives. Desire, arousal, orgasm, avoidance of intercourse, leakage during sex. The literature is not perfect, but it exists, it has been reviewed systematically, and it has produced treatment recommendations.

For men managing incontinence without a surgical history, the men wearing pads for OAB, urgency, or stress incontinence, virtually none of that research exists. Nobody has studied them. Nobody has asked.

This is that article.

What the research shows for women

A 2022 narrative review found strong evidence that urinary incontinence negatively affects female sexual function across all subtypes (Frigerio et al., PMC9025831). Urge incontinence is particularly damaging. Sexual inactivity rises from 35% to 50% in women with urgency urinary incontinence compared to those without.

Coital incontinence, leaking during sex, restricts sexual activity in 57% of affected women, interferes with orgasm in 67%, and would lead up to 77% to abstain from sex entirely. An ICS 2024 abstract puts the headline numbers plainly: up to 50% of incontinent women refuse any sexual activity; 5-38% avoid intercourse altogether; up to 68% experience sexual dysfunction (Urbaneja Dorado et al., 2024).

Treatments work. Pelvic floor muscle training, surgery, and antimuscarinics all improve sexual function scores. There is a loop from problem to measurement to treatment. That loop exists because someone measured the problem in the first place.

What the research shows for men: post-surgery only

For men, the equivalent research is almost entirely confined to those who have had prostate surgery. The phenomenon studied is climacturia. In plain terms: orgasm triggers a leakage event. It is not the same as general urinary incontinence and it does not mean the surgery has failed. It is, however, common and almost entirely underdiscussed.

A systematic review of 13 studies covering 5,208 patients found climacturia present in 27.2% of men after radical prostatectomy (PMC11869926, 2024). Other estimates place the range at 20-48% depending on surgical approach and study population. It is not a rare complication. It is a common one that patients are rarely warned about and rarely asked about afterwards.

The impact on sexual behaviour is the part the numbers make disturbing. A study on arousal incontinence after radical prostatectomy found that 87% of affected men reported bother of some severity, 64% perceived their partner was also bothered, and 41% of men with current symptoms avoided sexual activity entirely because of it (PMC8519164, 2021).

The shame is doing more work than the leakage itself. Men who only experience leakage during foreplay, not at climax, still avoid intimacy. The uncertainty of when it might happen, and the fear of a partner's reaction, is enough to shut down sexual activity entirely.

The impact extends to partners regardless of which person in the relationship has the condition. A 2010 study found that men whose female partners had urinary incontinence reported lower frequency of intercourse, less sexual satisfaction, and more erectile problems than men with continent partners (Bekker et al., 2010). Incontinence reorganises the sexual behaviour of both people in a relationship.

The population nobody has asked

Men managing incontinence from OAB, urgency, or non-surgical stress incontinence represent a large share of the male incontinence market. They wear pads. They manage leakage daily. And as far as the published literature is concerned, their sex lives do not exist.

No study has measured sexual dysfunction rates in men with OAB. No validated tool has been applied to how urgency incontinence affects desire or frequency in men who have not had surgery. The asymmetry is near-complete.

What a pad actually means in the bedroom

The pad has to come off before sex, or it does not. That decision, when, whether, and in what context, affects spontaneity in ways that have no clinical measurement attached to them.

Does the man tell his partner about the pad before they are in a sexual situation, or manage it quietly? Does anxiety about leakage during intercourse lead him to avoid certain positions or curtail the encounter? Has the pad reduced the frequency with which he initiates? Has the uncertainty changed how he feels about his own body in a sexual context?

None of this is documented. None of it has been measured. None of it has been asked.

For men managing urgency incontinence specifically, the uncertainty compounds the issue. Stress leakage during exertion follows a predictable pattern that can be anticipated and prepared for. Urgency leakage does not. The pad is not the problem. It is the unmanaged uncertainty around what might happen that shapes behaviour.

What this means in practice

If you are managing incontinence and it is affecting your sex life or your relationship, you are not unusual. You are in a group that has simply never been counted. The absence of data is not evidence that the problem is rare. It is evidence that the question has not been asked.

The most useful single step is disclosure: to a partner if you have one, and to a GP if the anxiety around sex is significant enough to be affecting your daily life. Sexual dysfunction related to incontinence is a legitimate clinical concern. It does not require a surgical history to be taken seriously.

LeakedBriefs is including questions about sexual activity, partner disclosure, and the practical impact of pad use in its independent survey. Take the survey. Results will be published in full.

A note on the post-surgical context

If you have had prostate surgery and are managing climacturia, there are specific product options worth knowing about. A pull-up product rather than a shaped pad provides more reliable containment during sexual activity. Some men use a condom catheter or a penile clamp for specific occasions. These are practical solutions, not clinical treatments. The GP or continence nurse conversation is worth having if climacturia is affecting quality of life, because treatment options including pelvic floor physiotherapy and in some cases surgical intervention do exist.