Decide what you actually want from the conversation
Before you say anything, get clear in your own head about what you want out of it. Not the perfect words — the purpose. There are only a few real options, and they need different conversations.
You might want her to stop guessing why you've pulled away. You might want practical cooperation — a towel by the bed, a lamp instead of the big light, no comment when you get up at two. You might want to say that you still want her, and that the distance is not about wanting less. Or you might just want it said out loud so it stops taking up so much room.
Pick one. A conversation with one purpose lands. A conversation carrying four ends up as an apology, and an apology is not what you need to give here.
Pick a moment that is not the bedroom and not the aftermath
The worst time to talk about this is straight after something has gone wrong — a leak during sex, or a night where you turned away. Feelings are too loud, and whatever you say will sound like it is about that one event.
Better: side by side, doing something ordinary. Driving. Washing up. A walk. No eye contact required, no bed in the room, an easy exit if it gets heavy. Men often talk more plainly when they are facing forwards rather than facing each other.
Give it a beginning. "There's something I've been keeping to myself and I'd rather you heard it from me" is enough of a start. It tells her this is deliberate, not a complaint that slipped out.
Say the plain thing first, then the explanation
The instinct is to build up to it — background, surgery, the physio, and then the fact. Reverse that. Lead with the fact in short words. "I leak. It happens when I move, and sometimes it happens during sex. That's why I've been keeping my distance."
Plain language does two jobs. It stops the guessing, and it takes the shame out of the room by refusing to dress the thing up. Euphemisms signal that a subject is unspeakable. You do not want that signal in the house.
Then explain, briefly. What causes it, what you are doing about it, that it can improve with training and time. Keep the explanation shorter than you think it needs to be. She is listening to your tone more than your content.
Expect her relief, not her disgust
Here is what most men brace for: revulsion. Here is what usually arrives instead: relief, and often some hurt. Because from the other side of this, months of withdrawal look like one thing — you have gone off her, or there is someone else, or you are ill and not saying.
Against those explanations, "I leak and I was ashamed" is easy news. It may take her a moment to catch up. She may be annoyed that you carried it alone. That annoyance is not rejection; it is what being shut out feels like.
Let her respond without correcting her. If she says it does not bother her, do not argue that it should. You do not have to believe it today. Just let it be said.
Talk about intimacy as something to redesign, not something to mourn
Intimacy after prostate surgery changes on more than one front, and leaking is only part of it. The conversation goes better when it is practical rather than mournful. What could work now? What would make it easier?
There are real answers. Emptying your bladder beforehand. Less to drink in the hour before. A dark towel that lives in the bedside drawer so it is unremarkable. Positions that put less load on your middle. Morning instead of late evening, when the bladder tends to be more cooperative. Touch that is not aimed at sex at all, so that closeness stops being a test you might fail.
Say plainly which parts you would like to keep. Being held. Sharing a bed. Going to bed at the same time. Those are the things that quietly disappear while a man is busy protecting himself, and they are the easiest to get back.
Agree what happens if it happens
Most of the fear is not about a leak. It is about the moment after a leak — the freeze, the apology, the evening ending badly. So decide in advance, together, what that moment looks like. It sounds unromantic. It removes an enormous amount of dread.
Something simple: you deal with it, you come back, you carry on if you both want to. No inquest, no apologising twice. A phrase you both agree on, so nobody has to find words while feeling exposed. Some couples want it named and passed over; some want nothing said at all. Either works, as long as it is agreed.
Having a plan changes what you bring into the bedroom. You stop monitoring yourself all evening. And that watchfulness — not the leaking — is what does most of the damage to a good night.
Come back to it once, briefly, a few weeks later
One conversation rarely finishes a subject like this. But a second one does not need to be as big. A short check-in a few weeks on — is the towel arrangement fine, is there anything she has been holding back, is anything easier than it was — keeps it from silting up again.
If something has become alarming rather than awkward — blood, pain, fever, or a sudden change in what your bladder is doing — that is a conversation with your doctor, not with your partner, and it should happen soon.
The useful measure over the coming months is not whether you have stopped leaking. It is whether the subject has stopped being unspeakable in your own house, and whether you are going to bed at the same time again. Those tend to move before anything else does, and they make everything after them easier.