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Climacturia following radical prostatectomy: the time is now to query and treat

McCraw, C1; Christine, B1; Bella, A2

1: Urology Centers of Alabama, United States; 2: Ottawa Urology and Men's Health, United States

Objective: Orgasm/sexual activity induced urinary incontinence (climacturia) is not uncommon after radical prostatectomy. Men with climacturia uniformly list this as a significant detractor to quality of life contributing to shame and avoidance of sexual intimacy. Current literature suggests climacturia may be present in 20-40% of men who have undergone radical prostatectomy. Unfortunately, post-prostatectomy patients are rarely queried as to the presence of climacturia. We report the largest series to date of men with climacturia after radical prostatectomy who were treated with a transobturator male sling.

Materials and Methods: Review of registry data for men treated with the AdVance transobturator male sling following robotically assisted radical prostatectomy from January, 2010 through April, 2016 identified 44 men who had climacturia concurrent with clinically significant stress urinary incontinence (SUI) and 2 as a stand alone complaint. At the time of this abstract all had resumed sexual activity following sling placement and had reported on their incontinence, sexual function and specifically climacturia.

Results: All 46 patients (100%) report complete resolution of orgasm/sexual activity induced incontinence. Of the men with day to day SUI, 37/44 (84%) report complete resolution of SUI.

Conclusion: Climacturia may be present following radical prostatectomy and impacts cancer survivorship. As we report in this series, we have successfully treated men with climacturia either in conjunction with day-to-day SUI or as a stand alone complaint. The AdVance transobturator sling has proven to be an effective treatment for climacturia with resolution in 100% of our patients. Given these results, we now routinely query our patients with post-prostatectomy SUI about climacturia and, if present, counsel them that an AdVance sling will effectively treat this complaint. Also, we readily offer sling treatment to men who only complain of climacturia.


Work supported by industry: no. The presenter or any of the authors act as a consultant, employee (part time or full time) or shareholder of an industry.

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