Korean J Urol Oncol.  2015 Aug;13(2):85-92. 10.0000/kjuo.2015.13.2.85.

Climacturia (Orgasm-associated Incontinence) Following Radical Prostatectomy

• Kim YB
• Ryu JH
• Jung TY
• Kim DY
• Cho HJ
• Yoo TK

• KMID: 2307838
• DOI: http://doi.org/10.0000/kjuo.2015.13.2.85

Abstract

PURPOSE
Climacturia is involuntary loss of urine during orgasm. The mechanism of climacturia in men who undergo radical prostatectomy (RP) is not fully understood, while deficiency in bladder neck coaptation during orgasm may be the cause. We evaluated the prevalence and risk factors of climacturia after RP.
MATERIALS AND METHODS
We retrospectively reviewed the medical records of prostate cancer patients who underwent RP from 2002 to 2013 and was able to have a vaginal intercourse postoperatively. RP was conducted using open or robot-assisted approach. We analysed the symptoms of climacturia, relationship between climacturia and several clinical factors. Also, we tried to find factors to predict the presence of climacturia.
RESULTS
Total of 123 patients were analyzed in this study. The median age of the men was 65 year and postoperative follow-up period for the interview was 37 months. Of the total 123 patients, 29 (23.6%) complained of the climacturia. In climacturia group, robot-assisted RP (p=0.018), nerve-sparing (p=0.046) and penile rehabilitation (p=0.012) were significantly less frequent, and more pad were comsumed (p=0.001) compared to non-climacturia group. On multivariable analysis, post-prostatectomy incontinence (PPI) (OR 6.49, p=0.004) and penile rehabilitation (OR 0.22, p=0.036) were significant factors to predict the presence of climacturia.
CONCLUSIONS
Climacturia occurs in more than 20% patients who were potent enough after RP in our study. PPI and penile rehabilitation were positive and negative factor to predict an occurrence of climacturia, respectively. Therefore, in addition to PPI and erectile dysfunction, patients must be informed of this complication before undergoing RP.

Keyword

Orgasm; Prostatectomy; Urinary incontinence

MeSH Terms

Erectile Dysfunction
Follow-Up Studies
Humans
Male
Medical Records
Neck
Orgasm
Prevalence
Prostatectomy*
Prostatic Neoplasms
Rehabilitation
Retrospective Studies
Risk Factors
Urinary Bladder
Urinary Incontinence