Almost half of the men who experience climacturia after radical prostatectomy are bothered by the situation, a recent Journal of Sexual Medicine study reports.
Climacturia – urine leakage during orgasm – affects an estimated 20% to 93% of men after prostatectomy, the authors said. In many cases, the issue is caused by nerve damage during surgery.
Some men cope with it by using condoms, drinking less fluids, and urinating before sex. Others undergo pelvic floor muscle training or use a variable tension penile loop that compresses the urethra during orgasm.
How bothersome is climacturia for men and their partners? The current study investigated bother prevalence rates and the predictors of climacturia-related bother.
The researchers surveyed 3,207 men (average age 61 years) who were experiencing sexual problems after radical prostatectomy. All were patients at a single center and were first seen between May 2006 and August 2018. Most of the men were heterosexual and in stable relationships.
The men completed questionnaires about their sexual function and sexual incontinence. Men with climacturia described its frequency and the quantity of urine leaked.
Overall, 23% of the men had had climacturia after prostatectomy. Of these, the following amounts were reported:
- 70% said their volume was “small” (drops).
- 24% had “moderate” volume (less than 30 mL).
- 6% reported “large” volume (30 mL or more).
Almost half the men said their climacturia was “occasional,” happening during 25% to 50% of their orgasms. Just under a third of the men reported “rare” climacturia (less than 25% of orgasms), and 22% had “frequent” climacturia (more than half their orgasms).
The amount of time since prostatectomy did not influence either quantity of urine leaked or frequency of occurrence, the authors said.
Forty-five percent of the men said climacturia bothered them. For most of them (62%), the degree of bother was “mild.” Only 9% said their bother was “severe.”
Patients tended to feel more bother when they thought their partners were also bothered by climacturia. Bother also increased with the frequency and quantity of urine leakage. Shorter relationship duration was another predictor of patient bother.
Fifteen percent felt that their partner was bothered by their climacturia. However, partners were not assessed directly.
“Intuitively, it makes sense that patients in shorter relationships or with higher perceived partner bother would be more bothered by climacturia,” the authors wrote. “Similarly, it is unsurprising that worsening symptoms in terms of frequency and quantity are also predictive of bother.”
Clinicians should discuss the possibility of climacturia with patients before surgery, the authors added.
International Society for Sexual Medicine
“What is climacturia?”
The Journal of Sexual Medicine
Salter, Carolyn A., MD, et al.
“Bother Associated With Climacturia After Radical Prostatectomy: Prevalence and Predictors”
(Full-text. Published online: January 21, 2020)