Climacturia is a condition where men experience involuntary loss of urine during orgasm. This is particularly common after undergoing a radical prostatectomy (RP), a surgical procedure for prostate cancer. Understanding climacturia is crucial for men who have undergone prostate surgery, as it can significantly impact their quality of life and sexual health.
How Common is Climacturia After Prostate Surgery?
Climacturia is relatively common, affecting approximately 30%. Despite its prevalence, many men feel embarrassed and avoid discussing it with their healthcare providers, which may contribute to underreporting.
What Causes Climacturia? Exploring the Mechanisms
The exact cause of climacturia remains unclear, but it is thought to be related to damage or removal of the internal urethral sphincter during robotic prostatectomy. Other potential causes include loss of penile length, external sphincter relaxation, and intrinsic sphincter deficiency.
What Are the Symptoms of Climacturia? Identifying the Signs
Men with climacturia often notice urine leakage during sexual activity, particularly at the time of orgasm. This can range from a small amount of urine to significant leakage, and it can be distressing for both the individual and their partner.
How is Climacturia Diagnosed? Steps to Take
Patients should openly discuss any urinary leakage during orgasm, as well as any other urinary or sexual symptoms following prostate surgery.
Can Climacturia Be Prevented? Proactive Measures and Lifestyle Changes
While climacturia cannot always be prevented, certain measures can reduce the risk or severity, such as:
- Pelvic floor exercises before and after prostate surgery.
- Voiding before sexual activity to minimise leakage.
What Are the Treatment Options for Climacturia?
There are several treatment options available, ranging from conservative to surgical interventions:
- Pelvic Floor Muscle Training (PFMT): Exercises designed to strengthen the pelvic floor muscles, which can help reduce urine leakage.
- Penile Variable Tension Loop: A device placed around the base of the penis to control urine flow during orgasm.
- Soft Silicone Occlusion Loop: A non-invasive device that has shown success in preventing urine leakage during sexual activity.
- Artificial Urethral Sphincter (AUS): A surgical option that involves placing a device to control urine flow.
- Mini-Jupette Graft: A relatively new surgical technique that has shown promising results, particularly for men with both erectile dysfunction and climacturia.
How Effective Are Climacturia Treatments? Success Rates and Outcomes
The success of climacturia treatments varies depending on the method used:
- PFMT: Shows improvement in about 67% of patients.
- Penile Variable Tension Loop: Offers complete resolution of climacturia in up to 48% of cases.
- Soft Silicone Occlusion Loop: Achieves complete resolution in 80% of patients.
- AUS and Male Urethral Sling: Provide significant relief for patients with concurrent stress urinary incontinence (SUI).
- Mini-Jupette Graft: Has demonstrated improvement in 78.6% of cases, with a complete resolution in 68%.
