SAN ANTONIO — Almost half of men who remain sexually potent after radical prostatectomy exhibit “climacturia”—leakage of urine at orgasm—according to a poster presented by Jason Lee, M.D., at the annual meeting of the American Urological Association.
In a consecutive cohort of 42 men who were at least 12 months post prostatectomy, 19 (45%) reported climacturia. Dr. Lee and his colleagues from Princess Margaret Hospital, Toronto, found no significant associations between climacturia and age, time since surgery, Gleason score, international prostate symptom score, urine flow rate, or the presence of incontinence.
Among the men experiencing climacturia, 4 (21%) said they experienced it rarely and 9 (47%) said they experienced it occasionally. Four others (21%) experienced climacturia most of the time or always.
Nine of the men (52%) said that the condition caused them significant bother, and 10 said it caused them nonsignificant bother. Four men (21%) said it caused their partners significant bother, and 15 (79%) said it caused their partners nonsignificant bother.
Leakage was only a few drops in 11 of the men, but 2 men said they leaked more than an ounce of urine, and a third man said he leaked more than 5 ounces.
Most of the men (16 of 19 [84%]) coped with their climacturia by voiding before intercourse. Two men additionally required a condom. Three men took no action.
The investigators concluded that climacturia is not uncommon following radical prostatectomy, and it should be discussed as a possible complication for men evaluating their treatment options.