Climacturia
The prostate gland is surrounded by nerves and tissue that support urinary and sexual function. Damage to these nerves and tissues during surgery can lead to incontinence and erectile dysfunction.
The Prevalence of Climacturia
The percentage of men who experience climacturia after a prostatectomy varies. The condition can be distressing for both men and their partners. Some men cope by avoiding sex, leaving partners to wonder what is wrong. Other men feel too embarrassed to discuss it with their partner or physician.
Researchers surveyed 3,207 men (with an average age of 61) to learn about their experiences with climacturia and found that they were all having sexual problems after prostatectomy. The study, published in the January 2020 edition of the Journal of Sexual Medicine, showed that nearly a quarter of men had climacturia.
For about 70% of the men surveyed, urine leaked in drops. The remaining participants leaked 30 mL (about an ounce) or more. About half of the men said they experienced climacturia during 25% to 50% of their orgasms.
About 45% of the men with climacturia said their condition was causing distress. And 15% believed their partners were bothered by the leaked urine.
Treating and Managing Climacturia
There are a few different ways to manage climacturia. Some men empty their bladder before having sex. Other options include:
- Variable tension penile loop: A variable tension penile loop is made of soft silicone and placed over the penis before sex. The man adjusts the tension of the loop for optimal comfort. The loop compresses the urine channel to prevent urine leaks during orgasm.
- Pelvic floor muscle training (PFMT): These exercises help develop strength and endurance in the pelvic floor muscles to treat or reduce the frequency of climacturia. A trained physical therapist can teach patients to manage or prevent incontinence and help improve their sexual health. The pelvic floor muscles support pelvic organs and are responsible for urination and bowel movements. These muscles are also used to control urine and prevent leakage. PFMT, or Kegel exercises, should be done before standing up, walking, walking to the bathroom, coughing, laughing, and sneezing to prevent urine leakage.
- Surgery: An artificial urethral sphincter (AUS) or male urethral sling may help address climacturia. An AUS is a device that contains an inflatable cuff around the urethra. A hand-operated pump releases the cuff and allows urine to pass through. A male urethral sling is a synthetic mesh-like tape that is placed around the urethral bulb that compresses and moves the urethra into a new position.
Men with climacturia should communicate their feelings of frustration and anxiety to their partners. Without honest communication, partners may feel shunned, especially if the man is avoiding sex. Counseling can help couples learn how to talk about sexual issues affecting their relationship.
Men with climacturia should schedule an appointment with their physician to learn more about their treatment options.
