Climacturia after prostatectomy: hidden struggles in sexual well-being

Sandra Garcia, Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
Sebastian Peña-Rodriguez, Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia
Natalia Ramirez, Faculty of Medicine, Universidad de los Andes, Bogotá D.C., Colombia
César Díaz-Ritter, Department of Urology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá D.C., Colombia

Objective: Climacturia is a form of urinary incontinence associated with orgasm that occurs after radical prostatectomy, which extends beyond the physical realm and affects patients’ psychological well-being. This study aimed to identify the prevalence of climacturia in patients who underwent radical prostatectomy at a Latin American reference center for the management of prostate cancer. Method: We performed a cross-sectional study that included patients who underwent radical prostatectomy between January 2020 and March 2023 at our institution. Those who had completed more than 6 months after surgery were included, while those who had received other forms of therapy, such as radiation, were excluded. Continuous variables are presented as measures of central tendency according to the normality of their distribution. Categorical variables are presented with frequency tables and percentages. The main outcome was the presence of urinary incontinence at the moment of sexual climax reported by patients. Results: The prevalence of climacturia was 30%; 54 patients (32%) reported urinary incontinence during excitation, and 37 patients (21,8%) reported both issues. Nevertheless, up to 67.3% of patients reported some degree of incontinence unrelated to sexual activity. Finally, 21.2% of patients with climacturia reported being satisfied with their sexual activity, compared to 30.3% of patients who did not report climacturia, although no statistically significant difference was observed (p = 0.23). Conclusions: Climacturia is a frequent side effect of the radical prostatectomy, which must be considered in the follow-up of patients undergoing radical prostatectomy and may affect the patients’ quality of life.

Keywords: Sexual health. Prostatectomy. Urinary Incontinence. Orgasmic disorder. Climacturia.