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Climacturia: a comprehensive review assessing pathophysiology, prevalence, impact, and treatment options regarding the “leak of pleasure”

International Journal of Impotence Research volume 33, pages 259–270 (2021)Cite this article

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Abstract

Aim of this review is to summarize and evaluate the current literature on the pathophysiology, prevalence, sociosexual impact, and potential treatment options of climacturia. Climacturia, defined as orgasm-associated urinary incontinence and characterized by great prevalence variability, ranging between 15.7 and 93% was, so far, a relatively neglected post-radical prostatectomy functional side-effect. Recent studies have shown that it can significantly impact the quality of life of couples after prostate cancer treatment. A knowledge gap characterizes the pathophysiologic pathways while treatment is based on empirically chosen treatment options (condom use, presexual intercourse urination) or on therapeutic modalities proposed by low-quality studies (pelvic floor muscle training, penile applied devices). Evidence regarding efficacy of surgical techniques (artificial urinary sphincter, male sling, or dual implantation of penile prosthesis with a sling) for climacturia treatment are limited but with an increasing trend of relevant published data in the last 5 years. The mini-jupette sling plus inflatable penile prosthesis placement is a promising surgical technique that has been studied in a multi-institutional cohort with encouraging results regarding climacturia, erectile dysfunction, and mild-incontinence control. However, future studies with longer follow-up and larger sample sizes are certainly needed to confirm the long-term safety and benefits of this intervention.

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Fig. 1: IPP plus “Andrianne mini-jupette” sling.

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Authors and Affiliations

  1. Centre Hospitalier Universitaire de Liège, Service d’Urologie, Hasselt, Belgium

    Ioannis Mykoniatis, Maxime Sempels & Robert Andrianne

  2. Department of Urology, Jessa Hospital, Hasselt, Belgium

    Ioannis Mykoniatis & Koenraad van Renterghem

  3. Faculty of Medicine, Hasselt University, Hasselt, Belgium

    Koenraad van Renterghem

  4. University Hospitals Leuven, Leuven, Belgium

    Koenraad van Renterghem

  5. Department of Urology, Martha-Maria Hospital Nuremberg, Nuremberg, Germany

    Ioannis Sokolakis & Georgios Hatzichristodoulou

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  1. Ioannis Mykoniatis
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Correspondence to Ioannis Mykoniatis.

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Mykoniatis, I., van Renterghem, K., Sokolakis, I. et al. Climacturia: a comprehensive review assessing pathophysiology, prevalence, impact, and treatment options regarding the “leak of pleasure”. Int J Impot Res 33, 259–270 (2021). https://doi.org/10.1038/s41443-020-0257-1

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