Orgasm‐Associated Incontinence (Climacturia) after Bladder Neck‐Sparing Radical Prostatectomy: Clinical and Video‐Urodynamic Evaluation

Manassero, Francesca; Paola, Giuseppe Di; Paperini, Davide; Mogorovich, Andrea; Pistolesi, Donatella; Valent, Francesca; Selli, Cesare

doi:10.1111/j.1743-6109.2012.02829.x

Cited by 30 publications

(17 citation statements)

References 20 publications

(43 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Here, video‐urodynamic evaluations of seven patients with OAI and five controls without OAI were performed. It was found that the OAI patients had significantly shorter functional urethral length compared with controls ( P = 0.02) [15]. In addition to this finding, it can be speculated that damage to the bladder neck and/or sympathetic nerve damage during surgery may play a role as sympathetic nerve fibers constrict the bladder neck and relax the external sphincter during normal antegrade ejaculation.…”

Section: Resultsmentioning

confidence: 99%

Neglected Side Effects After Radical Prostatectomy: A Systematic Review

Frey¹,

Sønksen²,

Fode³

2014

The Journal of Sexual Medicine

View full text Add to dashboard Cite

Introduction A series of previously neglected sexually related side effects to radical prostatectomy (RP) has been identified over the recent years. These include orgasm-associated incontinence (OAI), urinary incontinence in relation to sexual stimulation (UISS), altered perception of orgasm, orgasm-associated pain (OAP), penile shortening (PS), and penile deformity. Aim The aim of this article is to conduct a systematic review of the literature regarding the above-mentioned side effects. Methods A predefined search strategy was applied in a thorough search of Medline, Web of science, and the online Cochrane library. The PRISMA guidelines for systematic reviews were followed, and protocol as well as search strategies was registered at http://www.crd.york.ac.uk/Prospero/ (RN: CRD42012003165). Main Outcome Measure The main outcome measure was incidence rates for the relevant side effects. Results A total of 43 articles were included. OAI and UISS are experienced by 20–93% of RP patients at least a few times after surgery. Although these issues are associated to postoperative daytime incontinence, previous transurethral resection of the prostate (TURP) is the only known predicting factor. Alterations of orgasmic function are experienced by approximately 80% after RP. Erectile dysfunction seems to play an important role in waning orgasmic function. OAP is only experienced by a subset of the patients with reported rates varying between 3% and 19%. Sparing of the tips of the seminal vesicles has been shown to double the risk of OAP. PS occurs in 15–68% of RP patients. Nerve sparing and preservation of erectile function may help preserve penile length. With regard to all side effects, studies indicate that they are reduced over time. Conclusions The sexually related side effects summarized in this review are common after RP. Meanwhile, it is difficult to predict which patients are at risk. Daytime incontinence, previous TURP, a lack of nerve sparing, and erectile dysfunction are all associated with the above-mentioned sexually related side effects.

show abstract

Section: Resultsmentioning

confidence: 99%

Neglected Side Effects After Radical Prostatectomy: A Systematic Review

Frey¹,

Sønksen²,

Fode³

2014

The Journal of Sexual Medicine

View full text Add to dashboard Cite

show abstract

“…, climacturia, which is defined as a leakage of urine occurring at orgasm) [9]. Moreover, in a single study aiming to assess the pathophysiologic mechanisms of climacturia, Manassero et al [18] analysed video-urodynamic data coming from a series of patients with post-RP orgasm-associated UI compared to a control group; they showed a significantly lower functional urethral length in patients with climacturia compared to controls, thus concluding that final urethral length may play a major role in determining this specific orgasmic alteration.…”

Section: Physiopathology Of Orgasmic Dysfunctions After Radical Prostmentioning

confidence: 99%

Orgasmic Dysfunction after Radical Prostatectomy

Capogrosso

Ventimiglia

Cazzaniga

et al. 2017

World J Mens Health

View full text Add to dashboard Cite

In addition to urinary incontinence and erectile dysfunction, several other impairments of sexual function potentially occurring after radical prostatectomy (RP) have been described; as a whole, these less frequently assessed disorders are referred to as neglected side effects. In particular, orgasmic dysfunctions (ODs) have been reported in a non-negligible number of cases, with detrimental impacts on patients' overall sexual life. This review aimed to comprehensively discuss the prevalence and physiopathology of post-RP ODs, as well as potential treatment options. Orgasm-associated incontinence (climacturia) has been reported to occur in between 20% and 93% of patients after RP. Similarly, up to 19% of patients complain of postoperative orgasm-associated pain, mainly referred pain at the level of the penis. Moreover, impairment in the sensation of orgasm or even complete anorgasmia has been reported in 33% to 77% of patients after surgery. Clinical and surgical factors including age, the use of a nerve-sparing technique, and robotic surgery have been variably associated with the risk of ODs after RP, although robust and reliable data allowing for a proper estimation of the risk of postoperative orgasmic function impairment are still lacking. Likewise, little evidence regarding the management of postoperative ODs is currently available. In general, physicians should be aware of the prevalence of ODs after RP, in order to properly counsel all patients both preoperatively and immediately post-RP about the potential occurrence of bothersome and distressful changes in their overall sexual function.

show abstract

“…Five studies met the inclusion criteria (5,(26)(27)(28)(29). Frey et al's study with patients (n = 316) of 64 years average age who were assessed within 3-36 months after RP reported UIDSA in 38% of the participants.…”

Section: Prevalence Of Orgasm Associated Incontinence/climacturia Aftmentioning

confidence: 99%

The Prevalence and the Use of the Questionnaire’s Related to the Neglected Sexual Side Effects After Prostate Cancer Treatment: A Scoping Review of the Literature

Röscher

Sathiram

Milios

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Early prostate cancer (PCa) treatment interventions may leave men with debilitating sexual side effects. These side effects may remain permanent, often undiagnosed, and undermanaged. The objective of this study was to map the evidence pertaining to the prevalence, and use of questionnaires, related to the neglected sexual side effects (NSSE) after PCa treatment consisting of radical prostatectomy (RP) surgery or radiation treatment (RT).Methods: This systematic scoping review’s search strategy involved the search of PubMed, Science Direct, and Google Scholar databases. Following title searching, two-independent reviewers conducted screening of abstracts and full articles. The screenings were guided by the eligibility criteria. Data were extracted from the included studies and the emerging themes were analysed. The review team analysed the implications of the findings in relation to the research question and aims of the study. The Mixed Method Appraisal Tool was employed for quality appraisal of included studies.Discussion: Twenty-three studies about the prevalence and questionnaire use for NSSE after early PCa treatment were included. Two studies investigated most of the collective group of NSSE’s, and all the other studies mostly looked at a single NSSE. No single validated questionnaire was found that investigates the NSSE after early PCa treatment. Most studies incorporated some aspects of other questionnaires. Two studies used non-validated questionnaires that picked up on the majority of the collective group of NSSE.Conclusion: NSSEs are prevalent in men after RP and RT. Peyronie’s Disease, orgasmic Dysfunction and Penile Length Shortening are all similarly prevalent after RP and RT. Anejaculation was only found to be prevalent after RT*. Orgasm associated incontinence resulted from RP and RT, but the prevalence in RP patients was 6 times that of RT patients. Study participants felt inadequately informed about possible sexual side effects caused by their treatment choices. Questionnaires are effective at detecting NSSE after PCa treatment, but there is no valid and reliable questionnaire currently available to detect all the collective NSSE after PCa treatment. There is a scope to develop a validated and reliable PCa NSSE questionnaire. The NSSE questionnaire must be quick, straightforward, and effective.

show abstract

Orgasm‐Associated Incontinence (Climacturia) after Bladder Neck‐Sparing Radical Prostatectomy: Clinical and Video‐Urodynamic Evaluation

Cited by 30 publications

References 20 publications

Neglected Side Effects After Radical Prostatectomy: A Systematic Review

Neglected Side Effects After Radical Prostatectomy: A Systematic Review

Orgasmic Dysfunction after Radical Prostatectomy

The Prevalence and the Use of the Questionnaire’s Related to the Neglected Sexual Side Effects After Prostate Cancer Treatment: A Scoping Review of the Literature

Contact Info

Product

Resources

About