Incidence of climacturia in men with sexual dysfunction after radical prostatectomy

Abstract

ABSTRACT Introduction Many series report the incidence of climacturia after radical prostatectomy (RP) as greater than 50%, and yet it is remarkable the short space for its discussion, which remains largely unrecognized and unaddressed. Objective Our aim was to describe the incidence and characterize climacturia in patients with erectile dysfunction (ED) after RP. Methods We performed a retrospective analysis of a prospectively maintained database of men after RP with complaints of ED not responsive to oral therapy. Patients seen in the sexual medicine group of our institution underwent a structured visit which included the investigation of the presence of climacturia and a detailed characterization (frequency, intensity, discomfort). Other factors such as the presence of stress urinary incontinence (SUI) and demographics were also recorded. Finally, patients were asked if they were counseled of this possible side effect of RP. Results Data from 56 patients were available, with a mean age of 66 years. Climacturia was reported by 37 patients (66,07%). Of these, 62,2% reported to occur rarely or occasionally, while 37,8% reported to occur frequently. In terms of the amount of urinary leakage, the vast majority (79%) reported leakage in small amounts, with only 8 patient (21%) reporting leakage in moderate volume. In general, 28,6% reported that climacturia generated significant discomfort, and only 10,5% recalled being warned preoperatively. Among patients with climacturia, 19,35% had SUI. Conclusions Our analysis supports a high incidence of climacturia, with perceived negative impact on approximately half of patients and with almost 90% of them not being aware of this possible complication. This preliminary analysis is one of the first on sexual urinary incontinence in Brazil and highlights the importance of its recognition and better patient counseling. Disclosure Work supported by industry: no.