Orgasm associated incontinence (climacturia) following radical pelvic surgery: Rates of occurrence and predictors Journal Article


Authors: Choi, J. M.; Nelson, C. J.; Stasi, J.; Mulhall, J. P.
Article Title: Orgasm associated incontinence (climacturia) following radical pelvic surgery: Rates of occurrence and predictors
Abstract: Purpose: Orgasm associated incontinence, that is the inadvertent leakage of urine at orgasm, has received little attention in the literature. We evaluated the rate of occurrence of orgasm associated incontinence following radical pelvic surgery as well as its associated factors and predictors. Materials and Methods: From January 2005 to March 2006, 696 patients were evaluated for post-radical pelvic surgery sexual dysfunction. A database was created, and descriptive statistics, chi-square analysis and logistic regression analysis were used to evaluate associated factors and predictors. Results: Of 475 patients 96 (20%) reported orgasm associated incontinence following radical pelvic surgery. The incidence was significantly less in the cystoprostatectomy group than in the open and laparoscopic radical prostatectomy groups (p <0.05). Orgasm associated incontinence was more commonly found within 12 months following surgery vs greater than 12 months (RR 0.81, 95% CI 0.72-0.92, p <0.01) and in patients with orgasm associated pain (RR 1.09, 95% CI 1.01-1.16, p <0.01) and penile length loss (RR 1.32, 95% CI 1.09-1.59, p <0.01). On multivariate analysis all factors associated on univariate analyses remained predictive. Orgasm associated incontinence was not associated with patient age, the degree of nerve sparing, surgical margin status, seminal vesicle or lymph node involvement, preoperative erectile function, nocturnal erections, libido level or daytime continence. Conclusions: Orgasm associated incontinence occurs in a fifth of men (96 of 475) following radical pelvic surgery. The incidence of orgasm associated incontinence is greater with radical prostatectomy than with radical cystectomy and it is unrelated to the type of prostatectomy performed (open vs laparoscopic). Orgasm associated incontinence is more likely to be reported within year 1 following surgery and in men who complain of orgasmic pain and/or penile shortening. © 2007 American Urological Association.
Keywords: adult; controlled study; aged; middle aged; retrospective studies; major clinical study; laparoscopy; disease association; pain; statistics; incidence; risk factors; data base; time factors; confidence interval; prostatic neoplasms; prostate; sexual dysfunction; preoperative period; prostatectomy; lymph node; cystectomy; predictor variable; cross-sectional studies; multivariate analysis; reflex; seminal vesicle; chi square test; univariate analysis; urinary incontinence; climacterium; libido; pelvis surgery; incontinence; orgasm
Journal Title: Journal of Urology
Volume: 177
Issue: 6
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2007-06-01
Start Page: 2223
End Page: 2226
Language: English
DOI: 10.1016/j.juro.2007.01.150
PUBMED: 17509325
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 15" - "Export Date: 17 November 2011" - "CODEN: JOURA" - "Source: Scopus"
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. John P Mulhall
    601 Mulhall
  2. Christian Nelson
    391 Nelson
  3. Jason Stasi
    26 Stasi