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Climacturia (Uroclimax) in Men After Radical Prostatectomy: A Comprehensive Review of the Current Literature and Treatment Strategies

  • Kirtishri Mishra
  • Nishant Jain
  • Laura Bukavina
  • Aram LoebEmail author
Male Sexual Dysfunction and Disorders (A Pastuszak and N Thirumavalavan, Section Editors)
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Part of the following topical collections:
  1. Topical Collection on Male Sexual Dysfunction and Disorders

Abstract

Purpose of Review

Climacturia is an underreported condition seen in men who undergo radical prostatectomy. An estimated 16–93% of these patients may suffer from climacturia, with significant adverse effect on their sexual satisfaction and quality of life. Our understanding of the pathology is limited, with no standard treatment algorithm. In this review, we aim to contextualize the condition in relation to the current literature and offer an in depth evaluation of the treatment strategies, with a focus on the surgical interventions.

Recent Findings

There has been an increased emphasis on evaluating patients for climacturia routinely after radical prostatectomy. Due to the increased identification of climacturia, the last two decades have seen the development of novel techniques to address the condition. Behavioral therapy is the initial intervention that should be tried; however, depending on other comorbidities, the patient can be offered surgical interventions. These include artificial urinary sphincter, male sling, or dual implantation of penile prosthesis with an artificial sphincter or a sling.

Summary

In this review, we provide a comprehensive review of the etiology, pathophysiology, and treatment strategies related to climacturia. This review focuses on current literature on the topic, with an emphasis on the available surgical interventions.

Keywords

Climacturia Men’s health Sexual dysfunction Sexual medicine 

Abbreviations

RALP

Robot-assistant laparoscopic prostatectomy

PCa

Prostate cancer

RP

Radical prostatectomy;

EBRT

External beam radiation therapy

PFPT

Pelvic floor physical therapy

SUI

Stress urinary incontinence

AUS

Artificial urethral sphincter

IPP

Inflatable penile prosthesis

MUMS

Male urethral mini-sling

Notes

Compliance With Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

This article does not contain any studies with human or animal subjects performed by the author.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Kirtishri Mishra
    • 1
    • 2
  • Nishant Jain
    • 1
    • 2
  • Laura Bukavina
    • 1
    • 2
  • Aram Loeb
    • 1
    • 2
    Email author
  1. 1.University Hospitals Cleveland Medical CenterUrology InstituteClevelandUSA
  2. 2.Case Western Reserve University School of MedicineClevelandUSA

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