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

  • Male Sexual Dysfunction and Disorders (A Pastuszak and N Thirumavalavan, Section Editors)
  • Published:
  • volume 11, pages 381–388 (2019)
Current Sexual Health Reports Aims and scope Submit manuscript

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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.

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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

References

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

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Authors and Affiliations

  1. University Hospitals Cleveland Medical Center, Urology Institute, 11100 Euclid Avenue, Mailstop LKS 5046, Cleveland, OH, 44106, USA

    Kirtishri Mishra, Nishant Jain, Laura Bukavina & Aram Loeb

  2. Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH, 44106, USA

    Kirtishri Mishra, Nishant Jain, Laura Bukavina & Aram Loeb

Authors
  1. Kirtishri Mishra
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  2. Nishant Jain
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Correspondence to Aram Loeb.

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Mishra, K., Jain, N., Bukavina, L. et al. Climacturia (Uroclimax) in Men After Radical Prostatectomy: A Comprehensive Review of the Current Literature and Treatment Strategies. Curr Sex Health Rep 11, 381–388 (2019). https://doi.org/10.1007/s11930-019-00217-8

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  • DOI: https://doi.org/10.1007/s11930-019-00217-8

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