Climacturia: what treatment options do we offer to those with and without concomitant erectile dysfunction?

Area of Science:

• Urology
• Oncology
• Sexual Medicine

Background:

• Radical prostatectomy for prostate cancer can lead to climacturia, a frequently under-recognized sequela.
• Management options for climacturia, particularly when co-occurring with erectile dysfunction, require further understanding.

Purpose of the Study:

• To review nonoperative and operative treatments for climacturia.
• To explore treatment strategies for patients with both climacturia and erectile dysfunction, including those requiring penile implantation.

Main Methods:

• Comprehensive literature review of nonoperative and operative interventions for climacturia.
• Analysis of treatment options for isolated climacturia and combined climacturia and erectile dysfunction.

Main Results:

• Nonoperative treatments include behavioral modifications, physical therapy, and tension loops.
• Operative treatments include artificial urinary sphincter, male urethral slings, Mini-Jupette sling, and periurethral prosthesis.
• Synchronous implantation of devices for climacturia and erectile dysfunction is feasible and effective.

Conclusions:

• Effective nonoperative and operative treatments exist for climacturia following radical prostatectomy.
• Combined treatment approaches for climacturia and erectile dysfunction, including simultaneous device implantation, offer safe and efficacious solutions.