Sexual Health Q&A

What is climacturia?

Climacturia, also called orgasm-associated incontinence, occurs when a man leaks urine as he ejaculates. It is a common side effect of radical prostatectomy (surgical removal of the prostate gland).

The prostate is surrounded by nerves and tissue needed for proper urinary and sexual function. But sometimes, these nerves and tissues are damaged during surgery, which can lead to incontinence and erectile dysfunction.

An estimated 22% to 43% of men experience climacturia after prostatectomy. It can be a distressing situation for both men and their partners. Some men start to avoid sex because of it, leaving partners to wonder what is wrong. Others feel too embarrassed to talk about it, with their partners or with a healthcare provider.

What can men do?

First they should see their urologist. A doctor can suggest certain strategies for coping with climacturia, such as emptying the bladder before having sex.

Using a variable tension penile loop may help. Made of soft silicone, the loop is placed over the penis before sex. The man then adjusts the tension of the loop for his comfort. The loop compresses the urine channel so that urine won’t leak during orgasm. A urologist can provide more information, including instructions for use.

Pelvic floor muscle training (PFMT) is another option. This technique involves building strength and endurance in the pelvic floor muscles with the help of a trained physical therapist. Research published in 2015 found that men who underwent a three-month PFMT program saw greater improvements in climacturia and erectile function compared to men who received no treatment.

Men with climacturia are also encouraged to communicate with their partners and share their feelings of frustration or anxiety. Without communication, partners may feel distanced, especially if the man is avoiding sex. Couples may find that seeing a therapist can help them learn to talk about sexual and relationship issues.

For some men, climacturia does get better in a year or two.