title: Orgasm-associated urinary incontinence and sexual life after radical prostatectomy.
abstract: BACKGROUND
  Involuntary release of urine during sexual climax, orgasm-associated urinary incontinence, occurs frequently after radical prostatectomy. We know little about its prevalence and its effect on sexual satisfaction.
  
  
  OBJECTIVE
  To determine the prevalence of orgasm-associated incontinence after radical prostatectomy and its effect on sexual satisfaction.
  
  
  METHODS
  Consecutive series, follow-up at one point in calendar time of men having undergone radical prostatectomy (open surgery or robot-assisted laparoscopic surgery) at Karolinska University Hospital, Stockholm, Sweden, 2002-2006. Of the 1,411 eligible men, 1,288 (91%) men completed a study-specific questionnaire.
  
  
  METHODS
  Prevalence rate of orgasm-associated incontinence.
  
  
  RESULTS
  Of the 1,288 men providing information, 691 were sexually active. Altogether, 268 men reported orgasm-associated urinary incontinence, of whom 230 (86%) were otherwise continent. When comparing them with the 422 not reporting the symptom but being sexually active, we found a prevalence ratio (with 95% confidence interval) of 1.5 (1.2-1.8) for not being able to satisfy the partner, 2.1 (1.1-3.5) for avoiding sexual activity because of fear of failing, 1.5 (1.1-2.1) for low orgasmic satisfaction, and 1.4 (1.2-1.7) for having sexual intercourse infrequently. Prevalence ratios increase in prostate-cancer survivors with a higher frequency of orgasm-associated urinary incontinence.
  
  
  CONCLUSIONS
  We found orgasm-associated urinary incontinence to occur among a fifth of prostate cancer survivors having undergone radical prostatectomy, most of whom are continent when not engaged in sexual activity. The symptom was associated with several aspects of sexual life.
authors.affiliation: Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institutet, Stockholm, Sweden. andreas.nilsson@karolinska.se
authors.forename: Andreas E
authors.initials: AE
authors.lastname: Nilsson
authors.forename: Stefan
authors.initials: S
authors.lastname: Carlsson
authors.forename: Eva
authors.initials: E
authors.lastname: Johansson
authors.forename: Martin N
authors.initials: MN
authors.lastname: Jonsson
authors.forename: Christofer
authors.initials: C
authors.lastname: Adding
authors.forename: Tommy
authors.initials: T
authors.lastname: Nyberg
authors.forename: Gunnar
authors.initials: G
authors.lastname: Steineck
authors.forename: N Peter
authors.initials: NP
authors.lastname: Wiklund
mesh_terms: D000328:Adult; D000368:Aged; D006801:Humans; D008297:Male; D008875:Middle Aged; D009948:Orgasm / Q000502:physiology; D015995:Prevalence; D011468:Prostatectomy / Q000009:adverse effects* / Q000523:psychology; D011471:Prostatic Neoplasms / Q000601:surgery; D011788:Quality of Life / Q000523:psychology; D012307:Risk Factors; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology*