{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:59:27Z","timestamp":1790949567513,"version":"4.1.0"},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T00:00:00Z","timestamp":1585958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"},{"start":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T00:00:00Z","timestamp":1585958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"}],"content-domain":{"domain":["jsm.jsexmed.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Climacturia affects up to 45% of men after radical prostatectomy (RP). Although urethral slings decrease the severity and frequency of stress incontinence after RP, their efficacy as a treatment for climacturia after RP has not been well studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>The aim of this study was to assess patient-reported changes in climacturia symptoms after implantation of a urethral sling as a treatment for stress incontinence after RP.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>After Institutional Review Board approval, a retrospective chart review identified males aged 18\u201380 years who received urethral slings for stress incontinence after RP at our institution from 2012 to 2017. These patients were mailed an 11-item questionnaire asking them about climacturia symptoms before and after implantation of a urethral sling. Written informed consent was obtained from patients participating in the mailed questionnaire.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>Respondents were asked to report on climacturia frequency and severity, bother, partner bother, and incontinence before and after implantation of urethral slings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 42 questionnaires were mailed; 17 were available for analysis. The median age (and interquartile range, IQR) of the sample at RP was 64 (59.5, 68.0). Almost all (94.1%) of the men were sexually active at the time of the study and 64.7% reported experiencing urinary leakage during sexual arousal. Most (58.8%) underwent the urethral sling procedure to treat general incontinence; 35.3% underwent the procedure to treat both general incontinence and incontinence during sexual activity and 1 (5.9%) underwent it for other reasons. A median of 28.1\u00a0months elapsed between RP and sling procedure (IQR: 18.36, 53.88; minimum: 8.00; maximum: 108.36). Statistically significant shifts toward improvement from presling to postsling were noted for frequency of leakage during sexual arousal or orgasm (P\u00a0=\u00a0.041) and for the degree to which leakage of urine during sexual arousal or orgasm was a \u201cbother\u201d (P\u00a0=\u00a0.027). While almost all (94%) of the men were incontinent before sling, this percentage dropped to 53% after sling (P\u00a0=\u00a0.031).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>Urethral slings should be discussed as a treatment strategy for climacturia during clinical consultations with patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths &amp; Limitations<\/jats:title>\n                  <jats:p>Strengths include consistent surgical technique. Limitations include retrospective design, lack of a nonsling comparison group, subjective nature of outcome measures, possible response bias, and variability in time interval between RP and sling procedure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Use of urethral slings after RP is associated with improvements in climacturia symptoms, bother, and incontinence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1016\/j.jsxm.2020.03.001","type":"journal-article","created":{"date-parts":[[2020,4,4]],"date-time":"2020-04-04T20:35:04Z","timestamp":1586032504000},"page":"1203-1206","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"title":["Use of the Urethral Sling to Treat Symptoms of Climacturia in Men After Radical Prostatectomy"],"prefix":"10.1093","volume":"17","author":[{"given":"James","family":"Nolan","sequence":"first","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Kershen","sequence":"additional","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilene","family":"Staff","sequence":"additional","affiliation":[{"name":"Hartford Hospital Research Program \u00a0 , Hartford, CT , USA"},{"name":"Hartford Hospital \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Tortora","sequence":"additional","affiliation":[{"name":"Hartford Hospital Research Program \u00a0 , Hartford, CT , USA"},{"name":"Hartford Hospital \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Gangakhedkar","sequence":"additional","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Pinto","sequence":"additional","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Champagne","sequence":"additional","affiliation":[{"name":"Hartford Hospital Research Program \u00a0 , Hartford, CT , USA"},{"name":"Hartford Hospital \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Wagner","sequence":"additional","affiliation":[{"name":"Urology Division \u00a0 , Hartford, CT , USA"},{"name":"Hartford Healthcare Medical Group \u00a0 , Hartford, CT , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,4,4]]},"reference":[{"key":"2023011111090652600_bib1","first-page":"2562","article-title":"Climacturia following radical prostatectomy: prevalence and risk factors","volume":"176","author":"Lee","year":"2006","journal-title":"J\u00a0Urol"},{"key":"2023011111090652600_bib2","first-page":"2223","article-title":"Orgasm associated incontinence (climacturia) following radical pelvic surgery: rates of occurrence and 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