Contemporary Practices in the Assessment and Management of Climacturia: Results from an International Survey

Background Climacturia is a distressing but underrecognized complication following prostate cancer treatment. Despite increasing awareness, its assessment and management remain heterogeneous in clinical practice. Objective To evaluate current diagnostic and therapeutic practices for climacturia among expert urologists and to propose a preliminary, practice-based Climacturia Assessment Tool. Design, setting, and participants A 34-item survey was distributed to members of the Trauma and Reconstructive Urology Working Party of the European Association of Urology (EAU) Young Academic Urologists (YAU) and the European Association of Urology Section of Genitourinary Reconstructive Surgeons (ESGURS). Fifty-one urologists and eight doctors in training completed the questionnaire. Descriptive statistics were used to summarize the findings. Outcome measurements and statistical analysis Survey responses were summarized using medians (interquartile ranges [IQRs]) and frequencies. Results and limitations Among the participants, 86% correctly defined climacturia, but only 59% routinely assessed it. Approaches to severity assessment were highly variable. Estimated prevalence ranged from 5% to 30%, depending on timing and association with stress urinary incontinence (SUI) or erectile dysfunction. Across 24 clinical scenarios, conservative strategies predominated in mild cases, male slings in moderate SUI-associated scenarios, artificial urinary sphincters in severe SUIs, and the Mini-Jupette procedure when penile prosthesis was required. Conclusions Current assessment and management of climacturia vary substantially among participants. These findings highlight unmet needs in standardization and support further validation of structured assessment tools.

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Publication Details

Journal
European Urology Open Science
Published
2026-06-17
DOI
https://doi.org/10.1016/j.euros.2026.05.004
Primary Topic
Prostate Cancer Diagnosis and Treatment
Type
article
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article

Contemporary Practices in the Assessment and Management of Climacturia: Results from an International Survey

Ozan Bozkurt, Łukasz Białek, Marie‐Aimée Perrouin‐Verbe, Patrizio Vicini et al.
European Urology Open Science
Prostate Cancer Diagnosis and Treatment
article

Contemporary Practices in the Assessment and Management of Climacturia: Results from an International Survey

Ozan Bozkurt, Łukasz Białek, Marie‐Aimée Perrouin‐Verbe, Patrizio Vicini, Mehmet Gökhan Çulha, François-Xavier Madec, Malte W. Vetterlein, Juan Diego Tinajero, Guglielmo Mantica, Paolo Geretto, Cyrille Guillot‐Tantay, Koenraad van Renterghem, Mark Joseph Abalajon, L. Freton, A. Cocci, François Hervé, Radoš DJINOVIĆ, Mikołaj Frankiewicz, Maciej Oszczudłowski, Sabrina De Cillis, Arthur Peyrottes, Bruno Bucca, Gökhan Çeker, Behzad Abbasi, Mikołaj Przydacz, Müslim Doğan Değer, S. De Vergie, Marjan Waterloos, P. Neuville, Félix Campos‐Juanatey, Giovanni Drocchi, Hussain M. Alnajjar, Fabiana Cancrini, Mattia Lo Re, Charalampos Konstantinidis, Wesley VERLA, Elaine J. Redmond, Jean-Pierre Graziana, Yanira Ortega, Bülent Çeti̇nel, Jose Medina-Polo, Giorgio I. RUSSO, Faysal Yafi, Mario Álvarez-Maestro, Leonidas Karapanos, Francesco Chierigo, Lionel A. Micol, M Ferro, D Ralph, Andrey Morozov, Clemens M. Rosenbaum, Sam Ward, Marco Falcone, Celeste Manfredi, Jordán Scherñuk, Jakob Klemm, Jan Novák, Sachin Malde, Jan Adamowicz, Carlo Bettocchi, Luisana Castillo Carvajal
article en

Abstract

Background Climacturia is a distressing but underrecognized complication following prostate cancer treatment. Despite increasing awareness, its assessment and management remain heterogeneous in clinical practice. Objective To evaluate current diagnostic and therapeutic practices for climacturia among expert urologists and to propose a preliminary, practice-based Climacturia Assessment Tool. Design, setting, and participants A 34-item survey was distributed to members of the Trauma and Reconstructive Urology Working Party of the European Association of Urology (EAU) Young Academic Urologists (YAU) and the European Association of Urology Section of Genitourinary Reconstructive Surgeons (ESGURS). Fifty-one urologists and eight doctors in training completed the questionnaire. Descriptive statistics were used to summarize the findings. Outcome measurements and statistical analysis Survey responses were summarized using medians (interquartile ranges [IQRs]) and frequencies. Results and limitations Among the participants, 86% correctly defined climacturia, but only 59% routinely assessed it. Approaches to severity assessment were highly variable. Estimated prevalence ranged from 5% to 30%, depending on timing and association with stress urinary incontinence (SUI) or erectile dysfunction. Across 24 clinical scenarios, conservative strategies predominated in mild cases, male slings in moderate SUI-associated scenarios, artificial urinary sphincters in severe SUIs, and the Mini-Jupette procedure when penile prosthesis was required. Conclusions Current assessment and management of climacturia vary substantially among participants. These findings highlight unmet needs in standardization and support further validation of structured assessment tools.

European Urology Open ScienceVol. 90
University College Hospital (GB), AOL (United States) (US), Universidad de Cantabria (ES), University College London Hospitals NHS Foundation Trust (GB), Universität Hamburg (DE), Policlinico Umberto I (IT), Ghent University Hospital (BE), Cork University Hospital (IE), Nicolaus Copernicus University (PL), Marqués de Valdecilla University Hospital (ES), Hospices Civils de Lyon (FR), University Medical Center Hamburg-Eppendorf (DE), Instituto de Investigación Marqués de Valdecilla (ES), Azienda Ospedaliero-Universitaria Careggi (IT), Postgraduate School of Molecular Medicine (PL), UCL Biomedical Research Centre (GB), AZ Maria Middelares (BE), Clinique Hartmann (FR), Asklepios (DE), University of Florence (IT), University College London (GB), Gdańsk Medical University (PL), University of Genoa (IT)
Openalex Percentile: Top 8%
Prostate Cancer Diagnosis and Treatment
DOIOpen Access PDFOpenAlex
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