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Orgasm-Associated Urinary Incontinence

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As the name reveals, orgasm-associated urinary incontinence refers to leaking urine during the point of sexual climax (orgasm).

Medically reviewed by

Dr. Raveendran S R

Published At October 9, 2023
Reviewed AtMarch 26, 2024

Introduction

Urinary incontinence generally means an individual leaks urine unintentionally or by accident. So, it is the involuntary passing of urine. The loss of bladder control can vary from a slight loss of urine to a significantly complete inability to control urination. But what if it happens during sex? Urinary incontinence during sex is a common concern with more female prevalence.

While urinary incontinence during sexual orgasm is more common in males due to one surgery. Leakage of urine at the point of sexual climax is a distressing problem for the individual and their partner, as this could take pleasure and gratification out of sex. This condition is called orgasm-associated urinary incontinence, and this awkward concern can be effectively managed with treatments and lifestyle modifications.

What Is Orgasm Associated Urinary Incontinence?

Orgasm-associated urinary incontinence, called climacteric, results when an individual leaks urine during ejaculation or sexual orgasm (climax). Urinary continence during sexual climax is more common in males than females. It is considered the most common problem in males during recovery from radical prostatectomy (surgical removal and treatment of the prostate gland).

How Common Is Orgasm-Associated Urinary Incontinence?

After a prostatectomy, climacturia is common. It is underreported, according to many experts. According to some research, as many as 93 percent of patients who have undergone a radical prostatectomy are affected. Of the men with climacturia, 45 percent found their condition to be bothersome.

What Is the Cause of Orgasm Associated Urinary Incontinence?

The exact and solitary cause of orgasm-associated urinary incontinence has not been determined yet. However, it can occur as a major side effect of a surgical procedure called prostatectomy in males and from certain other causes in females. It is also known that orgasm-associated urinary incontinence can be associated with a combination of determinants, including hormonal changes, bladder dysfunction, and weakened muscles.

  • Prostatectomy: The prostate gland is surrounded by a range of nerves and tissues that operate for urinary and sexual function. At times, these associated nerves or tissues could be damaged during surgery called prostatectomy, resulting in erectile dysfunction and urinary incontinence. Such orgasm-associated urinary incontinence can be distressing for the males and their partners.

  • Urinary Incontinence and Stress Incontinence: Men and women can have urine leakage at any point during sexual activity, particularly an orgasm. Sexual stimulation generally puts a certain pressure on the bladder. When this occurs with weakened pelvic floor muscles in females, such pressure can cause stress incontinence, resulting in urine leakage. It is a predominant sign of an overactive bladder. People with underlying urinary or stress incontinence could have orgasm-associated urinary incontinence.

What Are the Possible Risk Factors for Urinary Incontinence?

Though urinary incontinence is common in people who have undergone prostatectomy, certain individuals might be at increased risk for urinary incontinence during sex.

The possible risk factors include the following.

  • Menopause.

  • Pregnancy and childbirth.

  • Enlarged prostate.

  • Being obese.

  • Bladder stone concerns.

  • Infections involving the lower urinary tract, prostate, or bladder.

  • Nerve damage resulting from diabetes and stroke.

  • Constipation.

  • Certain groups of medications, like blood pressure drugs and antidepressants.

  • Impaired movement abilities.

  • Impairments in cognitive functioning.

  • Past urinary tract and other gynecological surgeries.

  • Natural bladder irritants such as alcohol and caffeine.

How Can Orgasm Associated Urinary Incontinence Be Managed?

Orgasm-associated urinary incontinence can be managed with a few self-care treatments, like wearing condoms and emptying the bladder before sex. However, this condition could require professional treatment in certain cases.

Effective treatment options include the following:

  • Pelvic Floor Muscle Training (PFMT): A certified and trained physical therapist developed this approach, which contains exercises and training. This therapy helps build strength and endurance for the pelvic floor muscles, where orgasm-associated urinary incontinence results from weakening pelvic floor muscles.

  • Variable Tension Penile Loop: Here, a loop containing silicone material is placed over the penis before sex. This helps compress the urine channel and intercept urinary incontinence. The silicone loop's tension is designed so that the individual can adjust to their comfort. However, the variable tension penile loop treatment option holds a drawback, though it best prevents urinary incontinence during orgasm. So, its notable interference with sexual functions, resulting in pain, discomfort, superficial injuries, and bruising are known to be major drawbacks.

  • Surgery: Surgical treatment options involving surgical devices like a male urethral sling and artificial urethral sphincter could be helpful for men with climacturia.

  • Mini-Jupette Sling: The mini-Jupette sling is another possible treatment for climacteric. A Mini-Jupette sling is helpful for patients who have not responded well to simple treatment options.

Self-Care and Lifestyle Modifications:

There are a range of lifestyle changes and home remedies that seem helpful in preventing urinary incontinence during orgasms.

  • Limiting Fluids Before Sex: Orgasm-associated urinary incontinence is often accompanied by stress urinary incontinence. So, limiting water and fluids before sex can be more helpful in the case of involuntary urine leakage occurring due to stress urinary incontinence and certain causes of overactive bladder. One can limit the fluid intake two to a few hours prior to sex. This could prevent one from ejaculating urine. Moreover, it could limit the amount of urine one leak to the very minimum.

  • Wearing Condoms: Wearing a condom might not seem very effective in cases of urinary incontinence during sex, as it does not prevent one from ejaculating urine. But, it can arrest some amount or the complete urine that comes out during sex.

  • Peeing Before Sex: Limiting fluid intake before sex is as significant as emptying the bladder. So, emptying the bowel and bladder before sex could help prevent or decrease urine leakage. Bowel emptying is also to be considered because having a stool in the rectum might prevent complete emptying of the bladder, and this could also stress the bladder.

  • Other Considerations: One can try a different and more comfortable position during sex, as this might help by not putting pressure on the bladder. Also, consider losing weight if case of being overweight. Moreover, restrict the intake of food items and beverages that contain alcohol and caffeine. This is because alcohol and caffeine serve as natural diuretics and bladder irritants, increasing one’s urge for urination.

What Are the Potential Risks and Side Effects of the Mini-Jupette Sling?

The following are potential risks and side effects of the procedure:

  • Pain following surgery necessitating removal of the device.

  • Urinary retention.

  • Explosion of the urethra.

  • Infection of the device.

Since it is a new mode of treatment, research is being conducted to improve its function and test its efficacy. Individuals should consult with their doctor to determine which is the best possible treatment.

Conclusion:

Orgasm-associated urinary incontinence is known for the involuntary release of urine during the sexual climax. Though this can occur to anyone, it seems to be more common and frequent in males following radical prostatectomy. It is also referred to as climacturia. This is not a profound concern to worry about. It can be effectively managed with simple self-care aids. If not, it should be considered and taken into account for the professional's guidance. The doctors will prescribe appropriate treatment options for getting relief from such an awkward condition.

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Dr. Raveendran S R
Dr. Raveendran S R

Sexology

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