Climacturia is defined as urinary incontinence associated with sexual climax and was first described as an adverse effect of radical prostatectomy (RP) in 1996. Research into this entity and treatment options are relatively sparse when compared to erectile dysfunction (ED) and stress urinary incontinence (SUI) as complications of RP. The reported prevalence of climacturia following (RP) varies, but two large studies revealed prevalence rates of 23% and 36%, suggesting this is a common entity. Climacturia can also be present without other forms of incontinence like stress or urge incontinence (UUI). In addition to its considerable prevalence, climacturia is associated with high rates of bother in many of these patients and is associated with avoidance of sexual activity. In this chapter, we will detail the management of climacturia with a focus on the surgical technique of the Mini-Jupette sling as well as avoidance, early recognition, and management of surgical complications.