BE repair in girls leads to good sexual function, poor fertility and body image in adulthood

Long term outcome of bladder exstrophy (BE) repair in female patients showed fair results with respect to sexual function with more or less stable sexual relationship, according to the new study by Egyptian researchers from Kasr El Einy Hospital, Department of Urology in Giza, Cairo.The investigation also revealed that the procedure may put the fertility of these patients at risk as well as cause negative body image and urinary incontinence.

This study was a long-term follow up of adult female patients between 16-28 years old, the results of which are to be presented at the 28th Annual EAU Congress which is now held in Milan, Italy.

"Genitourinary malformations in bladder exstrophy (BE) leads to vulnerability and psychosocial dysfunction and can affect all aspects of life including schooling, interactions with peers, sexuality, partnership, and fertility,” write the authors.

In the course of the study, twenty patients underwent staged primary reconstruction, and three patients underwent primary or secondary ureterosigmoidostomy. Evaluation consisted of pediatric medical records, interview questionnaire, including the sexual and uro-gynecological history, to assess the outcome regarding sexual function, fertility, and continence. Additionally, the researchers conducted a structured interview to explore the psychosexual aspect of the patient’s lives.

The results of the study revealed that three patients were married (13%), of whom two patients had children, one after natural conception in one, and the other after assisted reproductive technique.

The remaining 20 patients were not married due to the feeling of sexual inadequacy. Six patients did not believe to be able to engage in sexual intercourse, 10 patients were afraid of the cosmetic appearance of the genitalia and 4 patients were troubled by incontinence.

Cosmetic outcome was considered satisfactory by 30 % of the patients. Fourteen patients voided per urethra, of which 4 used pads, 6 patients performed Clean Intermittent Catheterization (CIC).

Reference

H.K. Salem, et al., “Long-term follow up of adult female patients (16-28 years old) with history of bladder exstrophy (BE) repair in childhood: Urological and fertility function outcome,” Abstract 640; 28th Annual EAU Congress, Milan, Italy.