Long-term sexual outcomes in patients with exstrophy-epispadias complex

Area of Science:

• Urology
• Pediatric Surgery
• Reproductive Medicine

Background:

• Exstrophy-epispadias complex (EEC) encompasses a range of genitourinary malformations affecting external genitalia and the lower urinary tract.
• Long-term sexual outcomes in EEC patients are not well-established, particularly in relation to urinary function.

Purpose of the Study:

• To evaluate the long-term sexual outcomes in adult patients with exstrophy-epispadias complex (EEC).
• To investigate the relationship between sexual outcomes and urinary continence in EEC patients.

Main Methods:

• Retrospective analysis of a database of EEC patients who underwent surgery between 1990 and 2019.
• Selection criteria included patients aged 14 years or older with at least one surgery and 12 months of follow-up, resulting in a cohort of 29 patients.
• Data collected included demographics, surgical procedures, sexual function, and urinary continence outcomes.

Main Results:

• High rates of sexual activity (96% men, 75% women) and satisfaction (79% men, 67% women) were reported.
• Fertility was achieved in 67% of men and 100% of women.
• Good continence rates were observed (83% diurnal, 93% nocturnal), though often requiring multiple procedures.

Conclusions:

• Adults with exstrophy-epispadias complex can achieve favorable long-term sexual and urinary outcomes.
• Multiple surgical interventions are frequently necessary for successful genitourinary reconstruction and functional recovery.
• Positive sexual outcomes appear correlated with improved urinary continence and overall reconstructive success.