Sexual Dysfunction and Lower Urinary Tract Dysfunction in Adults With Spina Bifida

To evaluate sexual function and lower urinary tract dysfunction in adults with spina bifida (SB) compared with healthy controls and their impact on quality of life (QOL).

In this prospective observational study, 30 adults with SB (21 women, 9 men) and 28 healthy volunteers (17 women, 11 men) were enrolled (September 2023-December 2024). Sexual and urinary function were assessed with the FSFI, SHIM, IPSS, Overactive Bladder Symptom Score, ICIQ-SF, and King's Health Questionnaire. Group differences were analyzed with Mann-Whitney U or chi-square tests with Benjamini-Hochberg correction; effect sizes were reported as rank-biserial r or Cramér's.

Patients with SB had significantly poorer sexual and lower urinary tract function than controls. In women, sexual desire was relatively preserved (q = 0.21, r = 0.20), whereas arousal, lubrication, orgasm, and satisfaction were markedly reduced (all q ≤ 0.003, r = 0.51-0.79). In men, erectile function was severely impaired (SHIM total 3.0 vs. 21.0; q = 0.0006, r = 0.81). IPSS and ICIQ-SF totals were higher in the SB group in both sexes (all q ≤ 0.0004, r ≥ 0.79). IPSS-QOL correlated with ICIQ-SF in both women (Spearman r = 0.57, p = 0.009) and men (r = 0.80, p = 0.011).

Adults with SB had substantial sexual and lower urinary tract dysfunction. Sexual desire was relatively preserved in women, whereas urinary incontinence was associated with poorer QOL.