Universität zu Köln

Ebert, Anne-Karoline, Lange, Theresa, Reutter, Heiko, Jenetzky, Ekkehart ORCID: 0000-0001-5415-8784, Stein, Raimund, Boemers, Thomas M., Hirsch, Karin, Rosch, Wolfgang H. and Zwink, Nadine (2017). Evaluation of sexual function in females with exstrophy-epispadias-complex: A survey of the multicenter German CURE-Net. J. Pediatr. Urol, 13 (2). OXFORD: ELSEVIER SCI LTD. ISSN 1873-4898

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Abstract

Objective Standardized knowledge about genital function in adult female individuals with exstrophy-epispadias complex (EEC) is scarce. The aim of this study was to investigate sexual function using the standardized Female Sexual Function Index (FSFI), and to assess the influence of bladder and vaginal reconstruction and the presence of incontinence on FSFI results. Method Sixty-one females (aged >= 18 years) recruited by the German multicenter network for congenital urorectal malformations (CURE-Net) were asked to complete the FSFI and a self-designed semi-structured questionnaire assessing comprehensive medical data, gynecological, and psychosocial items. Twenty-one eligible females (34%) returned both questionnaires (mean +/- standard deviation [ SD] age of 26 +/- 5.1 years). Results In 43% of participants, a staged or single-staged approach had been used for reconstruction, and these had their bladder in use. A primary or secondary urinary diversion (UD) after cystectomy had been performed in 38% of participants. Of the participants, 57% lived in a committed partnership, and 62% had sexual intercourse on a regular basis, with a further 19% experiencing pain or discomfort thereby. Introitus plasty was done in 43%. Mean total FSFI all participants was 21.3 (SD 1.9). Most domain scores of patients after introitus plasty were similar compared with those without an operative vaginal approach, except for satisfaction (p = 0.057) and pain (p = 0.024). Comparing incontinent with continent patients, significant differences were found for desire (mean 4.6 vs. 3.5, p = 0.021), lubrication (mean 3.1 vs. 4.2, p = 0.049), and satisfaction (mean 1.6 vs. 3.6, p = 0.0065). In contrast pain was not significant between groups. Conclusions Sexual activity rate in the present study was similar to that reported in the literature (81% vs. 89%), whereas dyspareunia rate was lower in our cohort (19% vs. 24%). The risk for sexual dysfunction seems to be lower in patients reconstructed with primary or secondary UD than patients with bladder in use. It is surprising that lubrification was better after UD than after bladder neck surgery. Incontinence and in some parts the history of an introitus plasty may play an additional role in development of sexual dysfunction in EEC. Although most of the female EEC patients lived in a committed partnership and had sexual intercourse, total FSFI values <26.55 clearly indicate a risk of sexual dysfunction. Although continence itself played a major role, females reconstructed with UD seem to have better sexual function. Further evaluation of sexual outcome and improvement of care for these patients is mandatory.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ebert, Anne-Karoline UNSPECIFIED UNSPECIFIED UNSPECIFIED Lange, Theresa UNSPECIFIED UNSPECIFIED UNSPECIFIED Reutter, Heiko UNSPECIFIED UNSPECIFIED UNSPECIFIED Jenetzky, Ekkehart UNSPECIFIED orcid.org/0000-0001-5415-8784 UNSPECIFIED Stein, Raimund UNSPECIFIED UNSPECIFIED UNSPECIFIED Boemers, Thomas M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Hirsch, Karin UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosch, Wolfgang H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Zwink, Nadine UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-234500
DOI:	10.1016/j.jpurol.2016.04.052
Journal or Publication Title:	J. Pediatr. Urol
Volume:	13
Number:	2
Date:	2017
Publisher:	ELSEVIER SCI LTD
Place of Publication:	OXFORD
ISSN:	1873-4898
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language CLASSIC BLADDER EXSTROPHY; QUALITY-OF-LIFE; INDEX FSFI; CYSTECTOMY; WOMEN Multiple languages Pediatrics; Urology & Nephrology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/23450