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Fertility and sexuality issues in congenital lifelong urology patients: female aspects.

Authors
  • De Win, Gunter1, 2, 3
  • Dautricourt, Stéphanie4, 5
  • Deans, Rebecca6, 7
  • Hamid, Rizwan8, 9
  • Hanna, Moneer K10, 11
  • Khavari, Rose12, 13
  • Misseri, Rosalia14, 15
  • Mueller, Margaret G16
  • Roth, Joshua14
  • Spinoit, Anne-Françoise17, 14
  • 1 University of Antwerp, Faculty of Medicine and Health Science, Antwerp, Belgium. [email protected] , (Belgium)
  • 2 Department of Urology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium. [email protected] , (Belgium)
  • 3 Department of Urology, University College London Hospitals, London, UK. [email protected]
  • 4 University of Antwerp, Faculty of Medicine and Health Science, Antwerp, Belgium. , (Belgium)
  • 5 Department of Urology, University Hospital Antwerp, Wilrijkstraat 10, 2650, Edegem, Belgium. , (Belgium)
  • 6 Royal Hospital for Women, School of Women's and Children's Health, University of New South Wales, Sydney, Australia. , (Australia)
  • 7 Gynaecological Research and Clinical Evaluation (GRACE) Unit, Royal Hospital for Women, Sydney, NSW, Australia. , (Australia)
  • 8 Royal National Orthopaedic Hospital Stanmore, Middlesex, UK.
  • 9 Department of Urology, University College London Hospitals, London, UK.
  • 10 New York Presbyterian/Weill Cornell Medical Center, New York, USA.
  • 11 New York Weill Cornell Medical Center, New York, USA.
  • 12 Neurourology and Transitional Urology Clinic, Houston Methodist Hospital, Houston, USA.
  • 13 Center for Restorative Pelvic Medicine, Houston Methodist Hospital, Houston, TX, USA.
  • 14 Pediatric Urology, Riley Hospital for Children, Indiana University Health, Indianapolis, IN, USA. , (India)
  • 15 Indiana University School of Medicine, Indianapolis, IN, USA. , (India)
  • 16 Department of Obstetrics and Gynecology, Division of Female Pelvic Medicine and Reconstructive Surgery (Urogynecology), Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
  • 17 Ghent University Hospital, Faculty of Pediatric Urology, Ghent, Belgium. , (Belgium)
Type
Published Article
Journal
World journal of urology
Publication Date
Sep 28, 2020
Identifiers
DOI: 10.1007/s00345-020-03461-z
PMID: 32989556
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

With advances in treatment modalities and medical knowledge, girls with congenital urologic disorders are living well into adulthood. Although, sexual and reproductive function in this population is still poorly understood. The aim is to review existing literature about fertility and sexuality in women with congenital genitourinary disorders, including spina bifida (SB), bladder exstrophy-epispadias complex (BEEC) and congenital adrenal hyperplasia (CAH). This review represents the joint SIU-ICUD (Société Internationale d'Urologie-International Consultation on Urological Disease) consultation on congenital lifelong urology. The results of this analysis were first presented at a joint consultation of the SIU and ICUD at the 2018 SIU annual conference in Seoul, South Korea. Appropriate experts were asked to write specific sections regarding sexuality and reproductive function in female patients with these complex congenital urogenital disorders. Each expert performed their own literature review which was reviewed by GDW, AFS, Hadley M. Wood and Dan Wood. Expert opinion was obtained where data are non-existent. Only about half of the individuals with SB express a satisfactory sex life. In women with BEEC, cosmetic concerns surrounding genital appearance and function may increase psychological distress, including severe depression, suicide and sexual dysfunction. Professional health care is key for improving self-esteem and to interact in the biopsychosocial model of the quality of life. Patients with SB and BEEC should be informed about all the potential risks and difficulties before, during and after pregnancy. Screening for pelvic organ prolapse is important as it can exacerbate their already existing sexual dysfunction, difficulties achieving pregnancy and challenges with clean intermittent catheterization. Lifelong multidisciplinary follow-up and management are complex but necessary. As these patients grow into their adolescence, they may have the desire to become involved in personal relationships and have sexual interactions. Their healthcare team needs to be increasingly sensitive to these aspects.

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