Self-Esteem and Satisfaction with Penile Appearance in Adolescent Males with Bladder Exstrophy: A Pilot Study

Abstract

PURPOSE Self-esteem can play an important role in satisfaction with body appearance. The present pilot study was designed to examine the relationship between self-esteem and satisfaction with penile appearance in adolescent males with bladder exstrophy and/or epispadisas. MATERIAL AND METHODS Nine adolescent males aged 11-16 with bladder exstrophy or primary epispadias were identified in the Manchester Bladder Exstophy database. Six took part in the study completing a ‘satisfaction with penile appearance’ questionnaire and the Harter Self-Perception Profile to provide a global measure of self-worth. Standarised photographs were taken of each participant's genital area. Two Paediatric Urologists independently rated participants’ penile appearance based on the anonymised photographs using a penile appearance rating scale. Each participant's genital developmental stage was assessed using the Tanner Rating Scale. RESULTS Discrepancy scores were calculated between objective/professional assessments of the penile appearance and subjective/young people's assessments of the penile appearance. Lower self-worth scores on the Harter Self-Perception Profile were noted for participants who had a larger discrepancy between subjective and objective ratings of penile appearance. 4 of the 6 participants had self-worth ratings within the normal range. Developmental stage as assessed using the tanner rating scale did not seem to affect satisfaction with the penile appearance in this small group. CONCLUSIONS The limited numbers in this study prevent generalisation of the results, however it is relevant that 4 of our 6 patients showed normal self-worth during adolescence despite having visibly different penises. Further research is required to examine the link between self-esteem and satisfaction with the penile appearance.