Sexual health in complete male epispadias (CME) patients

Abstract

We provide the first long-term followup on sexual function in post-reconstruction CME patients. We administered a sexual-health telephone survey to CME patients who underwent reconstructive surgery at our institution. We screened a prospective institutional database of 1216 exstrophy-epispadias patients for CME patients currently ≥18 years of age who underwent reconstruction since 1969. Patients who could be contacted were asked to complete a phone survey regarding sexual function. Reconstructive history and clinical details were obtained by chart/database review. Patient-perceived importance of fertility was assessed using a five-point Likert-like scale (1 = least important, 5 = most important). Descriptive data is presented as median (range). Of 132 CME patients, 74 met inclusion criteria, and 14 (19%) completed the telephone questionnaire (Table 1). Of the 14 patients, 50% reported currently being in a relationship. Although 86% reported satisfactory sexual intercourse, 71% of patients admitted to problems with sexual function including unsatisfactory/difficulty ejaculating (50%), diminished sensation (21%), and difficulty maintaining an erection (21%). When questioned regarding the importance of fertility, 71% of patients responded with ≥4. Five patients reported having impregnated a sexual partner. Although four patients described suspicions of fertility problems, only two had confirmed abnormal semen analysis findings.Tabled 1Patient Demographics and ResultsAge at First Repair1.5 years (1–14)Current Age30.5 years (20–58)1° Epispadias Repair Type: Young/Cantwell-Ransley8 (57%) /6 (43%)Pts Requiring Second Epispadias Repair3 (21%)Pts Requiring Bladder Neck Reconstruction13 (93%)Continent via Urethra/Continent via Stoma/Incontinent10 (71%) /2 (14%) /2 (14%)Length of Follow-Up19 years (7–41)Relationship Status: Single7 (50%)Partner/Engaged2 (14%)Married5 (36%)Engage in Regular Sexual Intercourse11 (79%)Satisfactory Sexual Intercourse12 (86%)Issues Regarding Sexual Intercourse10 (71%)Fertility Importance: ≥410 (71%)≤34 (29%)Impregnated Partner (Natural/ART)5 (3/2)Suspected Fertility Issue4 (29%)Abnormal Semen Test2/4 (50%) Open table in a new tab To the best of the authors’ knowledge, this is the first report on sexual health in post-reconstruction CME. Patients are able to engage in relationships, enjoy sexual intercourse, and sometimes impregnate their partners. Still, these results highlight sexual concerns and issues that can aid in counseling CME patients.