PURPOSE: Complete male epispadias (CME) is a rare congenital anomaly characterized by failed closure of the entire penopubic dorsal urethra.
Epispadias repair is typically performed during infancy, and resultant genitourinary abnormalities can have a large impact on adult life. This study assesses long-term post-reconstruction sexual health and fertility outcomes in adult CME patients.
MATERIALS AND METHODS: A total of 132 CME reconstruction patients currently ≥18 years of age were identified from a prospectively maintained institutionally approved database. 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.
RESULTS: Of 132 CME patients, 74 met inclusion criteria, and 15 (20%) completed the questionnaire. Seven (47%) reported currently being in a relationship. Although 12 (80%) reported overall satisfactory sexual intercourse, 11 (73%) of patients admitted to one or more problem with sexual function including abnormal ejaculation (53%), diminished sensation (20%), and difficulty maintaining an erection (20%). When questioned regarding the importance of fertility, 10 (67%) of patients responded with ≥4 on a 0 to 5 Likert-type item. Five (33%) patients reported having impregnated a sexual partner. Although 4 (27%) patients reported suspicion of fertility problems, only 2 (13%) reported having abnormal semen analyses.
CONCLUSIONS: This is one of few studies examining sexual health and function in post-reconstruction CME. Although small, our study demonstrates that patients are able to engage in relationships, enjoy sexual intercourse, and sometimes impregnate their partners. Still, these results highlight sexual concerns and outcomes that may be of use when counseling CME patients and their families.
Written by:
Reddy SS, Inouye BM, Anele UA, Abdelwahab M, Le B, Gearhart JP, Rao PK. Are you the author?
The James Buchanan Brady Urological Institute, The Johns Hopkins Medical Institutions, Baltimore, Maryland, 21287, USA.
Reference: J Urol. 2015 Apr 24. pii: S0022-5347(15)03877-X.
doi: 10.1016/j.juro.2015.04.082
PubMed Abstract
PMID: 25916676