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Fertility and sexuality issues in congenital lifelong urology patients: male aspects

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Abstract

Purpose

To review existing literature about fertility and sexuality of boys born with complex congenital genitourinary anomalies.

Methods

A Pubmed review was performed in December 2018 to identify the most relevant original manuscripts regarding male complex congenital conditions affecting the urogenital system in male patients including spina bifida (SB), bladder exstrophy–epispadias complex (BEEC) and hypospadias. A comprehensive review was drafted exploring sexual dysfunction from a medical, psychosexual, surgical and reproductive point of view during transition from childhood (or adolescence) to adulthood.

Results

About 75% of men with SB have erectile dysfunction (ED) (Gamé et al. in Urology 67(3):566–570, 2006; Diamond et al. in 58(4):434–435, 1986). Most SB patients have impaired sexual development mainly due to diminished self-esteem, dependence on caregivers and lack of privacy (Blum et al. in Pediatrics 88(2):280–285, 1991). Men with BEEC have fewer intimate relationships than women because of the greater difficulties with issues regarding their genitalia and sexual activities (Deans et al. in Am J Obstet Gynecol 206(6):496.e1–496.e6, 2012). However, a good quality of life is achievable with the effective use of coping strategies (Deng et al. in Transl Androl Urol 7:941, 2018; Rikken et al. in BMC Womens Health 18(1):163, 2018; Friedler et al. in Reprod Biomed Online 32(1):54–61, 2016). Chordee occurs in 25% of all hypospadias patients. More severe hypospadias is related to a greater risk for complications. The long-term sexual quality of life (QoL) in men who underwent hypospadias surgery is influenced by a lot of factors. Therefore, an interactive and dynamic biopsychosocial model of sexual QoL was proposed.

Conclusions

The care of patients with congenital urologic conditions becomes a challenge especially in the period of ‘transition’. The goal of follow-up is a holistic management viewed from a medical, psychosexual, surgical end reproductive point. All patients should be asked for specific urinary, fecal or sexual concerns.

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Abbreviations

AYA:

Adolescents and young adults

BE:

Bladder exstrophy

BEEC:

Bladder exstrophy–epispadias complex

DSD:

Disorders of sexual development

ED:

Erectile dysfunction

SB:

Spina bifida

VC:

Ventral curvature

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Author information

Author notes

  1. Anne-Françoise Spinoit and Mieke Waterschoot contributed equally as first author.

Authors and Affiliations

  1. Department of Urology, Ghent University Hospital, Ghent, Belgium

    Anne-Françoise Spinoit, Mieke Waterschoot & Céline Sinatti

  2. Pediatric Urology, Sidra Hospital, Doha, Qatar

    Tariq Abbas

  3. Centre for Research on Culture and Gender, Department of Languages and Cultures, Ghent University, Ghent, Belgium

    Nina Callens

  4. Department of Paediatric and Adolescent Endocrinology and Diabetology, Ghent University Hospital, Ghent, Belgium

    Martine Cools

  5. Department of Neuro-Urology, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK

    Rizwan Hamid

  6. University College London Hospitals, London, UK

    Rizwan Hamid

  7. New York Presbyterian/Weill Cornell Medical Center, New York, USA

    Moneer K. Hanna

  8. Kulkarni Reconstructive Urology Centre, Pune, India

    Pankaj Joshi

  9. Pediatric Urology, Riley Hospital for Children at Indiana University Health, Indiana University School of Medicine, Indianapolis, IN, USA

    Rosalia Misseri

  10. Division of Urology, Department of Surgery, Sidra Medical and Research Center, Doha, Qatar

    Joao Luiz Pippi Salle

  11. Paediatric Urology, Riley Hospital for Children, Indiana University Health, Indianapolis, IN, USA

    Joshua Roth

  12. Division of Paediatric Endocrinology, Department of Internal Medicine and Paediatrics, Ghent University Hospital, Ghent, Belgium

    Lloyd J. W. Tack

  13. Faculty of Medicine and Health Science, University of Antwerp, University Hospital Antwerp, Antwerp, Belgium

    Gunter De Win

  14. Department of Urology, University of College London Hospitals, London, UK

    Gunter De Win

Authors
  1. Anne-Françoise Spinoit
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  2. Mieke Waterschoot
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  3. Céline Sinatti
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  4. Tariq Abbas
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  5. Nina Callens
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  6. Martine Cools
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  7. Rizwan Hamid
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  8. Moneer K. Hanna
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  9. Pankaj Joshi
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  10. Rosalia Misseri
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  11. Joao Luiz Pippi Salle
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  12. Joshua Roth
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  13. Lloyd J. W. Tack
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  14. Gunter De Win
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Contributions

A-FS: protocol project development, data management, data analysis, manuscript editing and writing. MW: manuscript writing. CS: data collection. TA: data collection. NC: data collection. MC: data collection. RH: data collection. MKH: data collection. PJ: data collection. RM: data collection. JLPS: data collection. JR: data collection. LT: data collection. GDW: protocol project development, data management, data analysis, manuscript editing.

Corresponding author

Correspondence to Anne-Françoise Spinoit.

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The authors have no conflict of interests to report.

Animal and human rights statement

This is a review of existing data in the literature; it does not concern research involving human or animals participants. No patients’ data were analyzed, as the study was a review of the literature.

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Spinoit, AF., Waterschoot, M., Sinatti, C. et al. Fertility and sexuality issues in congenital lifelong urology patients: male aspects. World J Urol 39, 1013–1019 (2021). https://doi.org/10.1007/s00345-020-03121-2

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  • DOI: https://doi.org/10.1007/s00345-020-03121-2

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