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13:50 - 13:53
S26-4
(PP)
SEXUAL FUNCTION AND FERTILITY OF WOMEN WITH BLADDER EXSTROPHY
AFTER URINARY DIVERSION
Peter RUBENWOLF
1
, Joachim THÜROFF
2
and Raimund STEIN
1
1) Mainz University Medical Center, Paediatric Urology, Mainz, GERMANY - 2) Mainz University Medical Center, Urology,
Mainz, GERMANY
PURPOSE
To evaluate female patients born with classic bladder exstrophy having undergone continent urinary diversion (CUD) for
sexual function, social integration and fertility.
MATERIAL AND METHODS
The medical records of female exstrophy patients having undergone CUD in our department were reviewed. Patients
were asked to complete questionnaires relating to sexual function, psychosocial integration and maternity.
RESULTS
29 patients were included in the study. Follow-up was 22.3 years. 62% had undergone primary and 38% secondary CUD
after failed reconstruction of the exstrophic bladder. Except for desire, sexual function as measured by the Female
Sexual Function Index (FSFI) was only little affected in all domains, with a mean total score of 28.4. 72% had a stable
relationship and 41% were married. 31% achieved a high level of education. Pelvic organ prolapse requiring surgical
repair occurred in 38%. 12 patients conceived a total of 16 healthy children. Pregnancy rates were significantly higher in
patients with primary compared with secondary CUD
CONCLUSIONS
Sexual function, fertility and social integration of female exstrophy patients having undergone CUD appears to be
comparable with previously reported series of patients in whom the bladder had been preserved. Evaluation of sexual
function, gynecologic pathologies and fertility should be part of the long-term follow-up and treatment options should be
discussed if required. Nowadays, modern concepts of exstrophy repair should be applied whenever possible to improve
the cosmetic and functional results of reconstructive surgery.