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Long-term sexual outcomes in patients with exstrophy-epispadias complex

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Abstract
Exstrophy-epispadias complex (EEC) is a spectrum of genitourinary malformations that ranges in severity and affects external genitalia and the lower urinary tract. The aim of this study was to determine the long-term sexual outcomes of patients with EEC. Sexual outcomes were hypothesized to be related to those of urinary ones. A retrospective database including all patients with EEC who had surgery at a tertiary referral institution from 1990 to 2019 was created. Data based on patient's charts were collected: demographics, surgeries, sexual outcomes, urinary outcomes. Fifty-eight patients with EEC had surgery at tertiary referral institution and entered our database. For this analysis of sexual outcomes, a sub-set of the whole population was selected: patients being 14 years old and older, having at least one surgery at our institution and having at least 12 months of follow-up. Applying this selection criteria to our database resulted in a series of 29 patients. High rates of sexual activity were observed in pubertal and post-pubertal men (96%) and women (75%). Seventy-nine percent of men and 67% of women reported sexual satisfaction; 63% of men reported normal ejaculation. To achieve these rates, 96% of men required surgery (84% penoplasty, 52% phalloplasty), and 25% of women required introitoplasty. Fertility was achieved in 67% of men and 100% of women. Assisted reproductive technology was needed in one man. Continence rates were high (diurnal continence in 83% and nocturnal continence in 93%). However, 76% required multiple continence procedures. Men and women with EEC can have good long-term sexual and urinary outcomes, but this may require multiple surgeries. Good sexual outcomes seem to be related to good urinary and continence outcome.
Keywords
CLASSIC BLADDER EXSTROPHY, FOLLOW-UP, FERTILITY, RECONSTRUCTION, CONTINENCE, CHILDHOOD

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MLA
Sinatti, Céline, et al. “Long-Term Sexual Outcomes in Patients with Exstrophy-Epispadias Complex.” INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, vol. 33, no. 2, 2021, pp. 164–69, doi:10.1038/s41443-020-0248-2.
APA
Sinatti, C., Waterschoot, M., Roth, J., Van Laecke, E., Hoebeke, P., & Spinoit, A.-F. (2021). Long-term sexual outcomes in patients with exstrophy-epispadias complex. INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, 33(2), 164–169. https://doi.org/10.1038/s41443-020-0248-2
Chicago author-date
Sinatti, Céline, Mieke Waterschoot, Joshua Roth, Erik Van Laecke, Piet Hoebeke, and Anne-Françoise Spinoit. 2021. “Long-Term Sexual Outcomes in Patients with Exstrophy-Epispadias Complex.” INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH 33 (2): 164–69. https://doi.org/10.1038/s41443-020-0248-2.
Chicago author-date (all authors)
Sinatti, Céline, Mieke Waterschoot, Joshua Roth, Erik Van Laecke, Piet Hoebeke, and Anne-Françoise Spinoit. 2021. “Long-Term Sexual Outcomes in Patients with Exstrophy-Epispadias Complex.” INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH 33 (2): 164–169. doi:10.1038/s41443-020-0248-2.
Vancouver
1.
Sinatti C, Waterschoot M, Roth J, Van Laecke E, Hoebeke P, Spinoit A-F. Long-term sexual outcomes in patients with exstrophy-epispadias complex. INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH. 2021;33(2):164–9.
IEEE
[1]
C. Sinatti, M. Waterschoot, J. Roth, E. Van Laecke, P. Hoebeke, and A.-F. Spinoit, “Long-term sexual outcomes in patients with exstrophy-epispadias complex,” INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH, vol. 33, no. 2, pp. 164–169, 2021.
@article{8676613,
  abstract     = {{Exstrophy-epispadias complex (EEC) is a spectrum of genitourinary malformations that ranges in severity and affects external genitalia and the lower urinary tract. The aim of this study was to determine the long-term sexual outcomes of patients with EEC. Sexual outcomes were hypothesized to be related to those of urinary ones. A retrospective database including all patients with EEC who had surgery at a tertiary referral institution from 1990 to 2019 was created. Data based on patient's charts were collected: demographics, surgeries, sexual outcomes, urinary outcomes. Fifty-eight patients with EEC had surgery at tertiary referral institution and entered our database. For this analysis of sexual outcomes, a sub-set of the whole population was selected: patients being 14 years old and older, having at least one surgery at our institution and having at least 12 months of follow-up. Applying this selection criteria to our database resulted in a series of 29 patients. High rates of sexual activity were observed in pubertal and post-pubertal men (96%) and women (75%). Seventy-nine percent of men and 67% of women reported sexual satisfaction; 63% of men reported normal ejaculation. To achieve these rates, 96% of men required surgery (84% penoplasty, 52% phalloplasty), and 25% of women required introitoplasty. Fertility was achieved in 67% of men and 100% of women. Assisted reproductive technology was needed in one man. Continence rates were high (diurnal continence in 83% and nocturnal continence in 93%). However, 76% required multiple continence procedures. Men and women with EEC can have good long-term sexual and urinary outcomes, but this may require multiple surgeries. Good sexual outcomes seem to be related to good urinary and continence outcome.}},
  author       = {{Sinatti, Céline and Waterschoot, Mieke and Roth, Joshua and Van Laecke, Erik and Hoebeke, Piet and Spinoit, Anne-Françoise}},
  issn         = {{0955-9930}},
  journal      = {{INTERNATIONAL JOURNAL OF IMPOTENCE RESEARCH}},
  keywords     = {{CLASSIC BLADDER EXSTROPHY,FOLLOW-UP,FERTILITY,RECONSTRUCTION,CONTINENCE,CHILDHOOD}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{164--169}},
  title        = {{Long-term sexual outcomes in patients with exstrophy-epispadias complex}},
  url          = {{http://dx.doi.org/10.1038/s41443-020-0248-2}},
  volume       = {{33}},
  year         = {{2021}},
}

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