Men with bladder exstrophy report robust sex lives, but women fare worse

Adult men born with a severe urological anomaly in which the bladder forms outside of the abdomen report much more robust sexual lives than women born with the same condition, according to a small study led by urologists at the Johns Hopkins Children's Center.

The condition, known as bladder exstrophy, requires a series of reconstructive surgeries throughout infancy and childhood and into early adolescence.The findings are being reported at the American Academy of Pediatrics Conference Oct. 26 through Oct. 30 in San Francisco.

In the study of 17 men and seven women between the ages of 19 and 68, two-thirds of the women reported moderate to severe dissatisfaction with their sexual lives, with scores lower than those of healthy women. By contrast, 64 percent of the men reported being moderately or very satisfied with their sexual lives, with scores similar to those of healthy men.

“Even though we've managed to restore more or less normal anatomy and function in women, their anatomy has always been more challenging in this type of surgery,” says senior investigator Yegappan Lakshmanan, M.D., a urologist at Hopkins Children's. “Armed with this new knowledge from the study, we will now go back and tweak the techniques we use in women to make sure we prevent at least some of the complications that cause sexual dysfunction later in life.”

One fairly common complication is prolapse, or falling, of the uterus. Taking MRI images of the abdomen before and after surgery gives surgeons visual clues about where the abdominal wall needs to be strengthened to prevent prolapse later on, Lakshmanan says.