Wijnsma, R.F. (2016) Kwaliteit van leven en seksueel functioneren van volwassenen geboren met een blaasexstrofie. thesis, Medicine.
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Abstract
Introduction The classic bladder exstrophy (vesicae ectropia) is one of the rare congenital anomalies in the spectrum of the bladder exstrophy-epispadias complex (BEEC), based on a severe form of a midline defect. Literature shows a detrimental effect of the bladder exstrophy on the quality of life and sexual function. This is the first study in the Netherlands to provide an analysis of the quality of life and sexual function. Objective The aim of this study is to provide an overview of the quality of life and the sexual functioning of patients born with a bladder exstrophy, and the possible correlation between the two subjects. Besides this, the overall satisfaction with cosmetic results, urinary continence and kidney function have been examined. Material and methods 44 patients, identified from a database of the department of Urology of the University Medical Centre Groningen, were assessed by self-developed questionnaires based on the WelzijnsScreeningsLijst, the SFQ and the IIEF. Medical data were retrospectively extracted from medical records. The patients were born between 1941 and 1997 (median age 36 years). Results 70.5% of the patients (31 patients) answered the questionnaires, of whom 19 were men and 12 were women. Scores for the quality of life did not differ by gender. 45.2% of the patients experienced a good quality of life. One man experienced a very poor quality of life. Half the patients experienced mental health problems, of whom 35.5% reported these problems were associated with physical complaints. The impact of the bladder exstrophy on their daily life is for half of the male, and half of the female patients 7 points or more out of ten. 36.8% of men and 33.3% of women indicate that incontinence does not play any role in their lives. 26.3% of men and 16.7% of women experienced influence of urinary incontinence on their sexual life. During the study one man was diagnosed with severe kidney failure. Two-thirds (67.7%) experienced a negative impact on their sexual lives, of which 71.4% male. The mean scores of the IIEF showed mild to serious dysfunction in each category, except ‘sexual desire’. 61.1% reported erectile dysfunction (ED), of whom 72.7% had a serious ED. All women had lowered scores on the questionnaire about sexual functioning. There was no significant correlation between sexual function and quality of life for both men and women. 26.3% of men and 33.3% of women are dissatisfied with the cosmetic result. An equal part of the group, in both men and women, is very satisfied. Nevertheless, 54.8% rated the influence of cosmetic results on their sexual life with a 7 or more out of 10. 47.4% of men is not satisfied with their penile length. They rated the impact of the penile length on sexual life with 8/10. Conclusion Bladder exstrophy negatively impacts sexual functioning. The effect on the quality of life is less clear. Mental problems and problems with physical capacity are common in many patients. There is no significant correlation between the quality of life and sexual functioning. Also, it can be concluded that incontinence and the cosmetic aspect of the genitals both play an important role in the lives of a large number of patients. This research emphasizes the demand for psychological and sexuological support during the follow-up.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisie door and Nijman, prof. dr. J.M. and Universitair Medisch Centrum Groningen and Afdeling Urologie and Augustus ‘15- Januari ’16 |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:48 |
| Last Modified: | 25 Jun 2020 10:48 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/916 |
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