Female sexual function and pregnancy after genitourinary reconstruction.

Abstract

Medical ethicists consider the right to bear children one of the most basic of all human rights. As reconstructive surgeons we should recognize that virtually all of our younger patients will eventually desire to become sexually active and, in most cases, have children. We review that ability in female patients who underwent lower urinary tract and genital reconstruction. We performed an extensive search and reviewed the medical literature regarding sexual function and pregnancy after genitourinary reconstruction. There are clear risks during pregnancy after genitourinary reconstruction. Although long-term followup with critical analysis is needed in this patient population, no surgical technique for lower urinary tract or genital reconstruction has been identified to date that negatively impacts intercourse or pregnancy to such a degree that it should not be considered at the initial surgery. Women who underwent lower urinary tract or genital reconstruction as a child often have complex issues. Once such patients express a desire to become pregnant, they can be encouraged to do so as long as they understand that there may be increased risks. Assessment of these risks must be done on an individual basis.