[Sexuality and Fertility in Urogenital Malformations: Care, Expectations, and Reality].

Sexual function and fertility have become increasingly important considerations in the management of urogenital malformations due to improved long-term outcomes. Despite substantial advances in reconstructive surgery, many patients continue to experience sexual dysfunction, including erectile and ejaculatory disorders, dyspareunia, and body image concerns, which affect partner relationships and quality of life. Psychosocial factors such as shame, insufficient education, and lack of specialized sexual medicine counseling further exacerbate functional impairments and have a significant negative impact on quality of life and self-esteem. Early, individualized counseling and structured transition programs are crucial to align expectations realistically and to outline reproductive prospects. Multidisciplinary care is essential to ensure patient-centered management and to establish sexual function and fertility as integral therapeutic goals.