Journal of pediatric surgery · 2025
Psychological and sexual outcomes in patients with bladder exstrophy and their caregivers.
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Bakır Ayten Ceren, Emül Hacı Murat, Eliçevik Mehmet, Emir Haluk, Söylet Yunus, Danişmend Nur, Büyükünal Cenk
Аннотация
BACKGROUND: Bladder exstrophy is a rare congenital anomaly with long-term physical and psychosocial implications. While surgical management has improved, little is known about the psychological and sexual outcomes of affected individuals and their caregivers.
METHODS: We retrospectively evaluated 27 patients (aged 12-33 years) who underwent bladder exstrophy closure and augmentation. Psychological and sexual well-being were assessed using validated psychometric tools, including the Arizona Sexual Experience Scale (ASES), Beck Depression Inventory (BDI), Maudsley Obsessive-Compulsive Inventory (MOCI), TEMPS Temperament Evaluation, State-Trait Anxiety Inventory (STAI), and the Zarit Caregiver Burden Interview. Ethical approval was obtained, and data were analyzed using standard statistical methods.
RESULTS: Depressive symptoms were common, with BDI scores averaging 12.6 (SD 11.7), and some patients showing severe depression. Anxiety levels were moderate (STAI-State: 37.1 ± 9.1; STAI-Trait: 41.2 ± 8.6). Sexual well-being varied, with ASES domains indicating reduced satisfaction but no significant correlation with age or gender. Caregivers reported a moderate to high burden (mean Zarit score: 36.4 ± 8.0). Significant correlations were found between depressive symptoms and both sexual dissatisfaction (ASES psychological arousal, rho = 0.625, p = 0.004) and trait anxiety (rho = 0.642, p = 0.003).
CONCLUSIONS: Patients with bladder exstrophy experience substantial psychological and sexual health challenges, while caregivers face a considerable burden. These findings highlight the need for holistic, long-term support that addresses both medical and psychosocial aspects in this population.
METHODS: We retrospectively evaluated 27 patients (aged 12-33 years) who underwent bladder exstrophy closure and augmentation. Psychological and sexual well-being were assessed using validated psychometric tools, including the Arizona Sexual Experience Scale (ASES), Beck Depression Inventory (BDI), Maudsley Obsessive-Compulsive Inventory (MOCI), TEMPS Temperament Evaluation, State-Trait Anxiety Inventory (STAI), and the Zarit Caregiver Burden Interview. Ethical approval was obtained, and data were analyzed using standard statistical methods.
RESULTS: Depressive symptoms were common, with BDI scores averaging 12.6 (SD 11.7), and some patients showing severe depression. Anxiety levels were moderate (STAI-State: 37.1 ± 9.1; STAI-Trait: 41.2 ± 8.6). Sexual well-being varied, with ASES domains indicating reduced satisfaction but no significant correlation with age or gender. Caregivers reported a moderate to high burden (mean Zarit score: 36.4 ± 8.0). Significant correlations were found between depressive symptoms and both sexual dissatisfaction (ASES psychological arousal, rho = 0.625, p = 0.004) and trait anxiety (rho = 0.642, p = 0.003).
CONCLUSIONS: Patients with bladder exstrophy experience substantial psychological and sexual health challenges, while caregivers face a considerable burden. These findings highlight the need for holistic, long-term support that addresses both medical and psychosocial aspects in this population.