Sexual Function and Fertility in Males With Vascular Malformations of the Genitourinary Tract and Pelvis

Abstract

Objectives: A subset of males with vascular malformations (VM) have involvement of their genitourinary (GU) tract. The purpose of this study was to survey males with VM to investigate whether patients with GU involvement experience problems with sexual function and fertility. Methods: An anonymous survey was designed based on modifications of Patient-Reported Outcomes Measurement Information System and International Index of Erectile Function surveys to examine sexual interest, function, satisfaction, and fertility. Surveys were sent electronically to 709 males 18 years or older (or parents of minor males under age 18) with VM through the Klippel-Trenaunay Support Group, the CLOVES Syndrome Community, and the Lymphangiomatosis & Gorham’s Disease Alliance. Results: Evaluable responses were received from 42 surveys (5.9%). Thirty-three of the 42 responses (79%) were from males with VM involving the GU tract (4.6% of surveys sent). Of the 33 with GU VM, 17 (52%) reported one or more problems including pain with masturbation and/or intercourse, bleeding with masturbation and/or intercourse, lack of interest in sex, and erectile dysfunction. Fourteen of 33 reported that they had fathered children. There was no statistically significant difference in these symptoms compared with responses from men with VM not involving the pelvis. Conclusion: Males with VM involving or not involving the GU system may experience problems with sexual function and satisfaction. While prospective studies are needed to clarify the prevalence and extent of these symptoms, providers should be aware that such symptoms can occur in this patient population.

Burdens of disease and caregiver burden in complex vascular malformations

“…Male patients described perceptions of stigma related to sexual activity when their VM involved their sexual organs or became visible when unclothed. Few studies have evaluated the sexual or reproductive health needs or outcomes for patients with complex VMs 25 . While clinicians can address and normalize these concerns, we lack evidence to inform these clinical questions across clinical contexts.…”

“…Few studies have evaluated the sexual or reproductive health needs or outcomes for patients with complex VMs. 25 While clinicians can address and normalize these concerns, we lack evidence to inform these clinical questions across clinical contexts. Future studies should further evaluate sexual health concerns of patients, fertility outcomes related to VMs and targeted therapies, and outcomes related to pregnancy and delivery.…”