Treatment of Urethral Intercourse and Impact on Female Sexual Function

ML Djordjevic, MD, PhD; M Bizic, MD, PhD; B Stojanovic, MD, PhD; O Ivanovski, MD, PhD; R Purohit, MD, MPH

Sexual Medicine (Aug 2022)

Treatment of Urethral Intercourse and Impact on Female Sexual Function

ML Djordjevic, MD, PhD,
M Bizic, MD, PhD,
B Stojanovic, MD, PhD,
O Ivanovski, MD, PhD,
R Purohit, MD, MPH

Affiliations

ML Djordjevic, MD, PhD: Belgrade Centre for Genitourinary Reconstructive Surgery, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia; Icahn School of Medicine at Mount Sinai, New York, NY, USA; Corresponding Author: Miroslav L. Djordjevic, MD, PhD, School of Medicine, University of Belgrade, Department of Urology, Tirsova, 11000 Belgrade, Serbia
M Bizic, MD, PhD: Belgrade Centre for Genitourinary Reconstructive Surgery, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
B Stojanovic, MD, PhD: Belgrade Centre for Genitourinary Reconstructive Surgery, Belgrade, Serbia; School of Medicine, University of Belgrade, Belgrade, Serbia
O Ivanovski, MD, PhD: School of Medicine, University of Skopje, Skopje, North Macedonia
R Purohit, MD, MPH: Icahn School of Medicine at Mount Sinai, New York, NY, USA

Journal volume & issue: Vol. 10, no. 4
p. 100534

Abstract

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Background: Urethral intercourse is a very rare entity which usually presents as urinary incontinence during and after intercourse and is most commonly seen in patients with vaginal agenesis (Mayer–Rokitansky–Hauser Syndrome) or hypoplasia, or other rear vaginal anomalies. Aim: To evaluate management and outcomes for vaginal and urethral consequences of urethral intercourse, including urinary incontinence. Methods: Between February 2006 and March 2021, 8 women aged from 17 to 22 years underwent genital and urethral reconstruction due to consequences of urethral sexual intercourse. Vaginal reconstruction included sigmoid vaginoplasty and introitoplasty with division of the vaginal septum in cases of vaginal agenesis (5 cases) and vaginal duplication (3 cases), respectively. Incontinence was treated by sling procedures in 5 women with longer history of urethral coitus and evident bladder neck prolapse. Outcomes: Sexual and psychosexual outcomes assessment was based on the Female Sexual Function Index and standardized questionnaires. Results: Follow-up ranged from 9 to 188 months (mean 78 months). Good esthetical and functional results were achieved in all 8 women. All patients reported satisfactory sexual intercourse. All 5 incontinent women who had underwent sling procedure were continent. In one of 3 nontreated cases, additional sling treatment was indicated 6 months after vaginal reconstruction with satisfactory outcome. One patient with vaginal duplication reported a successful pregnancy with a Caesarean section delivery. Clinical Implications: Urinary incontinence with megalourethra in young women, along with the presence of Mullerian anomalies should raise suspicion of urethral coitus. Surgical treatment includes correction of vaginal anomalies and management of consequences. Strengths and Limitations: This study represents one of the largest series for urethral intercourse, with assessment of psychosexual outcome. The limitation is the lack of statistical analysis due to small sample size. Conclusion: Urethral intercourse is very rare, but it can cause severe consequences. It is important to recognize this occurrence and treat it by well-known vaginal or urethral reconstructive procedures.Djordjevic ML, Bizic M, Stojanovic B, et al. Treatment of Urethral Intercourse and Impact on Female Sexual Function. Sex Med 2022;XX:XXXXXX.

Published in Sexual Medicine

ISSN: 2050-1161 (Online)
Publisher: Oxford University Press
Country of publisher: United Kingdom
LCC subjects: Medicine
Website: https://academic.oup.com/smoa

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