Reconstructive surgery for major sexual congenital anomalies in adults

Summary Objective Major sexual congenital anomalies can be traumatic as they are associated with dissatisfaction with body image, low self-esteem, depression and anxiety and as they can damage psychosexual development, deteriorate sexual function, long-term relationships and reproduction. The purpose of this article is to describe the surgical solutions offered to overcome these anatomical anomalies and describe the results of these interventions. Method A PubMed review of the literature on micropenis, bladder extrophy, hypospadias and epispadias was performed along with a collection of our surgical experience at the Hospices Civils de Lyon (France). Results Empirical studies along with our surgical experience show that corrective or reconstruction surgery often improves patient satisfaction with the appearance of their genitals, improves body image and self-esteem and remedies sexual dysfunctions related to penetration and resulting from a small or deviated penis. However, surgery or congenital anomalies can have negative impacts on ejaculation and fertility. Discussion The results from studies and from our experience advocate surgical intervention to correct various types of congenital anomalies as they result in psychological, social and sexual improvements for many if not most of these patients, even if these procedures are difficult and associated with complications.