Psychosexual dysfunction in males with genital anomalies: Late adolescence, tanner stages IV to VI

Objective: To assess psychosexual function in adolescent males with genital anomalies. Method: Fourteen consecutive males with bladder exstrophy-episp adias, 14 to 19 years old, Tanner stages IV to VI, were assessed along with their parents, using a developmental questionnaire, Hollingshead socioecon omic status rating, Child Behavior Checklist, Youth Self-Report, semistruct ured psychiatric interview, detailed sexual history, and 5 written, open-en ded questions. Results: All subjects showed psychosexual dysfunction in ter ms of genital satisfaction and genital touching; only 2 had ever undressed in front of anyone; only 2 had ever masturbated and only after age 16; 8 ha d few friends acid only 5 considered any girls as friends; all expressed he terosexuality but only 4 had dated, 1 at age 17 and 2 after age 18; only th e two 19-year-olds had experienced sexual intercourse, at the age of 19. Al l had an anxiety disorder. Half had experienced a major depressive disorder . Conclusions: Psychosexual dysfunction and anxiety were universal and chro nic in these males with genital anomalies, leading to social and sexual dev elopmental impairment. Half had a mood disorder. Implications for adulthood as well as for children with other genital anomalies are unclear but deser ve further study. Males with genital anomalies should be evaluated for psyc hosexual developmental impairment.