title: Female sexual function and pregnancy after genitourinary reconstruction.
abstract: OBJECTIVE
  Medical ethicists consider the right to bear children one of the most basic of all human rights. As reconstructive surgeons we should recognize that virtually all of our younger patients will eventually desire to become sexually active and, in most cases, have children. We review that ability in female patients who underwent lower urinary tract and genital reconstruction.
  
  
  METHODS
  We performed an extensive search and reviewed the medical literature regarding sexual function and pregnancy after genitourinary reconstruction.
  
  
  RESULTS
  There are clear risks during pregnancy after genitourinary reconstruction. Although long-term followup with critical analysis is needed in this patient population, no surgical technique for lower urinary tract or genital reconstruction has been identified to date that negatively impacts intercourse or pregnancy to such a degree that it should not be considered at the initial surgery.
  
  
  CONCLUSIONS
  Women who underwent lower urinary tract or genital reconstruction as a child often have complex issues. Once such patients express a desire to become pregnant, they can be encouraged to do so as long as they understand that there may be increased risks. Assessment of these risks must be done on an individual basis.
authors.affiliation: Division of Pediatric Urology, Monroe Carell Jr. Vanderbilt Children's Hospital, Nashville, Tennessee 37232-9820, USA. john.thomas@vanderbilt.edu
authors.forename: John C
authors.initials: JC
authors.lastname: Thomas
authors.forename: Mark C
authors.initials: MC
authors.lastname: Adams
mesh_terms: D001746:Bladder Exstrophy / Q000601:surgery; D005260:Female; D005836:Genitalia, Female / Q000002:abnormalities / Q000601:surgery*; D006801:Humans; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors; D019529:Sexuality / Q000502:physiology*; D016135:Spinal Dysraphism / Q000150:complications; D014551:Urinary Tract / Q000002:abnormalities / Q000601:surgery*