Using social media for patient-reported outcomes: A study of genital appearance and sexual function in adult bladder exstrophy patients



      There have been few prior studies on patient-centered outcomes of adults with bladder exstrophy; those performed have been single institution reviews. In collaboration with the Association for the Bladder Exstrophy Communities (ABeC) – an international support network for patients and families living with bladder exstrophy – an anonymous social media survey was performed of patient-reported genital appearance and erectile function.


      The study evaluated the Penile Perception Score (PPS) and the International Index of Erectile Function (IIEF-15) in adult men with bladder exstrophy. It was hypothesized that scores would be significantly lower than prior reported scores for men without the condition.

      Study design

      After review by an anonymous patient advocate volunteer, the ABeC performed an anonymous online survey using social media.


      Adult men with bladder exstrophy reported PPS, and satisfaction with penile length and axis that were lower than prior published controls (n = 54, P < 0.05). Orgasmic function, sexual desire, and overall satisfaction were also lower (n = 46, P < 0.05). There was no difference in erectile function or intercourse satisfaction compared to controls. There was an association between PPS and erectile function, intercourse satisfaction, and overall satisfaction (P < 0.05) (Summary Fig.). Respondents identified urinary issues, genital appearance, and sexual function as the three main domains that warranted further research.


      Summary Fig
      Graphical AbstractAssociation between Penile Perception Score (PPS) and International Index of Erectile Function (IIEF-15). *P < 0.05 on linear regression.


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