Sexual Dysfunction and Lower Urinary Tract Dysfunction in Adults With Spina Bifida.

OBJECTIVES: To evaluate sexual function and lower urinary tract dysfunction in adults with spina bifida (SB) compared with healthy controls and their impact on quality of life (QOL). METHODS: In this prospective observational study, 30 adults with SB (21 women, 9 men) and 28 healthy volunteers (17 women, 11 men) were enrolled (September 2023-December 2024). Sexual and urinary function were assessed with the FSFI, SHIM, IPSS, Overactive Bladder Symptom Score, ICIQ-SF, and King's Health Questionnaire. Group differences were analyzed with Mann-Whitney U or chi-square tests with Benjamini-Hochberg correction; effect sizes were reported as rank-biserial r or Cramér's. RESULTS: Patients with SB had significantly poorer sexual and lower urinary tract function than controls. In women, sexual desire was relatively preserved (q = 0.21, r = 0.20), whereas arousal, lubrication, orgasm, and satisfaction were markedly reduced (all q ≤ 0.003, r = 0.51-0.79). In men, erectile function was severely impaired (SHIM total 3.0 vs. 21.0; q = 0.0006, r = 0.81). IPSS and ICIQ-SF totals were higher in the SB group in both sexes (all q ≤ 0.0004, r ≥ 0.79). IPSS-QOL correlated with ICIQ-SF in both women (Spearman r = 0.57, p = 0.009) and men (r = 0.80, p = 0.011). CONCLUSIONS: Adults with SB had substantial sexual and lower urinary tract dysfunction. Sexual desire was relatively preserved in women, whereas urinary incontinence was associated with poorer QOL.