Female pelvic congenital malformations: Part II: Sexuality, reproductive outcomes and psychological impact

The second part of this review deals with the quality of life of patients with congenital pelvic malformations, focusing on the sexuality, reproductive outcomes and overall psychological impact of the women affected. The presence of deformed pelvic anatomy, congenital or iatrogenic, and therefore of altered urinary, anal or sexual functions, are not only a physical limitation but seriously compromise psychological health from childhood. These difficulties jeopardise the thorny path from childhood to adult life through adolescence, and if neglected, could be responsible for seriously impairing quality of life in adulthood, in terms of mental health and psychosocial functions. If, in the 1970s, the main objective was to save the lives of newborns/infants, nowadays the therapy concept looks beyond that, focusing on quality of life and aiming to establish a satisfactory sexual life, allow the possibility of becoming a parent and enable the successful psychosocial integration of the patient. Ensuring urinary and fecal continence as well as the possibility of normal sexual activity, are the basis for allowing a normal psychological growth during adolescence, which leads to a satisfactory life later on.