EAUN25 session report: Understanding and supporting sexual health
The Special Interest Group (SIG) Sexual Health organised a thematic session focused on sexual abuse at EAUN25 in Madrid, Spain in March.
The session began with the lecture ‘Understanding and supporting patients with experiences of sexual trauma’ presented by Ms. H. Belcher (GB). She gave an overview of understanding and supporting patients with sexual trauma and experiences.
The second lecture ‘Patient story: Impact of sexual abuse after the robotically assisted laparoscopic prostatectomy (RALP)’ was presented by a Dutch patient who experienced sexual abuse during early childhood. This trauma resurfaced as flashbacks during the diagnosis and treatment of his prostate cancer. He gave a powerful and moving talk about his abuse as a five-year-old boy and the physical complaints he experienced throughout his life, including abdominal and pelvic pain, and bowel difficulties. He was unable to speak about this with his parents or anyone else and kept it a secret for a very long time. Even his wife was unaware at the time they got married.
He experienced flashbacks during the biopsies performed for his prostate cancer diagnosis. The urologist recognised the possibility of past sexual abuse and recommended performing the biopsies under anaesthesia. However, the anaesthetist did not see the necessity and refused. He again experienced flashbacks during the radical prostatectomy, despite being under anaesthesia.
He was now able share his story and urges healthcare professionals to recognise signs of possible sexual abuse in their patients. He emphasised the importance of guiding patients through potentially triggering procedures with sensitivity and care. He advised staying beside the patient at an equal level and addressing them by their first name, if that is their preference.
Some attendees approached me at the end of the session, sharing how deeply moved they were by his story – many said it gave them goosebumps.
During the same session, Dr. C. Wiesender (GB), gave the lecture ‘Impact of female genital mutilation (FGM)’. In many countries around the world, FGM is a common cultural practice. It often involves the removal of the labia, clitoral hood, and sometimes the suturing of remaining tissue to prevent girls from becoming sexually active before marriage. This is mostly performed by elder women, using non-sterile materials such as razor blades, often in early childhood.
Many of these young girls suffer lifelong consequences, including urinary tract infections (UTIs), abdominal and pelvic pain, and difficulty urinating. Menstruation can be painful, and sexual penetration after marriage is often painful or even impossible without surgical intervention to open the vagina. Childbirth is also extremely difficult, frequently requiring caesarean sections.
The final state-of-the-art lecture on the first day of EAUN25 addressed abnormalities of the penis. This session covered several common and less common conditions, including congenital curvature, Peyronie’s disease, different forms of priapism, and skin conditions such as balanitis, lichen sclerosus, Morbus Zoon, and erythroplasia of Queyrat – a potential precursor to penile cancer.
Peyronie’s disease can lead to psychological distress due to penile curvature, which can make intercourse difficult and negatively affect self-image. Low-flow priapism (95% of cases) must be treated as a urological emergency – if not resolved within six hours, it can result in permanent erectile dysfunction, requiring a penile implant. High-flow priapism, while not an emergency or causing compartment syndrome, is still an uncomfortable and distressing condition, especially when recurrent.
Author: Mrs. J. Verkerk-Geelhoed (NL)