Sexual Function, Body Image, and Quality of Life After Genital Burns: A Burn Model System Database Study

Burn injuries impact both functional and psychosocial quality of life. Genital burns may uniquely affect anatomy, sensation, and self-perception, yet research remains limited. This study explores the impact of genital burns on body image, sexual satisfaction, and health-related quality of life. This retrospective analysis included adults (≥18 years) from 2016 to 2024 in a multicenter longitudinal patient-reported outcome database. Linear mixed-effect models evaluated the impact of genital burns on Patient-Reported Outcome Measurement Information System (PROMIS-29) outcomes (anxiety, depression, fatigue, pain, function, sleep, and sexual satisfaction) and Burn Specific Health Scale (BSHS) body image at 6, 12, and 24 months, adjusting for demographics, total burn size, and time. Interaction terms assessed differences in recovery trajectories. Of 4594 participants, 649 had genital burns and 3945 did not. After adjustment, no significant differences were observed in baseline PROMIS-29 or BSHS outcomes. Longitudinal analyses revealed significant differences in recovery trajectories for depression, sleep disturbance, and body image. At 24 months, participants with genital burns had increased depression scores (+1.22) compared to a reduction (-0.60) in those without (P = 0.036). Sleep disturbance improvements at 12 months were smaller for those with genital burns (0.9 vs. 1.88-point reduction, P = 0.042). Body image scores declined for participants with genital burns, while improving for those without, with significant differences at 12 months (P = 0.026) and 24 months (P = 0.001). No significant differences were observed for anxiety, fatigue, pain interference, physical function, or sexual satisfaction. Genital burns significantly impact recovery, particularly depression, sleep, and body image.