Objective and Subjective Sexual Outcomes in Adult Patients after Hypospadias Repair Performed in Childhood

• Published in: The Journal of urology Vol. 190; no. 4; pp. 1556 - 1560
• Main Authors: Chertin, Boris, Natsheh, Aladin, Ben-Zion, Itzhak, Prat, Dan, Kocherov, Stanislav, Farkas, Amicur, Shenfeld, Ofer Z
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.10.2013; Elsevier
• Subjects: Adolescent; Adult; Biological and medical sciences; Child; erectile dysfunction; Follow-Up Studies; Forecasting; Gynecology. Andrology. Obstetrics; Humans; hypospadias; Hypospadias - physiopathology; Hypospadias - psychology; Hypospadias - surgery; Male; Male genital diseases; Malformations of the urinary system; Medical sciences; Nephrology. Urinary tract diseases; Non tumoral diseases; Patient Satisfaction; Penile Erection - physiology; penis; Postoperative Period; psychosexual development; questionnaires; Retrospective Studies; Sexual Behavior; Surveys and Questionnaires; Treatment Outcome; Urinary tract. Prostate gland; Urologic Surgical Procedures, Male - methods; Urologic Surgical Procedures, Male - psychology; Urology; Young Adult; PCS; SEAR; hypospadias; psychosexual development; erectile dysfunction; questionnaires; physical component summary; premature ejaculation; PE; MAGPI; meatoplasty and glans incorporation; Self-Esteem and Relationship; penis; MCS; mental component summary; ED; Human; Nephrology; Urinary system disease; Urethral disease; Prognosis; Questionnaire; Erection disorders; Impotence; Sexual dysfunction; Hypospadias; Urinary tract disease; Male genital system; Urology; Malformation; Penis; Development; Adult; Repair; Male genital diseases; Child
• ISSN: 0022-5347; 1527-3792
• DOI: 10.1016/j.juro.2012.12.104

Purpose We evaluated sexual function and psychosexual adjustment in adults who underwent hypospadias repair in childhood. Materials and Methods After receiving institutional review board approval, 119 of 449 adult patients (26.6%) who underwent hypospadias repair between 1978 and 1993 responded to questionnaires on penile appearance and sexual life. Patients were divided into 3 groups according to primary meatal location in childhood, including group 1—45 (37.8%) with glanular hypospadias, group 2—56 (48.2%) with distal hypospadias and group 3—18 (14%) with proximal hypospadias. Results All group 1 and 2 patients, and 11% in group 3 were satisfied with the penile appearance. Of group 1 patients 8.9% reported mild erectile dysfunction, as did 50% and 72.2% in groups 2 and 3, respectively. A total of 99 patients (83.2%) complained of premature ejaculation. All group 1 and 2 patients reported excellent self-esteem and relationship on the Self-Esteem and Relationship questionnaire. Most group 3 patients were satisfied with their relationship and only 1 (5.6%) was not satisfied. Two-thirds of the patients in groups 1 and 2 reported that sexual quality of life was excellent and the others described it as good. In group 3 sexual quality of life was somewhat decreased in all patients and 1 (5.6%) had poor sexual quality of life. Physical and mental component summaries were satisfactory in all patients reviewed. Conclusions Our data show that the high incidence of mild erectile dysfunction and premature ejaculation should not be disregarded and requires appropriate counseling before surgery.