Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood

Abstract

Introduction: Potential long-term sequelae of hypospadias and its surgical correction include difficulties in voiding, sexual function, psychosexual adjustment and self-appraisal. These difficulties often evolve long after surgical repair as children grow to adulthood. Despite this, patient-driven data on long-term functional outcomes and satisfaction are limited, leaving the true success of hypospadias surgery essentially unknown. The aim of this study was to address these deficiencies. Methods:We conducted a chart review for all patients operated on by a single urologist from 1981 to 1988. Extensive efforts were made to obtain accurate current address information for patients. A database of patient demographics and pathology, operative details and complications was created. A 22-item questionnaire was mailed to study subjects. Telephone follow-up by an independent research nurse bolstered response rates. Responses from returned questionnaires were pooled and analyzed. Results:The chart review included 115 patients. Of 100 patients (with address information) who were sent questionnaires, 28 ultimately responded. The chart review group was comparable to groups in other published studies. Despite a slightly higher initial major complication rate (57.2%), respondents reported few long-term complications (11% fistula, 29% persistent chordee and 10% stricture) and excellent urinary and sexual functional results. The most common functional complaints were spraying and hesitancy during micturition. Overall, 86% of patients were satisfied with their surgical result, and 52% wished they had been provided longer follow-up. Conclusion:Long-term outcomes data are critical to an honest account of success rates for hypospadias surgery. Obtaining these data remains challenging. In this series, despite high initial complication rates, most patients reported excellent long-term functional results and were quite satisfied with their overall outcome.

Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction in childhood

“…Mean age at time of the first operation was 3.8 years (range 1.4e5.0; 849 patients) [7,8,12e24]. The average age surgery was completed was 3.5 years, but this was only reported in some studies (range 2.3e4.4; 220 patients) [8,15,17,20,21,23]. The mean age at follow up was 27.0 years (range 14.0e34.7; 965 patients) [7,8,12e17,19e21,23e29].…”

“…The mean age at follow up was 27.0 years (range 14.0e34.7; 965 patients) [7,8,12e17,19e21,23e29]. On average, patients were operated 2.7 times (range 1.0e20.0; 575 patients) [7,14,15,20,21,23,25,27,29].…”

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

“…Strikingly, most studies have focussed on the short-term outcomes of hypospadias repair, and not many authors have longitudinally evaluated its long-term cosmetic and functional consequences [1,3,11,12] . A recent review by Tourchi et al [3,4] appropriately highlights that problem and concludes that more attention should be paid to the impact of these techniques on cosmetic and psychosexual aspects in patients at the time of and after puberty, considering the impact on their adult quality of life.…”

Repair of Urogenital Anomaly with Anterior Displacement of Anus using a Posterior Sagittal Approach- Operative Steps

“…The child was satisfied with the outcome and was happy with the appearance of her genitalia. The child answered positively to the questionnaire (modified outcome questionnaire) given to her [8].…”