Long-Term Psychological and Sexual Outcomes of Severe Penile Hypospadias Repair

Abstract

Introduction Hypospadias is the most common penis malformation, and there exist a variety of surgical approaches used to correct the abnormal position of the meatus. Although the long-term outcomes of surgery are considered important for psychosexual development, only a few attempts have been made to evaluate patient satisfaction. Aim The aim of our study was to evaluate surgical results and psychosocial adaptations in a homogeneous group of subjects with severe penile hypospadias who underwent the same types of surgical repairs during childhood and compare the results to data obtained from age-matched healthy controls. Methods In this cross-sectional study, 104 men (between 24 and 42 years old) who underwent an uncomplicated two-stage hypospadias repair in their childhood and 63 age-matched healthy men without genital malformations completed the questionnaire. Main Outcome Measures Difference in self-perception assessed by a 15-item questionnaire regarding psychosexual well-being and penile appearance between subjects with corrected hypospadias and healthy participants. Results On average, subjects with a hypospadias repair were less satisfied with their genital appearance; however, they were more satisfied with their sex lives compared to healthy controls. The meatus distance was approximately 1.5 cm from the tip of the penis after surgical correction. None of the postoperative surgical results correlated with patient satisfaction. Furthermore, the small percentage of patients (11%) who were very unsatisfied with their surgical outcomes had no significant differences in surgical outcomes compared to satisfied patients. However, there was a significant difference between the two groups in almost all psychological outcome measures. Conclusions In adults who underwent an uncomplicated ventral repair of a severe penile hypospadias 20–30 years earlier, healthy psychosexual development was achieved despite the lack of a glanular meatus. Early identification of unsatisfied patients is important for appropriate long-term follow-up and counseling.

Proximal hypospadias treated with a transverse preputial island tube: long‐term functional, sexual, and cosmetic outcomes

“…No association was found between ejaculatory function, insensitivity of the glans, and orgasmic function. Also, our present patients reached sexual milestones at a similar age as patients with a two‐staged repairs and Dutch adolescents aged 12–24 years .…”

Proximal hypospadias: A persistent challenge. Single institution outcome analysis of three surgical techniques over a 10-year period

“…Outcomes are variable and difficult to interpret due to important discrepancies in pre-operative patient characteristics, operative techniques, follow-up duration and the surgeon's outcome perception [5,6]. Also, there is paucity of reports considering the patient's quality of life and perception of the repair, which should ultimately drive management [7].…”

Genital Abnormalities in Early Childhood in Sexual Homicide Perpetrators

“…Previous investigations about hypospadias suggested that the surgical repair of hypospadias may adversely affect psychosocial and sexual development . However, more recently published studies indicated that patients with corrected hypospadias may show a psychosexual development that is similar to healthy persons if they receive appropriate medical and psychological treatment and mentoring .…”