Objective and subjective sexual outcomes in adult patients after hypospadias repair performed in childhood

J Urol. 2013 Oct;190(4 Suppl):1556-60. doi: 10.1016/j.juro.2012.12.104. Epub 2013 Jan 8.

Abstract

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.

Keywords: ED; MAGPI; MCS; PCS; PE; SEAR; Self-Esteem and Relationship; erectile dysfunction; hypospadias; meatoplasty and glans incorporation; mental component summary; penis; physical component summary; premature ejaculation; psychosexual development; questionnaires.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Follow-Up Studies
  • Forecasting*
  • Humans
  • Hypospadias / physiopathology
  • Hypospadias / psychology*
  • Hypospadias / surgery
  • Male
  • Patient Satisfaction*
  • Penile Erection / physiology*
  • Postoperative Period
  • Retrospective Studies
  • Sexual Behavior*
  • Surveys and Questionnaires
  • Treatment Outcome
  • Urologic Surgical Procedures, Male / methods*
  • Urologic Surgical Procedures, Male / psychology
  • Young Adult