Long term follow up on cosmetic and sexual outcomes in patients after hypospadias repair performed in childhood [Poster presentation]

Abstract

<p><b>Aim: </b>Hypospadias repair is a complex reconstructive urological procedure in children. It is associated with significant early complications and possible long-term voiding and psychosexual squalene. However, little has been published in the literature on its long-term cosmetic satisfaction and sexual outcomes, even less so in Asian. Our study therefore aim to evaluate the long-term outcomes of hypospadias surgery relating to penile appearance, sexual function, and sexual satisfaction. <br></p><p><b>Methods: </b>We identified adult patients with hypospadias repair performed in childhood at our hospital between January 1, 1997 and December 31, 2000. At the same time, age-matched normal controls from public were also recruited. 22 of 42 (52%) patients and 19 normal controls responded to questionnaires on penile appearance and sexual life. Our primary outcomes were penile appearance satisfaction, Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) and shortened 5-item version of International Index of Erectile Function (IIEF-5). <br></p><p><b>Results:</b> Mean age of patients was 24±4.6 years old. 68.2% (n=15) had proximal hypospadias and 54.5% (n=17) received Snodgrass urethroplasty. Two patients denied any sexual exposure nor masturbation. Only one third of patients (n=7) was satisfied with their penile appearance. The most common reasons for dissatisfaction included short penis (12/22) and presence of chordee (6/22). The mean IIEF-5 score was 22.4±2.3 out of 25. The mean MSHQ-EjD satisfaction and anxiety score were 12.8±3.5 out of 15 and 0.5±0.8 out of 5 respectively. The types of hypospadias, repair received, and presence of complications had no significant impact on the outcomes. Comparison with age-matched controls revealed similar exposure to sexual activity and no significant difference in the mean IIEF-5 in recent 6 months, mean MSHQ-EjD satisfaction and anxiety score.<br></p><p><b> Conclusion:</b> Majority of adult patients after hypospadias repair performed in childhood were not satisfied with their penile appearance. However, the long-term sexual function and satisfaction of them was fair and comparable to age-matched normal controls. The above information can provide long term result for counselling on the long-term sexual function.<br></p>