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Objective and Subjective Sexual Outcomes of Adult Patients Following Hypospadias Repair Performed In Childhood

Monday, October 22, 2012: 11:20 AM
Grand Ballroom B (Hilton Riverside)
Boris Chertin, MD1, Aladin Natsheh1, Dan Prat1, Itzhak Ben-zion2 and Ofer Z. Shenfeld2, (1)Pediatric Urology, Shaare Zedek Medical Center, Jerusalem, Israel, (2)Urology, Shaare Zedek Medical Center, Jerusalem, Israel

Purpose

We aimed to evaluate sexual function and psychosexual adjustment in adult patients who underwent hypospadias repair in childhood.

Methods Following IRB approval 119(26.6%) of 449 adult patients who underwent hypospadias repair between 1978 -1993 and responded on the following questionnaires: psychological well being and penile appearance, International Index of Erectile Function (IIEF), Self Esteem and Relationship (SEAR), Short Form12 questionnaire (SF-12), Premature Ejaculation (PE), and Sexual Quality of Life-Male (SQoL-M) were included in our study. All patients were divided into three groups according to the primary meatus localization. Group I of 45 (37.8%) patients with glanular hypospadias, group II of 56 (48.2%) with distal hypospadias and group III of the remaining 18(14%) children with proximal hypospadias.

Results

All patients in group I and II were satisfied with the appearance of their penises. However, only 2 (11.1%) of 18 patients in the group III were pleased with their penile appearance. In group I 8.9% of patients reported mild erectile dysfunction(ED). However 62.5% and 72.2% of patients in groups II III reported mild ED respectively. Premature ejaculation (PE) was a common finding in 99 (83.2%) of the all patients with incidence of 88.9% in patients with proximal hypospadias. All group I and II patients reported excellent self-esteem and relationship. In group III most patients were satisfied with relationship and only one patient (5.6%) was not satisfied. Two-thirds of patients in group I and II reported their sexual quality of life as excellent and other patients described them as very good. In group III sexual quality of life was somewhat decreased in all patients with one (5.6%) who has bad sexual life. The physical component summary was 50.07±12.4, 52.92±6.5 and 44.4±4.3 in the first, second and third group respectively. The mental summary component was 40.64±4.4, 40.49±4 and 43.84±2.6 in the first, second and third group respectively.  

Conclusion

Our data show that excluding proximal hypospadias the majority of the patients who underwent hypospadias repair during childhood are satisfy with their penile appearance. However, the high incidence of mild ED and PE should not be disregarded and require appropriate counseling before surgery and during long term follow up.