Hypospadias in adulthood

Abstract

Hypospadias should not be considered as a congenital local defect only in the development of the urethra; the problem extends beyond the local malformation to the physical and intellectual development of the patient. It would also be incorrect to regard the problem of hypospadias as settled if the operative correction is performed, since mostly with puberty, but partly also later, changes may occur in general but particularly also in sexual development, placing a difficult burden on the hypospadias sufferer. The discussion of hypospadias problems in adults therefore embraces a subject that reaches far beyond operative correction into areas of miction, fertility and sexuality and therefore represents a wide complex of physical and mental problems. Above all, the question should be examined what quality of life a hypospadias patient can expect in the future after correction of this congenital malformation in infancy. The following factors describing the special circumstances of living after hypospadias operation, appear to be worthy of discussion: 1. The physical situation which includes the ability of erection, miction, fertility, the cosmetic aspect of the outer genital organ and potential consequences of combined malformations. The mental or "psychic" situation, which reaches into sexual life, partnership and profession. Only a few clinical departments concerned with the primary correction of hypospadias in infancy have controlled a group of patients up to adult age. For these reasons we considered it necessary to collect as far as possible the experiences mentioned in the literature and to combine them with our own observations to arrive at corresponding conclusions.