Long Term Follow Up Into Adulthood of Boys Operated for Hypospadias: A Study Into Functional And Cosmetic Results

Abstract

Purpose Assessment of long term results after hypospadias surgery with respect to urinary and sexual function, cosmetic appearance and intimate relationships. Material and Methods Patients, now adults, (n=116) operated in our institution between 1987 and 1992 were contacted for participation. Participation included postal questionnaires, the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-15), the Dutch Survey of Intimate Relations (Nederlandse Relatie Vragenlijst, NRV), uroflowmetry and assessment of cosmetic appearance using the Hypospadias Objective Penile Evaluation (HOPE). A control group of 151 male students filled out the IPSS and IIEF and performed uroflowmetry. Results Of 91 traceable patients, 66(73%) returned the questionnaires and 31/91(34%) visited the clinic. Forty-seven patients had distal, 8 had midshaft, and 11 had proximal hypospadias. IPSS scores were >7 in 14%(9/64) of the patients compared to 7%(10/151) of the controls. Patients with distal hypospadias reported more complaints of micturition. Patients with proximal hypospadias had a lower Q¬max compared to other patients and to controls. Concerning the IIEF, only the domain of orgasmic function was lower in patients compared to controls. Patients masturbate less frequently compared to controls. Patients with proximal hypospadias reported less satisfaction with penile length and, objectively, penile length was less than the patients' average (10.8 vs. 12.1 cm). Cosmetic outcome was considered satisfactory, by patients and observers. Thirty-three patients returned the NRV correctly, with above average outcomes, especially on sexuality and independence. Conclusions Long term outcomes after hypospadias surgery show good results with respect to urinary and sexual function, cosmesis and intimacy of relationships. Assessment of long term results after hypospadias surgery with respect to urinary and sexual function, cosmetic appearance and intimate relationships. Patients, now adults, (n=116) operated in our institution between 1987 and 1992 were contacted for participation. Participation included postal questionnaires, the International Prostate Symptom Score (IPSS), International Index of Erectile Function (IIEF-15), the Dutch Survey of Intimate Relations (Nederlandse Relatie Vragenlijst, NRV), uroflowmetry and assessment of cosmetic appearance using the Hypospadias Objective Penile Evaluation (HOPE). A control group of 151 male students filled out the IPSS and IIEF and performed uroflowmetry. Of 91 traceable patients, 66(73%) returned the questionnaires and 31/91(34%) visited the clinic. Forty-seven patients had distal, 8 had midshaft, and 11 had proximal hypospadias. IPSS scores were >7 in 14%(9/64) of the patients compared to 7%(10/151) of the controls. Patients with distal hypospadias reported more complaints of micturition. Patients with proximal hypospadias had a lower Q¬max compared to other patients and to controls. Concerning the IIEF, only the domain of orgasmic function was lower in patients compared to controls. Patients masturbate less frequently compared to controls. Patients with proximal hypospadias reported less satisfaction with penile length and, objectively, penile length was less than the patients' average (10.8 vs. 12.1 cm). Cosmetic outcome was considered satisfactory, by patients and observers. Thirty-three patients returned the NRV correctly, with above average outcomes, especially on sexuality and independence. Long term outcomes after hypospadias surgery show good results with respect to urinary and sexual function, cosmesis and intimacy of relationships.