MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS

Abstract

You have accessJournal of UrologyPediatric Urology III (MP47)1 Sep 2021MP47-08 LESSONS FROM ADULTS WITH UNTREATED DISTAL HYPOSPADIAS: FUNCTIONAL AND AESTHETIC CONCERNS Nicol Bush, and Warren Snodgrass Nicol BushNicol Bush More articles by this author , and Warren SnodgrassWarren Snodgrass More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002068.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The benefit of distal hypospadias repair has been questioned by studies of unoperated adults suggesting most adapt with few functional or aesthetic complaints (Fichtner 1995, Dodds 2008). Nearly all presented for unrelated urologic complaints and many were not aware of their anomaly. However, men self-identifying with uncorrected hypospadias in an on-line survey (Schlomer 2014) reported more difficulty with voiding and sexual function than unaffected men. We reviewed complaints in consecutive men with unoperated distal hypospadias to determine functional and aesthetic concerns. METHODS: Men with unoperated hypospadias were identified from a prospectively maintained database. Each was queried at presentation about his urinary stream, straightness of erections, sexual dysfunction and aesthetic concerns. RESULTS: From 2017-2020 a total of 25 men, mean age 42 years (18-63), presented with nonoperated distal hypospadias classified as MIP (8), coronal (6), subcoronal (8) and distal shaft (3). 14 (64%) were circumcised. Representative photos are shown. Of these, 20 (80%) had urine spraying. 9 (36%) had ventral or lateral (2) curvature, causing difficult penetration (1) and discomfort to their sexual partner (3). Altogether 8 (32%) reported painful sexual activity, including 3 with irritation of the exposed urethral mucosa and 1 whose scrotal web irritated his wife. 15 men (40%) were bothered by their appearance. Of all 25 men, 23 complained of an abnormal stream and/or appearance, and the other 2 experienced sexual dysfunction. CONCLUSIONS: Rather than adapting to their condition, all 25 men reported functional problems with voiding and/or sexual activity their entire adult life, and nearly half stated their different appearance currently bothered them. The denominator of men with uncorrected hypospadias is unknown, but the internet survey identified 52 with untreated hypospadias from 736 respondents, and they also reported significantly greater voiding concerns, penile curvature, and sexual disturbances. Even if our patients do not represent the entire population of men with uncorrected distal hypospadias, the adverse impact causing them to request repair even in middle age supports the conclusion that it cannot be dismissed as only a “cosmetic” problem or something men ultimately become accustomed to. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e826-e826 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicol Bush More articles by this author Warren Snodgrass More articles by this author Expand All Advertisement Loading ...