P-02-35 Sexual Dysfunction in Patients With Late Complications of Hypospadias Repair

Abstract

Failed hypospadias repair is responsible for some of the most extremely complex cases reconstructive urologist may encounter in his career. Some late complications of hypospadias surgery belong to the so called «nightmares in urology» category, while such unfortunate patients are known as «hypospadias cripples». Complications which lead to micturition disorders, such as strictures and fistulae, are relatively well-known. However, many patients who were unsuccessfully treated for hypospadias present with complaints regarding their sexual well-being. To evaluate sexual dysfunction in patients with late complications of hypospadias surgery. We performed an analysis of conditions and symptoms related to sexual dysfunction in 112 patients who underwent failed hypospadias repair in the past. Average age of patients was 32.1 years (min-max: 18-62). All patients consented to interview, completion of questionnaires, endocrine evaluation and penile doppler ultrasound when indicated. Seventy two patients (64.2%) were dissatisfied with their penile appearance, which influenced their sex life. Direct complaints on specific manifestations of sexual dysfunction were also quite common: 45 patients (40.2%) had erectile dysfunction (ED), 67 patients (59.8%) had decreased libido, 71 patients complained on weak semen expulsion (63.4%), 32 patients had premature ejaculation (28.6%), 8 patients had delayed ejaculation (7.1%), 4 had anejaculation (3.5%), 12 had painful ejactulation (10.7%) and 5 had orgasmic dysfunction (4.5%). Among patients with ED, 9 had vasculogenic ED, 2 had neurogenic ED, 13 had ED of endocrine origin, and 21 had psychogenic ED. All 11 patients with vasculogenic and neurogenic ED initially had proximal hypospadias and underwent at least 6 attempts of surgical repair.