Penile appearance, social adaptation and psychological condition of children and adolescents who underwent hypospadias: a follow-up study

Abstract

Objective To evaluate the outcomes of hypospadias surgery relating to penile appearance, social adaptation and psychological condition in children and adolescents. Methods 85 patients who underwent urethroplasty (2003-2013) in our department, hypospadias was distal and proximal in 50 and 35 patients; 27 of them with complications. All of patients were interviewed by a urologist in our department with self-designed questionnaire, Achenlach Child Behavior Checklist(CBCL) and Pediatric Penile Perception Score(PPPS). Mean age was 9.97 years and median follow-up of 6.4 years. Results 67(77.0%) patients were satisfied with their penile appearance. Patients with complications or more surgical times were more likely to improve the appearance by operation again. The PPPS data showed that patients themselves were most satisfied with the appearance of the genitals than the parents of boys or the urologists. Patients with poor genital self-perception, lower satisfaction of their penile appearance or severer types of hypospadias, they were more likely to suffer from psychosocial problems(P<0.05). The higher knowledge of hypospadias predicted the more positive penile self-perception, and the better follow-up rate(P<0.05). CBCL survey data revealed that some patients had few hobbies, while their social situation and learning ability were normal. Conclusions Boys with corrected hypospadias appeared to experience normal social and learning ability. The type of hypospadias, surgical times, complications and the penile appearance were important factors in assessing the outcome of hypospadias. Key words: Hypospadias; Cosmetic; Psychology; Follow-up Study