Psychosexual Functioning Outcome Testing after Hypospadias Repair.

Marko Majstorovic,Marko Bencic,Ivana Joksic,Miroslav Djordjevic,Marta Bizic,Borko Stojanovic,Dejan Nikolic

doi:10.3390/healthcare8010032

Abstract

Self-confidence plays an important role in both genders’ sexual functioning. Lack of genital self-esteem may have negative effects on psychosexual development, especially in males, where deviations from a standardized normal penile appearance can lead to inhibitions in entering into sexual relationships. The aim of our study was to evaluate the informativeness of studied domains of the Global Sexual Functioning (GSF) questionnaire and sexual functioning of patients surgically treated in childhood for different types of hypospadias. We evaluated 63 males with hypospadias and 60 healthy age- and gender-matched controls. The GSF questionnaire was used to estimate psychosexual function as a long-term follow-up after the surgical correction of hypospadias in the patient and control groups. Sexual activity (p = 0.017), arousal (p = 0.033) and orgasmic abilities (p = 0.002) values were significantly increased in patients. Strong correlation was noticed between sexual activity and sexual desire (R = 0.872); arousal and sexual desire (R = 0.753), as well as orgasmic and erectile abilities (R = 0.769). Different domains of psychosexual functioning in the patient group correlated with each other to various degrees, resulting in a heterogeneous expression of psychosexual dysfunctions, implicating the necessity of a personalized treatment approach.

Highlights

Urogenital congenital anomalies are among the most common congenital anomalies in the pediatric population, with hypospadias being one of the most frequent with the incidence of 1 in every200–300 male livebirths [1]
The aim of our study was twofold—first to evaluate the informativeness of the studied domains of Global Sexual Functioning (GSF), and second to investigate the sexual functioning of patients surgically treated in childhood for different types of hypospadias and to compare them with healthy controls
Late complications occurred in 3 (37.50%) patients: meatal stenosis developed in one patient with distal hypospadias and was conservatively solved; urethral stenosis developed in one patient with midshaft hypospadias and required augmentation urethroplasty with buccal mucosa graft; and urethral diverticulum developed in one patient with penoscrotal hypospadias and required excision and urethroplasty

Summary

Introduction

Urogenital congenital anomalies are among the most common congenital anomalies in the pediatric population, with hypospadias being one of the most frequent with the incidence of 1 in every. 200–300 male livebirths [1]. Hypospadias is characterized by an ectopic ventrally-positioned urethral meatus, ventral chordee, and excessive dorsal foreskin [2]. There have been over 300 different surgical techniques and their modifications for hypospadias repair, and still hypospadias repair poses a great challenge even for experienced pediatric surgeons and urologists. The goal of each of these techniques is to repair all present anomalies, involving urethral reconstruction, correction of any penile curvature, glans reconstruction and penile skin reconstruction, creating a functional and esthetically appealing penis [3]. It is advised that surgeries should be performed in an early age (until the age of two years of life), as it is presumed that genital awareness has not been established at that time and that the anxiety of separation from the mother will be diminished [1,4,5,6].

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