Psychosexual Outcome of Men with Non-Corrected Hypospadias

Abstract

Objective: Hypospadias is a common penile malformation, in which the urethral opening is on the underside of the penis. It is usually surgically corrected in early childhood. Severe types of hypospadias are corrected to solve functional problems. Mild types are mainly operated to achieve a better cosmetic result under the assumption that surgery improves psychosexual adjustment and quality of life. However, data on the outcome of non-operated men is scarce and therefore, this assumption is not evidence based. This study compares psychosexual outcome of men with non-corrected hypospadias to men without a genital malformation. Design and Method: In an ongoing cross-sectional survey, 21 men with noncorrected hypospadias (mean age: 48.71 years, SD: 10.33) and a control group of 21 age matched, non-affected men (mean age: 48.05 years, SD: 9.72) were asked to answer a penile self-perception score (PPS) and a questionnaire regarding their psychosexual adjustment. Results: Men with non-corrected hypospadias and controls reported the same level of sexual satisfaction and number of sexual partners. Men with non-corrected hypospadias were neither more often ashamed nor more often bothered because of their penile appearance. However, they had significantly less positive PPS. Conclusions: Although men with non-corrected hypospadias had an impaired penile self-perception, they were neither ashamed nor bothered due to their penile appearance and they reported the same level of sexual satisfaction as non-affected men. These results suggest that there is a subgroup of men with non-severe types of hypospadias, who do not suffer if left without surgical correction for their hypospadias in childhood.