Advertisement

International Urology and Nephrology

, Volume 43, Issue 1, pp 47–54 | Cite as

Long-term outcome of penile appearance and sexual function after hypospadias repairs: situation and relation

  • Chenwei Jiao
  • Rongde WuEmail author
  • Xiaoqing Xu
  • Qihai Yu
Urology – Original Paper

Abstract

Objective

The aim of this study was to assess the long-term cosmetic and sexual outcomes of hypospadias surgery performed in childhood and to analyze the relation between them.

Methods

A long-term follow-up was made to 174 patients who were operated for hypospadias in this institute between 1984 and 1992. Their records were analyzed retrospectively, and a detailed questionnaire was mailed to them. Responses from returned questionnaires were pooled and analyzed.

Results

Forty-three (24.7%) of 174 patients finished the questionnaire. The mean patient age of the 43 patients was 21.6 years. Twenty-three (53.5%) of 43 patients were dissatisfied with penile appearance. The main reason for dissatisfaction was smaller penile size and curvature. Thirty-six (83.7%) of 43 patients were satisfied with overall sexual function. Of these 43 patients, 76.7% reported good quality of erection, but 23.3% reported the existence of problems during erection. The main complaint was smaller penile size and curvature. There were 17 patients (39.5%) with ejaculation problems, mainly including impotent ejaculation. Sixteen (88.9%) of the 18 patients who had experienced sexual intercourse reported no problems during intercourse. Depending on the severity of hypospadias, these patients with proximal hypospadias were more dissatisfied with penile appearance than those with distal hypospadias (76.5 vs. 38.5%, P < 0.025). And they complained more problems during erection (41.2 vs. 11.5%, P < 0.05), ejaculation (100 vs. 0%), and sexual intercourse (50 vs. 0%, P < 0.05), and were less likely to experience sexual intercourse (23.5 vs. 53.8%, P < 0.05), compared to those with distal hypospadias. Depending on their self-evaluation on penile appearance, these patients who were satisfied with penile appearance had less problems in achieving erection (5.0 vs. 39.1%, P < 0.025) and ejaculation (20 vs. 56.5%, P < 0.025) and were more likely to experience sexual intercourse (60 vs. 26.1%, P < 0.05), compared to those who were dissatisfied. The self-rated satisfaction scale correlates positively with the penile appearance and sexual function (r = 0.469, P < 0.01).

Conclusions

Patients who had been operated for hypospadias have a significantly careful concern on penile appearance. Penile size can obviously impact satisfaction with penile appearance and sexual function. Some patients have erection, ejaculation, and intercourse problems in adulthood, but majority have a rather normal sexual function. The more severe the hypospadias, the more dissatisfactory the long-term outcome. Better cosmetic outcome is related to better sexual outcome. Although remaining challenging, it is necessary to follow up hypospadias patients after surgeries into adulthood.

Keywords

Hypospadias Sexual function Penis Follow-up 

Notes

Acknowledgments

The authors thank all the patients who participated in this study.

Conflicts of interest statement

The authors had no conflicts of interest to declare in relation to this article.

References

  1. 1.
    Baskin LS (2000) Hypospadias and urethral development. J Urol 163:951–956PubMedCrossRefGoogle Scholar
  2. 2.
    Ahmed SF, Dobbie R, Finlayson AR et al (2004) Prevalence of hypospadias and other genital anomalies among singleton births, 1988–1997, in Scotland. Arch Dis Child Fetal Neonatal Ed 89:F149–F151PubMedCrossRefGoogle Scholar
  3. 3.
    Canning DA (1999) Hypospadias trends in two US surveillance systems. Rise in prevalence of hypospadias. J Urol 161:366PubMedGoogle Scholar
  4. 4.
    Mouriquand PD, Persad R, Sharma S (1995) Hypospadias repair: current principles and procedures. Br J Urol 76(Suppl 3):9–22PubMedGoogle Scholar
  5. 5.
    Mureau MA, Slijper FM, Slob AK et al (1996) Satisfaction with penile appearance after hypospadias surgery: the patient and surgeon view. J Urol 155:703–706PubMedCrossRefGoogle Scholar
  6. 6.
    Mureau MA, Slijper FM, van der Meulen JC et al (1995) Psychosexual adjustment of men who underwent hypospadias repair: a norm-related study. J Urol 154:1351–1355PubMedCrossRefGoogle Scholar
  7. 7.
    Mureau MA, Slijper FM, Nijman RJ et al (1995) Psychosexual adjustment of children and adolescents after different types of hypospadias surgery: a norm-related study. J Urol 154:1902–1907PubMedCrossRefGoogle Scholar
  8. 8.
    Sommerlad BC (1975) A long-term follow-up of hypospadias patients. Br J Plast Surg 28:324–330PubMedCrossRefGoogle Scholar
  9. 9.
    Kenawi MM (1975) Sexual function in hypospadiacs. Br J Urol 47:883–890PubMedCrossRefGoogle Scholar
  10. 10.
    Berg R, Svensson J, Aström G (1981) Social and sexual adjustment of men operated for hypospadias during childhood: a controlled study. J Urol 125:313–317PubMedGoogle Scholar
  11. 11.
    Bracka A (1989) A long-term view of hypospadias. Br J Plast Surg 42:251–255PubMedCrossRefGoogle Scholar
  12. 12.
    Maier WA, Tewes G (1984) Sexual function after operations for hypospadias according to Ombredanne. Prog Pediatr Surg 17:79–82PubMedGoogle Scholar
  13. 13.
    Jayanthi VR, McLorie GA, Khoury AE et al (1995) Functional characteristics of the reconstructed neourethra after island flap urethroplasty. J Urol 153:1657–1659PubMedCrossRefGoogle Scholar
  14. 14.
    van der Werff JF, Ultee J (2000) Long-term follow-up of hypospadias repair. Br J Plast Surg 53:588–592PubMedCrossRefGoogle Scholar
  15. 15.
    Aho MO, Tammela OK, Tammela TL (1997) Aspects of adult satisfaction with the result of surgery for hypospadias performed in childhood. Eur Urol 32:218–222PubMedGoogle Scholar
  16. 16.
    Hoag CC, Gotto GT, Morrison KB et al (2008) Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood. Can Urol Assoc J 2:23–31PubMedGoogle Scholar
  17. 17.
    Moriya K, Kakizaki H, Tanaka H et al (2006) Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence. J Urol 176:1889–1893PubMedCrossRefGoogle Scholar
  18. 18.
    Liu G, Yuan J, Feng J et al (2006) Factors affecting the long-term results of hypospadias repairs. J Pediatr Surg 41:554–559PubMedCrossRefGoogle Scholar
  19. 19.
    Perovic SV, Djordjevic ML (2000) Penile lengthening. BJU Int 86:1028–1033PubMedCrossRefGoogle Scholar
  20. 20.
    Bubanj TB, Perovic SV, Milicevic RM et al (2004) Sexual behavior and sexual function of adults after hypospadias surgery: a comparative study. J Urol 171:1876–1879PubMedCrossRefGoogle Scholar
  21. 21.
    Berg R, Berg G (1983) Penile malformation, gender identity and sexual orientation. Acta Psychiatr Scand 68:154–166PubMedCrossRefGoogle Scholar
  22. 22.
    Aho MO, Tammela OK, Somppi EM et al (2000) Sexual and social life of men operated in childhood for hypospadias and phimosis: a comparative study. Eur Urol 37:95–101PubMedCrossRefGoogle Scholar
  23. 23.
    DE NuiningaJE, Gier RP, Verschuren R et al (2005) Long-term outcome of different types of 1-stage hypospadias repair. J Urol 174:1544–1548CrossRefGoogle Scholar
  24. 24.
    Moriya K, Kakizaki H, Tanaka H et al (2007) Long-term patient reported outcome of urinary symptoms after hypospadias surgery: norm related study in adolescents. J Urol 178:1659–1662PubMedCrossRefGoogle Scholar
  25. 25.
    Bracka A (1995) Hypospadias repair: the two-stage alternative. Br J Urol 76:31–34PubMedGoogle Scholar
  26. 26.
    Bracka A (1995) A versatile two-stage hypospadias repair. Br J Plas Surg 48:345–355CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, B.V. 2010

Authors and Affiliations

  • Chenwei Jiao
    • 1
  • Rongde Wu
    • 1
    Email author
  • Xiaoqing Xu
    • 2
  • Qihai Yu
    • 1
  1. 1.Department of Pediatric SurgeryProvincial Hospital Affiliated to Shandong UniversityJinanPeople’s Republic of China
  2. 2.Department of Radiation OncologyShandong Cancer Hospital and InstituteJinanPeople’s Republic of China

Personalised recommendations