In a controlled study 34 men operated on for hypospadias in childhood and 36 control subjects were interviewed concerning their sexual and social adjustment, which at the time of the interviews was shown to be virtually similar in the 2 groups. Most of the hypospadiacs had stable sexual relationships but they had been sexually less active than the controls. The sexual debut of the hypospadiacs was retarded although the age at first ejaculation was the same as for the controls. The hypospadiacs had less qualified professions compared to the controls. The results indicate the possibility of operated hypospadiacs being psychologically different from other men. Fertility seems to be equal in the 2 groups and even patients with severe forms of hypospadias reported fertility. The issue of optimal ambition in surgical repair is discussed in view of the fact that even patients with a less than perfect technical result are able to live a satisfactory sexual life.
Our study supports the importance of preventing maternal smoking during pregnancy and the infant years. Even a few cigarettes per day have negative consequences for the child. The goal must be total abstinence from smoking both pre- and postnatally.
Aspects of mental health were investigated by means of interviews and register data in 34 men operated on for hypospadias in childhood and in 36 matched control subjects. Most hypospadiacs adjust well both in childhood and adult age. However, they reported more neurotic disturbances in their childhood than the controls. Shyness and enuresis were common troubles among the probands, and they had been more timid, isolated and mobbed. Similar although less striking differences in mental health were reported also in adult age. Depression and anxiety were dominating symptoms. The interviewer assessed the hypospadiacs to show more anxiety and to use more immature defence mechanisms and consequently to have less stress tolerance. The probands were further judged to have less capacity for social relations and their overall capacity to utilize existent psychological resources was small as compared to the controls. The findings indicate that hypospadiacs are more prone to neurotic (but not psychotic) disturbances than other young men and have more disturbed social relations. The need for psychological guidance for the boys and their parents is stressed.
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