Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction in childhood

Rynja, Sybren P.; Jong, Tom P.V.M. de; Bosch, Jackie; Kort, L.M.O. de

doi:10.1016/j.jpurol.2011.02.008

Cited by 128 publications

(76 citation statements)

References 39 publications

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“…A recent systematic review of the long-term functional outcomes following hypospadias repair demonstrated that patient reported urinary symptoms, such as obstructive voiding, spraying, and deviated stream, more often than controls. 55 Obstructive flow based on evaluation of Qmax lower than the 95 th percentile was found in 13.5% of patients compared to 2.9% of controls. Fortunately, low flow rates have been found to improve in a majority of patients by puberty.…”

Section: Functional Outcomes After Hypospadias Repairmentioning

confidence: 91%

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Keays

Davé

2017

CUAJ

110

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Section: Functional Outcomes After Hypospadias Repairmentioning

confidence: 91%

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Keays

Davé

2017

CUAJ

110

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“…16 Several surveys have reported an increasing number of patients with failed hypospadias as they pass into adult care. 4,7 Thus, series with lifelong follow-up data are needed to calculate the true prevalence of failed hypospadias.…”

Section: Prevalence Of Failed Hypospadiasmentioning

confidence: 99%

“…It is worth noting that none of the repairs available to date can be used to create a urethra with the same biological and urodynamic properties as a native urethra and, therefore, functional outcomes, particularly voiding and ejaculatory function, can be severely affected even in the absence of any complications. 4 Furthermore, patient satisfaction is very subjective and mainly depends on the ability of the patient to cope with cosmetic and functional abnormalities. Patient perception of the outcomes can, therefore, be very subjective and diverge widely from the assessment of the surgeon.…”

Section: Introductionmentioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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| Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency.

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“…The basic principles of hypospadias surgery are to reconstruct the urethra to the tip of the glans, to straighten the curvature of penis, to achieve acceptable cosmetic penile appear-ance, and allow normal urinary and sexual function. These principles are well established and hundreds of surgical procedures have been described [2,[4][5][6][7][8] .…”

Section: Introductionmentioning

confidence: 99%

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

et al. 2015

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Objective: Hypospadias surgery, especially when performed early in life, may have a significant impact on the urinary and sexual functions in an adult. Because the literature is still limited, this paper assesses long-term functional, cosmetic and sexual results of hypospadias repair performed in childhood. Patients and Methods: The study includes 275 patients older than 12 years treated for a hypospadias by an Onlay, Mathieu, Duplay, or Duckett's technique between January 1990 and December 2000. Flowmetry results were retrospectively obtained from patients' charts. The Paediatric Penile Perception Score (PPPS), the Hypospadias Objective Scoring Evaluation (HOSE) and the IIEF-5 score (when older than 16 years old) questionnaires were used to assess cosmetic and sexual results. The PPPS is designed to assess both penile self-perception with regard to meatus, glans, skin and general appearance. The HOSE is a five-point scoring system designed to allow an objective appraisal of the outcome of hypospadias repair, based on evaluating meatal location, meatal shape, urinary stream, straightness of erection, and the presence and complexity of any complicating urethral fistula. Results: Q_max were within age-adjusted references, independent of the surgical technique, with median (range) Q_max of 18.8 ml/s (range 3-45, n = 136). Patients expressed a high satisfaction for every single item of the penile perception scale (PPPS), with mean values between 2 (satisfied) and 3 (very satisfied). Eighty-two percent were satisfied or very satisfied of the overall evaluation of penile appearance. Eighty-one percent of patients had a normal erectile function (IIEF-5 >22; n = 35/43). Conclusions: Taking into account the limitation of a small number of patients resulting from a low 21% questionnaire's response rate, the results of this study align with previous reports from the literature and confirms that hypospadias repair using standard techniques results in acceptable functional, cosmetic and sexual outcomes. This study highlights the need of developing a set of standard approved outcomes assessments tools for evaluating the long-term impact of hypospadias repair performed in infancy.

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Functional, cosmetic and psychosexual results in adult men who underwent hypospadias correction in childhood

Cited by 128 publications

References 39 publications

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Current hypospadias management: Diagnosis, surgical management, and long-term patient-centred outcomes

Failed hypospadias in paediatric patients

Long-Term Functional, Cosmetic and Sexual Outcomes of Hypospadias Correction Performed in Childhood

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