Hypospadias: Incidence and Effects on Psychosexual Development as Evaluated with the Minnesota Multiphasic Personality Inventory Test in a Sample of 11,649 Young Italian Men

Abstract

Purpose: We evaluated the incidence of hypospadias and its effects on psychosexual development in a sample of 11,649 young Italian males. Over the last 30 years only about 30 major publications have addressed these issues and the results of many studies have been contrasting. Some defects in methodology, such as low response rates, heterogeneity of age ranges and the choice of controls, have been the main limitations. Our study was designed to take these problems into account. Materials and Methods: Forty-two hypospadic subjects and a random sample of 500 nonaffected males selected from the large sample of 11,649 young men (>90% of the 18-year-old males living in the Italian region of Tuscany) were screened by the Minnesota Multiphasic Personality Inventory (MMPI) test, psychological interview and clinical evaluation. Results: The incidence of hypospadias in this representative group of Italian men is 3.6/1,000. No difference was noted in the percentage with altered MMPI compared with the control group. The age at surgical corrections and the number of operations are not related to an abnormal global psychological adjustment. Severity of disease influences a more negative genital appraisal and the number of operations is correlated only with more difficulty in initiating contact with the opposite sex. Conclusions: Surgery for hypospadias has to be strongly pursued in as many cases as possible. In addition, we strongly recommend following up all hypospadics, independently of the severity of their genital malformations, through adolescence to early adulthood, to ensure early detection of subjects with impaired psychological profiles.

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

“…Mondaini's group [29] performed a cross-sectional study in 500 men including 42 men with a history of hypospadias, and were thereby unable to provide a follow-up rate. The remaining 19 cohort studies reported a mean response rate of 48.4% (21.7e100%; 1027/ 2120 patients).…”

Is there an ideal age for hypospadias repair? A pilot study

“…These factors may become more important if a child has repeated operations due to two stage repairs or after complications (1,2).…”

Genital diseases awareness in young male students: Is information necessary to protect them?

“…Moreover previous studies demonstrated that andrological disorders were found in about 30% of youngsters: these data have been confirmed by the mean rate of 31.7% found in the present series independently from the geographical area investigated.The logical explanation of this phenomenon could be that a lot of students are adequately informed on medical glossaries but not on their body health awareness to avoid subsequent complications on fertility and couples's sexual problems. Hypospadia and disorders of sex development such as pseudo-hermaphroditism, have always already been diagnosed in all cases found in both military and school check-ups while less evident diseases such as penile congenital curvature and short prepucial fraenulum have been diagnosed just after a projection of slides session (11). About 1% of subjects showed a substantial reduction of testicular volume and all of them were counselled to check a second level visit to test the presence of complicated diseases such as Klinefelter Syndrome (KS) (karyotipe 47, XXY).…”