Long-Term Cosmetic and Sexual Outcome of Hypospadias Surgery: Norm Related Study in Adolescence

Moriya, Kyoji; Κakizaki, Hidehiro; Tanaka, Hiroshi; Furuno, T.; Higashiyama, Hiroshi; Sano, Hiroshi; Kitta, Takeya; Nonomura, Katsuya

doi:10.1016/s0022-5347(06)00600-8

Cited by 76 publications

(59 citation statements)

References 18 publications

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“…As a successful plastic surgery for hypospadias, not only the normal position of meatus should be reconstructed, but also the physical and psychological impact of penile appearance on patients after surgery should be considered. In our series, smaller penile size was the main reason for dissatisfaction with penile appearance and for improvement on cosmesis, which is similar to the reports of several other authors [6,10,17]. Mureau et al [5] also mentioned that patients are less satisfied with penile size than surgeon are.…”

Section: Discussionsupporting

confidence: 90%

“…When contacted directly with doctors, patients may not provide frank answers because of certain considerations or fears [17]. And we also believe that the best judge of the long-term success of hypospadias repairs is the patient himself, who can best assess functional outcomes and satisfaction [16].…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, two patients reported difficulties during sexual intercourse due to persistent curvature and excessive smaller penile size. Although the mild curvature will not disturb the normal sexual intercourse, the severe curvature, especially downward, will lead to painful erection, even dyspareunia [11,16,17,20]. Chordee (downward curvature of penis) is one of the three main deformities of hypospadias, and correction of fully straightening is required during surgical procedure, which is highly necessary for obtaining satisfactory cosmetic and sexual outcomes after repairs.…”

Section: Discussionmentioning

confidence: 99%

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

Jiao

et al. 2010

Int Urol Nephrol

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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.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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

Jiao

et al. 2010

Int Urol Nephrol

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“…In that regard, we may assume that a self-administered questionnaire would be a better method to elicit reliable answers than a direct interview for such delicate and personal matters. When contacted directly with doctors, patients may not provide frank answers because of certain assumptions or fears [22] .…”

Section: Discussionmentioning

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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“…While some contemporary studies showed significant differences between former hypospadias patients and controls concerning frequency of sexual activity, masturbation, orgasmic function and overall sexual satisfaction, other recent studies failed to show significant differences in sexual behavior patterns. 28,29 It seems that there is no clear cut answer as to the effects of prior hypospadias surgery on adult sexual function. This is probably due to the multi-factorial nature of the question at hand.…”

Section: Sexual Function In Adults Who Have Previously Undergone Hypmentioning

confidence: 99%

Outcome of pediatric hypospadias repair in adulthood

Chertin

Prat²,

Shenfeld³

2010

RRU

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Purpose:To review the evolution of the technique of hypospadias repair. Methods: A search of Pubmed, Medline and the Journal of Pediatric Urology was performed, and papers dealing with surgical techniques for hypospadias repair were critally reviewed. Special emphasis was given to papers on the effects in the long term of hypospadias repair on voiding and sexual dysfunction. Results:The techniques for hypospadias repair have evolved over the years. The most popular technique now is tubularized incised plate urethroplasty. Long-term results with the use of the new techniques of the hypospadias repair in terms of voiding and sexual problems should be addressed. Conclusion:There is a need for valid studies on the outcomes of hypospadias repair in adults that were performed in childhood in terms of cosmetic appearance, voiding and sexual performance. Keywords: hypospadias, hypospadias surgery, adult, later outcome Surgical techniques for hypospadias repairHypospadias may be defined as a ventral penile hypoplasia with some associated anomalies such as the following: opening of the meatus below the tip of the penis, ventral penile curvature (chordee) and a hooded foreskin with excessive dorsal part. The incidence of hypospadias in the Western countries has been in rise tremendously and is approximately 1 to 150,300 male births. 1The first description of urethral hypoplasia and hypospadias malformation is related to Celsius and Galen, and dates as far back as to the first and second centuries AD.2 The renaissance of hypospadias surgery was established by Thiersch 3 and Duplay 4 during the second part of the 19th century. Since then, hundreds of techniques have evolved, mostly to answer the challenge of creating a functional neourethra. Hypospadias surgical procedure is characterized by three steps: 1. Correction of chordee -straightening of the penis; 2. Urethroplasty -reconstruction of the missing part of the urethra; 3. Restoration of the tissues forming the ventral radius of the penis -the glans, corpus spongiosum, and skin, which finally will lead to the normal cosmetic appearance of the penis. In the majority of cases simple degloving of the penile skin may solve the penile curvature. If chordee persists after penile degloving, dorsal corporal plication is performed in order to straighten the penis. Many surgeons prefer to avoid freeing the urethral plate in order to avoid injury to the blood supply. The authors have previously Research and Reports in Urology downloaded from https://www.dovepress.com/ by 34.214.212.150 on 13-May-2018 For personal use only.

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Long-Term Cosmetic and Sexual Outcome of Hypospadias Surgery: Norm Related Study in Adolescence

Abstract: Although patients with hypospadias had a slightly higher rate of dissatisfaction with penile size, their sexual behavior was not different from that in control subjects.

Cited by 76 publications

References 18 publications

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

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

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

Outcome of pediatric hypospadias repair in adulthood

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