Psychosexual Adjustment of Children and Adolescents After Different Types of Hypospadias Surgery: A Norm-related Study

Mureau, Marc A.M.; Slijper, F. M. E.; Nijman, Rien J.M.; Meulen, Jacques C. van der; Verhulst, Frank C.; Slob, A. Koos

doi:10.1016/s0022-5347(01)66823-x

Cited by 144 publications

(104 citation statements)

References 17 publications

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“…Previous publications suggest that psychosexual function and quality of life in patients with distal hypospadias may be impaired 1,2 . However it is not clear, which factors influence this outcome and to which extent the surgical result contributes to it.…”

Section: Introductionmentioning

confidence: 97%

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

et al. 2008

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Descriptive RunningheadThe Pediatric Penile Perception Score: Assessment after hypospadias repair Key WordsHypospadias, outcome assessment, child, surgery 2 Abstract PurposeThe aim of this study is to develop and evaluate an instrument that allows to asses and compare the penile perception of patients, parents and surgeons. Materials and MethodsSeventy-seven boys after hypospadias repair between the ages of 6-17 years were interviewed by a psychologist with a standardized questionnaire regarding their penile self-perception, including the following items: Meatus, glans, skin and general appearance. The Pediatric Penile Perception Score (PPPS) was calculated, consisting of the sum of these four items. The results were compared with a control group of age matched boys after inguinal hernia repair. A parent was asked with a questionnaire to report his son's penile appearance using the PPPS. Fifty-six patients accepted standardized photo documentation and their pictures were sent for evaluation with the PPPS to six blinded urologists. ResultsThe PPPS allowed to assess perception of genitalia by patients, parents and urologists. Statistical analysis of the urologist's PPPS revealed a good interrater reliability (interclass correlation: 0.75-0.88) and stability (r=0.59-0.83). Intercorrelation of the items meatus, glans and skin with the general appearance was good in the boys, parents and urologists form. Hypospadias patients expressed a high satisfaction with their penile appearance that did not significantly differ from age matched controls. However, parents and urologists were less satisfied with the penile appearance than patients themselves. ConclusionsThe PPPS is an evaluated, reliable instrument to assess penile self perception in children after hypospadias repair and to appraise the surgical result by parents and non involved urologists.3

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Section: Introductionmentioning

confidence: 97%

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

et al. 2008

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“…Several studies have demonstrated, that boys with hypospadias suffer from negative genital appraisal and sexual inhibitions and that self-reported health related quality of life (HRQoL) can be diminished (3)(4)(5). There is a general agreement, that at certain ages, a child may be more vulnerable to psychological distress related to surgery (2,6).…”

Section: Introductionmentioning

confidence: 99%

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

Weber

Schönbucher

Gobet

et al. 2009

Journal of Pediatric Urology

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Objective:The aim of this study is to assess whether repairing hypospadias before or after 18 months affects psychological adjustment, health-related quality of life (HRQoL) and surgical outcome. Subjects/Patients77 boys with a current age of 6 to 17 years were assigned to two groups, according to whether they had a hypospadias repair before or after the age of 18 months. The surgical outcome was assessed with the Pediatric Penile Perception Score by non involved urologists. A psychologist interviewed the patients to assess HRQoL and gender-role behavior. The child's psychological adjustment was assessed with a questionnaire for parents. ResultsThe surgical outcome and complication rate were not significantly different. A covariance analysis of HRQoL, gender-role behavior and psychological adjustment as a function of age at the last operation with current age as covariant was performed, but differences did not reach significance. ConclusionThis study cannot provide evidence to support recommendations concerning the ideal age for hypospadias repair. In the absence of evidence of a benefit of early surgery, anesthesia related risk factors must be considered when operating in very early infancy.2 Large, prospective studies, measuring surgical and psychological outcome with similar instruments to those presented may reveal whether there is a truly ideal age for hypospadias surgery. KeywordsHypospadias, surgery, outcome assessment, psychosexual development, gender-role behaviour, health related quality of life

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“…1,2 In addition, significant contradiction exists in the literature regarding the psychosexual impact of hypospadias and hypospadias repair. [3][4][5] Some studies report that sexual development and function are normal, [6][7][8] whereas others report less positive results. [9][10][11] Some investigators have reported that all patients are satisfied with the cosmetic result, 12 whereas others have found that 38% still felt deformed 11 or that as many as 72% regarded their penis as abnormal.…”

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confidence: 99%

“…6 Regardless of their bias, most authors agree that these patients need to be followed into adolescence and adulthood to assess patient satisfaction. [4][5][6]11,13,14 To our knowledge, there is no Canadian-based literature on this subject, and there are few studies in the world literature that focus on functional outcomes and patient satisfaction as those with hypospadias grow into adulthood. 6,11,14,15 This study aimed to address these deficiencies in current understanding of the long-term outcomes of hypospadias repair during childhood.…”

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confidence: 99%

Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood

Hoag

Gotto

Morrison

et al. 2013

CUAJ

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Introduction: Potential long-term sequelae of hypospadias and its surgical correction include difficulties in voiding, sexual function, psychosexual adjustment and self-appraisal. These difficulties often evolve long after surgical repair as children grow to adulthood. Despite this, patient-driven data on long-term functional outcomes and satisfaction are limited, leaving the true success of hypospadias surgery essentially unknown. The aim of this study was to address these deficiencies. Methods:We conducted a chart review for all patients operated on by a single urologist from 1981 to 1988. Extensive efforts were made to obtain accurate current address information for patients. A database of patient demographics and pathology, operative details and complications was created. A 22-item questionnaire was mailed to study subjects. Telephone follow-up by an independent research nurse bolstered response rates. Responses from returned questionnaires were pooled and analyzed. Results:The chart review included 115 patients. Of 100 patients (with address information) who were sent questionnaires, 28 ultimately responded. The chart review group was comparable to groups in other published studies. Despite a slightly higher initial major complication rate (57.2%), respondents reported few long-term complications (11% fistula, 29% persistent chordee and 10% stricture) and excellent urinary and sexual functional results. The most common functional complaints were spraying and hesitancy during micturition. Overall, 86% of patients were satisfied with their surgical result, and 52% wished they had been provided longer follow-up. Conclusion:Long-term outcomes data are critical to an honest account of success rates for hypospadias surgery. Obtaining these data remains challenging. In this series, despite high initial complication rates, most patients reported excellent long-term functional results and were quite satisfied with their overall outcome.

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Psychosexual Adjustment of Children and Adolescents After Different Types of Hypospadias Surgery: A Norm-related Study

Cited by 144 publications

References 17 publications

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

The Pediatric Penile Perception Score: An Instrument for Patient Self-Assessment and Surgeon Evaluation After Hypospadias Repair

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

Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood

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