title: Psychosexual adjustment of children and adolescents after different types of hypospadias surgery: a norm-related study.
abstract: OBJECTIVE
  We studied the psychosexual adjustment, sexual behavior and genital appraisal of 9 to 18-year-old hypospadias patients.
  
  
  METHODS
  We interviewed 116 hypospadias patients and 88 comparison subjects in a semi-structured manner.
  
  
  RESULTS
  Hypospadias patients had a more negative genital appraisal and anticipated more ridicule by a partner because of penile appearance than comparison subjects but they did not have a different sexual adjustment. No significant impact of medical treatment (surgical procedures, number of operations or age at final surgery) was noted. Many hypospadias patients (38.8%) desired functional or cosmetic penile improvement.
  
  
  CONCLUSIONS
  In addition to procedures that bring the meatus to a more terminal position, those that bring it more ventral can be performed without negatively affecting psychosexual adjustment. Hypospadias patients were reluctant to seek advice for problems and, therefore, they should be followed through adolescence.
authors.affiliation: Department of Child and Adolescent Psychiatry, Sophia Children's Hospital, Rotterdam, The Netherlands.
authors.forename: M A
authors.initials: MA
authors.lastname: Mureau
authors.forename: F M
authors.initials: FM
authors.lastname: Slijper
authors.forename: R J
authors.initials: RJ
authors.lastname: Nijman
authors.forename: J C
authors.initials: JC
authors.lastname: van der Meulen
authors.forename: F C
authors.initials: FC
authors.lastname: Verhulst
authors.forename: A K
authors.initials: AK
authors.lastname: Slob
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000367:Age Factors; D002648:Child; D006801:Humans; D007021:Hypospadias / Q000523:psychology / Q000601:surgery*; D008297:Male; D012649:Self Concept; D012720:Severity of Illness Index; D012725:Sexual Behavior