title: Long-term cosmetic and sexual outcome of hypospadias surgery: norm related study in adolescence.
abstract: OBJECTIVE
  Even if performed early in life, hypospadias surgery may have a significant impact on self-esteem and sexual behavior in adolescence. We evaluated the long-term cosmetic and sexual outcomes of hypospadias surgery performed in childhood.
  
  
  METHODS
  A detailed questionnaire was mailed to 33 patients with hypospadias who were 18 to 26 years old and had undergone the first operation at age 6 years or younger. It was also mailed to 50 age matched controls.
  
  
  RESULTS
  A total of 22 patients (66.7%) and 38 controls (76.0%) returned the questionnaire. Mean age in the hypospadias and control groups was 20.6 and 21.0 years, respectively. Eight of the 22 patients had mild hypospadias and 11 had severe hypospadias. Severity was unknown in 3 patients. Age at the first and final operations was 31 to 75 (mean 46) and 35 to 81 months (mean 53). The number of operation was 1 in 10 patients, 2 in 10 and 3 in 2. The rate of dissatisfaction with penile appearance was slightly higher in the hypospadias group than in the control group (40.9% vs 34.2%). The single reason for dissatisfaction in the hypospadias group was inadequate penile size, whereas in the control group penile size, phimosis and curvature were the major reasons for dissatisfaction (69.2%, 46.2% and 23.1%, respectively). Experience with masturbation (100% and 97.4%) and sexual intercourse (52.4% and 55.3%), and mean age at first masturbation (13.4 and 13.0 years) and first sexual intercourse (16.6 and 17.3 years) were similar in the hypospadias and control groups, respectively.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Hokkaido University Graduate School of Medicine, North-15 West-7, Kita-Ku, Sapporo 060-0824, Japan. k-moriya@med.hokudai.ac.jp
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Moriya
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Kakizaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Furuno
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Higashiyama
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sano
authors.forename: Takeya
authors.initials: T
authors.lastname: Kitta
authors.forename: Katsuya
authors.initials: K
authors.lastname: Nonomura
mesh_terms: D000293:Adolescent; D000328:Adult; D005500:Follow-Up Studies; D006801:Humans; D007021:Hypospadias / Q000150:complications / Q000523:psychology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D010410:Penile Erection; D010413:Penis / Q000601:surgery*; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D011795:Surveys and Questionnaires