title: Long-term psychological and sexual outcomes of severe penile hypospadias repair.
abstract: BACKGROUND
  Hypospadias is the most common penis malformation, and there exist a variety of surgical approaches used to correct the abnormal position of the meatus. Although the long-term outcomes of surgery are considered important for psychosexual development, only a few attempts have been made to evaluate patient satisfaction.
  
  
  OBJECTIVE
  The aim of our study was to evaluate surgical results and psychosocial adaptations in a homogeneous group of subjects with severe penile hypospadias who underwent the same types of surgical repairs during childhood and compare the results to data obtained from age-matched healthy controls.
  
  
  METHODS
  In this cross-sectional study, 104 men (between 24 and 42 years old) who underwent an uncomplicated two-stage hypospadias repair in their childhood and 63 age-matched healthy men without genital malformations completed the questionnaire.
  
  
  METHODS
  Difference in self-perception assessed by a 15-item questionnaire regarding psychosexual well-being and penile appearance between subjects with corrected hypospadias and healthy participants.
  
  
  RESULTS
  On average, subjects with a hypospadias repair were less satisfied with their genital appearance; however, they were more satisfied with their sex lives compared to healthy controls. The meatus distance was approximately 1.5 cm from the tip of the penis after surgical correction. None of the postoperative surgical results correlated with patient satisfaction. Furthermore, the small percentage of patients (11%) who were very unsatisfied with their surgical outcomes had no significant differences in surgical outcomes compared to satisfied patients. However, there was a significant difference between the two groups in almost all psychological outcome measures.
  
  
  CONCLUSIONS
  In adults who underwent an uncomplicated ventral repair of a severe penile hypospadias 20-30 years earlier, healthy psychosexual development was achieved despite the lack of a glanular meatus. Early identification of unsatisfied patients is important for appropriate long-term follow-up and counseling.
authors.affiliation: Department of Urology, Heim Pál Children's Hospital, Budapest, Hungary.
authors.forename: Andras
authors.initials: A
authors.lastname: Kiss
authors.forename: Balint
authors.initials: B
authors.lastname: Sulya
authors.forename: A Marcell
authors.initials: AM
authors.lastname: Szász
authors.forename: Imre
authors.initials: I
authors.lastname: Romics
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Kelemen
authors.forename: József
authors.initials: J
authors.lastname: Tóth
authors.forename: Miklós
authors.initials: M
authors.lastname: Merksz
authors.forename: Sandor
authors.initials: S
authors.lastname: Kemény
authors.forename: Péter
authors.initials: P
authors.lastname: Nyírády
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D006801:Humans; D007021:Hypospadias / Q000523:psychology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D010413:Penis / Q000601:surgery; D010549:Personal Satisfaction; D012649:Self Concept; D012725:Sexual Behavior / Q000523:psychology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult