Urinary, sexual, and cosmetic results after puberty in hypospadias repair:  current results and trends.
OBJECTIVE
To give an overview of the recently published long-term outcomes of hypospadias surgery performed at childhood, of patients who have had multiple previous repairs, and results of surgery done to treat late complications following hypospadias repair.


RESULTS
Urethral function after hypospadias repair is good, but cosmesis based on the patients' opinion, on the long term, was disappointing. Also erectile function was reported to be good, although persisting curvature and ejaculation disorders were mentioned, more evidently in patients with proximal hypospadias. Long-term results using buccal mucosa repairs in hypospadias cripples are good, but the use of tissue expanders may be a good alternative. Late complications of hypospadias repair, such as urethral strictures, are difficult to treat, and have a high failure rate compared to urethroplasty for other reasons.


CONCLUSIONS
Functional results of hypospadias repair are generally satisfactory in the long term, although improvement must be pursued. Most adult men with a history of hypospadias present themselves with urinary tract symptoms. Cosmesis judged by patients remains rather poor in the long run and better techniques should be found. Preferably, assessment of long-term results should be done by validated test methods for better comparison.
University Medical Center Utrecht, The Netherlands.
Sybren P
SP
Rynja
Laetitia M O
LM
de Kort
Tom P V M
TP
de Jong
D000293:Adolescent; D000328:Adult; D002921:Cicatrix / Q000209:etiology / Q000523:psychology; D004542:Ejaculation; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D017060:Patient Satisfaction; D010410:Penile Erection; D011627:Puberty; D019651:Plastic Surgery Procedures / Q000009:adverse effects; D020127:Recovery of Function; D012086:Reoperation; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014521:Urethra / Q000002:abnormalities / Q000503:physiopathology / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology; D014554:Urination; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects; D055815:Young Adult