title: Objective and subjective sexual outcomes in adult patients after hypospadias repair performed in childhood.
abstract: OBJECTIVE
  We evaluated sexual function and psychosexual adjustment in adults who underwent hypospadias repair in childhood.
  
  
  METHODS
  After receiving institutional review board approval, 119 of 449 adult patients (26.6%) who underwent hypospadias repair between 1978 and 1993 responded to questionnaires on penile appearance and sexual life. Patients were divided into 3 groups according to primary meatal location in childhood, including group 1-45 (37.8%) with glanular hypospadias, group 2-56 (48.2%) with distal hypospadias and group 3-18 (14%) with proximal hypospadias.
  
  
  RESULTS
  All group 1 and 2 patients, and 11% in group 3 were satisfied with the penile appearance. Of group 1 patients 8.9% reported mild erectile dysfunction, as did 50% and 72.2% in groups 2 and 3, respectively. A total of 99 patients (83.2%) complained of premature ejaculation. All group 1 and 2 patients reported excellent self-esteem and relationship on the Self-Esteem and Relationship questionnaire. Most group 3 patients were satisfied with their relationship and only 1 (5.6%) was not satisfied. Two-thirds of the patients in groups 1 and 2 reported that sexual quality of life was excellent and the others described it as good. In group 3 sexual quality of life was somewhat decreased in all patients and 1 (5.6%) had poor sexual quality of life. Physical and mental component summaries were satisfactory in all patients reviewed.
  
  
  CONCLUSIONS
  Our data show that the high incidence of mild erectile dysfunction and premature ejaculation should not be disregarded and requires appropriate counseling before surgery.
authors.affiliation: Departments of Pediatric Urology and Urology, Shaare Zedek Medical Center, Jerusalem and Leumit National Health Services, Tel Aviv, Israel. Electronic address: chertinb@szmc.org.il.
authors.forename: Boris
authors.initials: B
authors.lastname: Chertin
authors.forename: Aladin
authors.initials: A
authors.lastname: Natsheh
authors.forename: Itzhak
authors.initials: I
authors.lastname: Ben-Zion
authors.forename: Dan
authors.initials: D
authors.lastname: Prat
authors.forename: Stanislav
authors.initials: S
authors.lastname: Kocherov
authors.forename: Amicur
authors.initials: A
authors.lastname: Farkas
authors.forename: Ofer Z
authors.initials: OZ
authors.lastname: Shenfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000523:psychology* / Q000601:surgery; D008297:Male; D017060:Patient Satisfaction; D010410:Penile Erection / Q000502:physiology*; D011184:Postoperative Period; D012189:Retrospective Studies; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000379:methods* / Q000523:psychology; D055815:Young Adult
keywords: ED; MAGPI; MCS; PCS; PE; SEAR; Self-Esteem and Relationship; erectile dysfunction; hypospadias; meatoplasty and glans incorporation; mental component summary; penis; physical component summary; premature ejaculation; psychosexual development; questionnaires