title: Erectile function in men with failed hypospadias repair.
abstract: OBJECTIVE
  While efforts have been made to study erectile function in patients with urethral stricture, very few prior investigations have specifically assessed erectile function in men with failed hypospadias surgery. We set forth to assess the baseline erectile function of men with hypospadias failure presenting for urethroplasty as adults.
  
  
  METHODS
  Retrospective data was analyzed on 163 adult patients with prior failed hypospadias repair who presented for urethroplasty from 2002-2007 at two sites in the United States and Italy. All patients had completed the International Index of Erectile Function (IIEF) pre-operatively. Standard IIEF-6 categories were used to assess baseline level of erectile dysfunction (ED) defined as none (≥ 26), minimal (18-25) ,moderate (11-17), and severe (≤ 10). A subset of 13 hypospadias patients prospectively completed the IIEF questionnaire pre and post- operatively.
  
  
  RESULTS
  The mean age at presentation for urethroplasty was 39.7 years. Based on IIEF-6 scores, 54% of patients presented with some degree of ED with 22.1%, 3.7%, and 28.2% reporting severe, moderate and mild ED respectively. While the oldest patient population (>50) had the highest incidence of severe ED (38.9%), the youngest age group (=30) had a 60% rate of ED with 18% classified as severe (Table I). Subset analysis of 13 failed hypospadias patients following urethroplasty revealed that 11 (85%) patients had the same or improved erectile function following surgery.
  
  
  CONCLUSIONS
  Patients presenting for repair after hypospadias failure often require complex penile reconstruction impacting both urinary as well as sexual quality of life. Among these patients there appears to be a high baseline prevalence of ED. Older patients had a higher incidence of more severe ED; however, the majority of younger patients still presented with some form of ED and a significant number with severe ED. Urethroplasty does not appear to negatively impact erectile function in men with previous hypospadias failure; however a disease specific questionnaire is needed to fully address this issue.
authors: Department of Urology. Northwestern University. Feinberg School of Medicine. Chicago. IL. USA.
authors: Daniel M
authors: DM
authors: Stein
authors: Department of Urology. Northwestern University. Feinberg School of Medicine. Chicago. IL, USA.
authors: Chris M
authors: CM
authors: Gonzalez
authors: Center for Reconstructive Urethral Surgery, Arezzo, Italy.
authors: Guido
authors: G
authors: Barbagli
authors: Department of Urology.University of Catania. Catania. Italy.
authors: Sebastiano
authors: S
authors: Cimino
authors: Department of Urology. University of Sassari.Italy.
authors: Massimo
authors: M
authors: Madonia
authors: Department of Experimental Medicine and Surgery. University of Tor Vergata. Rome.Italy.
authors: Salvatore
authors: S
authors: Sansalone
mesh_terms: D000328:Adult; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D006801:Humans; D007021:Hypospadias / Q000601:surgery*; D015994:Incidence; D007558:Italy; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014481:United States; D014525:Urethral Stricture / Q000473:pathology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods