title: Do adult men with untreated hypospadias have adverse outcomes? A pilot study using a social media advertised survey.
abstract: OBJECTIVE
  Hypospadias is usually treated in childhood. Therefore, the natural history of untreated mild hypospadias is unknown. We hypothesized that men with untreated hypospadias, especially mild, do not have adverse outcomes.
  
  
  METHODS
  Facebook was used to advertise an electronic survey to men older than 18 years. Men with untreated hypospadias identified themselves and indicated the severity of hypospadias with a series of questions. Outcomes included: Sexual Health Inventory for Men (SHIM), penile curvature and difficulty with intercourse, International Prostate Symptom Score (IPSS), Penile Perception Score (PPS), psychosexual milestones, paternity, infertility, sitting to urinate, and the CDC HRQOL-4 module.
  
  
  RESULTS
  736 men completed self-anatomy questions and 52 (7.1%) self-identified with untreated hypospadias. Untreated hypospadias participants reported worse SHIM (p < 0.001) and IPSS scores (p = 0.05), more ventral penile curvature (p = 0.003) and resulting difficulty with intercourse (p < 0.001), worse satisfaction with meatus (p = 0.011) and penile curvature (p = 0.048), and more sitting to urinate (p = 0.07). When stratified by mild and severe hypospadias, severe hypospadias was associated with more adverse outcomes than mild hypospadias.
  
  
  CONCLUSIONS
  Men with untreated hypospadias reported worse outcomes compared with non-hypospadiac men. Mild untreated hypospadias had fewer adverse outcomes than severe hypospadias. Research is needed to determine if treatment of childhood hypospadias improves outcomes in adults, especially for mild hypospadias.
authors.affiliation: Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA; University of California San Francisco, San Francisco, CA, USA. Electronic address: bruceschlomer@gmail.com.
authors.forename: Bruce
authors.initials: B
authors.lastname: Schlomer
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Breyer
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Hillary
authors.initials: H
authors.lastname: Copp
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Laurence
authors.initials: L
authors.lastname: Baskin
authors.affiliation: University of California San Francisco, San Francisco, CA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: DiSandro
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D006306:Health Surveys; D006801:Humans; D007021:Hypospadias / Q000150:complications* / Q000473:pathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011606:Psychosexual Development; D011788:Quality of Life; D057566:Self Report; D012680:Sensitivity and Specificity; D012725:Sexual Behavior; D061108:Social Media; D055815:Young Adult
keywords: Chordee; Hypospadias; Penile curvature