title: Sexuality and fertility in men with hypospadias; improved outcome.
abstract: The aim of this study was to investigate sexual function and fertility in adult men born with hypospadias. Patients born with hypospadias, age-matched controls, and a group of circumcised men completed a questionnaire constructed to reflect their psychosexual situation and fertility. Core gender identity, sexual orientation, and gender role behavior was also assessed. 167 patients [63% distal, 24% mid shaft and 13% proximal, mean age 34 (19-54) years], 169 controls from the general population [mean age 33 (19-48) years] and 47 controls circumcised because of phimosis (mean age 26 [19-44]) participated and completed the questionnaire. There were no differences in having a partner, reported fertility, age at sexarche (mean age 17.8), number of sex partners or sexual interest between the patients and controls. More patients than controls reported anejaculation. Reported glanular sensitivity was lower in hypospadias patients and circumcised controls compared with non-circumcised controls. The odds of being satisfied with their sexual life increased with a higher penile perception score in patients (OR = 1.54, p = 0.01). There was no association with penile length. Sexual orientation, core gender identity and gender role behavior were sex-typical in both patients and controls. Patients with proximal hypospadias had a lower reported fertility, experienced anejaculation more often, and were less satisfied with their sexual life. Men born with hypospadias have a good long-term outcome concerning sexual function and fertility. Men born with proximal hypospadias have a more impaired outcome concerning both sexual function and fertility. As satisfaction with genital appearance is important for sexual life satisfaction, clinical, and psychological follow-up into adulthood is especially important in boys born with proximal hypospadias.
authors.affiliation: Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.|Unit of Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Örtqvist
authors.affiliation: Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.|Unit of Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Fossum
authors.affiliation: Sahlgrenska Academy, Women's and Children's Health, Gothenburg, Sweden.|Department of Pediatric Surgery, Queen Silvia's Children's Hospital, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Andersson
authors.affiliation: Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.|Department of Pediatric Endocrinology, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Nordenström
authors.affiliation: Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.|Child and Adolescent Psychiatry Research Center, Karolinska Institutet, Stockholm, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Frisén
authors.affiliation: Sahlgrenska Academy, Women's and Children's Health, Gothenburg, Sweden.|Department of Pediatric Surgery, Queen Silvia's Children's Hospital, Gothenburg, Sweden.
authors.forename: G
authors.initials: G
authors.lastname: Holmdahl
authors.affiliation: Department of Women's and Children's Health and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden.|Unit of Pediatric Surgery, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Nordenskjöld
mesh_terms: D000328:Adult; D005298:Fertility / Q000502:physiology*; D005783:Gender Identity; D006801:Humans; D007021:Hypospadias / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D012725:Sexual Behavior / Q000502:physiology / Q000523:psychology*; D019529:Sexuality / Q000502:physiology / Q000523:psychology*; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: fertility; hypospadias; sexuality