Factors affecting long-term psychosocial outcomes after hypospadias repair
Keywords:
Hypospadias, long term, psychosocial, outcome, urethro-cutaneous fistulaAbstract
Background: Hypospadias is one of the most common congenital genital malformations. Despite current progress in surgical techniques, long-term psychosocial outcomes received little attention.
Objective: To evaluate long-term psychosocial outcomes after hypospadias repair and analyze the root causes regarding satisfactory outcomes.
Methods: Patients who underwent hypospadias repair during childhood period were recruited. Regarding psychosocial outcomes, the patients were invited for evaluation by the questionnaires in Thai version form. Data were analyzed by STATA program. Univariate analysis and multiple linear regression were used for statistical analysis.
Results: There were 38 hypospadias patients, median age = 14 years (range 11 - 27) recruited into the study. The patients underwent first hypospadias repair at the median of 3.5 years old (range 1 - 14). The types of hypospadias were namely: glandular type (1/38), corona type (5/38), midshaft type (10/38), and penoscroal type (22/38). The overall average score of satisfactory psychosocial outcomes was 25.3 ± 5.9 (range 14 - 37, maximal score = 39). Using simple linear regression analysis, factors affecting psychosocial outcomes (P < 0.05), were older age at first hypospadias surgery, mild type of hypospadias, technique of hypospadias repair, current urethro-cutaneous fistula, conduct problems, and abnormal peer difficulty problems. When applying multiple linear regression analysis, only 3 factors were significantly associated with psychosocial outcomes: severe type of hypospadias when compared with corona and mid-shaft type ( = 7.94 and 5.16, P = 0.001 and 0.005, respectively), current urethro-cutaneous fistula (= - 4.38, P = 0.02) and high peer difficulty problems, ( = - 5.88, P = 0.04).
Conclusion: Factors which affected long-term decreasing psychosocial satisfactory outcomes were penoscrotal hypospadias, current urethro-cutaneous fistula, and high peer difficulty problems
Downloads
References
Holland AJ, Smith GH, Ross FI, Cass DT. HOSE: anobjective scoring system for evaluating the resultsof hypospadias surgery. BJU Int 2001;88:255-8. https://doi.org/10.1046/j.1464-410x.2001.02280.x
van der Toorn F, de Jong TP, de Gier RP, Callewaert PR,van der Horst EH, Steffens MG, et al. Introducingthe HOPE (Hypospadias Objective Penile Evaluation)-score: a validation study of an objective scoringsystem for evaluating cosmetic appearance inhypospadias patients. J Pediatr Urol 2013;9:1006-16.
https://doi.org/10.1016/j.jpurol.2013.01.015
Mondaini N, Ponchietti R, Bonafè M, Biscioni S, DiLoro F, Agostini P, et al. Hypospadias: incidence andeffects on psychosexual development as evaluatedwith the minnesota multiphasic personality inventorytest in a sample of 11,649 young italian men. Urol Int2002;68:81-5.
https://doi.org/10.1159/000048423
Aho MO, Tammela OK, Somppi EM, Tammela TL.Sexual and social life of men operated in childhoodfor hypospadias and phimosis. A comparative study.Eur Urol 2000;37:95-100.
https://doi.org/10.1159/000020107
Mureau MA, Slijper FM, Nijman RJ, Van der MeulenJC, Verhulst FC, Slob AK. Psychosexual adjustmentof children and adolescents after different types ofhypospadias surgery: A norm-related study. J Urol1995:154:1902-7. https://doi.org/10.1016/S0022-5347(01)66823-X
Bracka A. A long-term view of hypospadias. Br JPlast Surg 1989;42:251-5.
https://doi.org/10.1016/0007-1226(89)90140-9
Jones BC, O'Brien M, Chase J, Southwell BR,Hutson JM. Early hypospadias surgery may lead toa better long-term psychosexual outcome. J Urol2009;182:1744-9. https://doi.org/10.1016/j.juro.2009.02.089
Schönbucher VB, Weber DM, Landolt MA.Psychosocial adjustment, health-related quality oflife, and psychosexual development of boys withhypospadias: a systematic review. J Pediatr Pychol2008;33:520-35. https://doi.org/10.1093/jpepsy/jsm098
Schultz JR, Klykylo WM, Wacksman J. Timing ofelective hypospadias repair in children. Pediatrics1983;71:342-51. https://doi.org/10.1542/peds.71.3.342
MacNeily AE, Hoag CC, Gotto GT, Morrison KB,Coleman GU. Long-term functional outcome andsatisfaction of patients with hypospadias repaired inchildhood. J Canadian Urol Assoc 2008;2:23-31.
https://doi.org/10.5489/cuaj.521
Ardelt PU, Cederqvist M, Barth M, Frankenschmidt A.The SIGHT questionnaire: A novel assessment toolfor satisfaction in genital hypospadias treatment. JPediatr Urol 2017;13:33.e1-e8.
https://doi.org/10.1016/j.jpurol.2016.10.011
Wang WW, Deng CH, Chen LW, Zhao LY, Mo JC,Tu XA. Psychosexual adjustment and age factors in130 men undergone hypospadias surgery in a Chinesehospital. Andrologia 2010;42:384-8.
https://doi.org/10.1111/j.1439-0272.2010.01061.x
Glaser T. Zeitgemäße Hypospadiekorrektur:Evaluation der Freiburger Operationsverfahren underste Bewertung einer neuen Modifikation der Techniknach Barcat; Current hypospadias: repair evaluationof the operative techniques from the university ofFreiburg and first valuation of a new modificationtechnique of Barcat. Germany, Europe: Albert-Ludwigs-Universität Freiburg; 2004.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Chulalongkorn Medical Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
