Adolescent patients express satisfaction after hypospadias repair

Hypospadias repair during childhood draws satisfaction from adolescent patients who had undergone such procedure, particularly for cosmetic, urinary, and sexual outcomes, according to a study.

“However, variations in satisfaction and persistent psychological concerns following complications underline the importance of recognizing patients’ subjective experiences,” the researchers said.

In this study, all patients who had undergone initial hypospadias repair at two Italian centres between 1979 and 2015 and were aged >16 years were contacted by telephone following institutional approval. Consenting individuals (n=163) completed questionnaires, with clinical records providing data on hypospadias type (distal vs proximal) and reinterventions.

The research team analysed the scores by domain and compared these according to hypospadias severity and reoperation status. The median follow-up age was 24 years.

Of the patients, 79.8 percent were distal (n=130) and 20.2 percent were proximal (n=33). Fifty-one (31.3 percent) had undergone reoperation.

Outcomes were generally favourable. The median hypospadias objective scoring evaluation (HOSE) was 14.0, the median penile perception score was 9.0, and the median hypospadias objective questionnaire (HOQ) satisfaction was 14.0. Moreover, patients had a median total satisfaction in genital hypospadias treatment (SIGHT) of 29.0.

More than half of the participants (51.6 percent) were sexually active, with a median SIGHT sexual-function item score of 4.0. Nearly one in four (26.4 percent) developed urethrocutaneous fistula.

Patients with proximal hypospadias (51.5 percent vs 26.1 percent) were more likely to undergo reoperation than those with the distal type. They also tended to have worse aesthetic (PPS median 8.0 vs 10.0), functional (HOSE median 13.0 vs 14.0), and psychosocial (SIGHT median 26.0 vs 30.0) scores.

Notably, patients who underwent reintervention still reported satisfaction (median HOSE 14.0) and SIGHT (29.0) scores. The median follow-up preference, surgery recall, and centre loyalty were 3.0, 2.0, and 2.0, respectively.

“Multidisciplinary, long-term follow-up and tailored psychosocial support are essential to optimize psychosexual adjustment and quality of life after surgery,” the researchers said.

“Hypospadias is a common congenital malformation of the genitourinary tract that can lead to lasting functional, cosmetic, and psychosocial consequences, they said.