76
29
th
CONGRESS OF THE ESPU
S8: ADOLESCENT UROLOGY 1
Moderators: Radim Kocvara (Czech Republic), Hezi Landau (Israel)
ESPU Meeting on Thursday 12, April 2018, 11:45–12:15
11:45–11:48
S8-1 (PP)
★
LONG-TERM FOLLOW-UP OF ADOLESCENTS OPERATED
FOR PROXIMAL HYPOSPADIAS; ARE PSYCHOSOCIAL
AND SEXUAL OUTCOMES AFFECTED?
Marie ANDERSSON
1
, Lisa ÖRTQVIST
2
, Agneta NORDENSKJÖLD
2
,
Sofia SJÖSTRÖM
1
and Gundela HOLMDAHL
1
1) The Sahlgrenska Academy, Department of Pediatric Urology, Queen Silvia's Children's Hospital, Sahlgrenska
University Hospital, Gothenburg, SWEDEN - 2) Karolinska Institutet, Department of Pediatric Surgery, Astrid Lindgren
Children's Hospital, Karolinska University Hospital, Stockholm, SWEDEN
PURPOSE
Long-term studies of psychosocial and sexual outcomes after hypospadias surgery are few with
diverging results, often not considering grade of hypospadias. We hypothesized that psychosocial
outcomes and sexual aspects of hrQoL in adolescents with proximal hypospadias are negatively
affected and tested this in a prospective matched control study.
MATERIAL AND METHODS
57 young men ≥ 14 years operated between 1996–2005 for penoscrotal to perineal hypospadias
at a single center were identified. 33 patients, Md age 17.5 years (14–25) accepted clinical assess-
ment and answered a web-based questionnaire, designed to reflect social factors, general wellbe-
ing, body esteem, penile perception and sexual well-being including the validated tests PGWB
(Psychological General Well Being), BESAA (Body Esteem of Adults and Adolescents) and PPPS
(Pediatric Penile Perception Score). 25 age-matched healthy men, Md age 17.5 years (14–25) and
31 patients treated for distal hypospadias, Md age 19 years (14–35) served as controls.
RESULTS
No differences in educational levels were found, but extra support in school was more frequent
among boys with proximal hypospadias (p=0.024 vs distal, p=0.068 vs control).
There were no differences regarding PGWB, BESAA or PPPS. Proximal hypospadias patients were
more unsatisfied with penile length (39 %) compared to controls (12 %) (p=0.049).
No difference in satisfaction regarding meatal position, shape of glans, penile skin or glanular
sensibility (controls uncircumcised) was found. Interest in sex, age at sexarche and satisfaction with
sexual experiences were comparable although among proximal hypospadias 3/30 (10 %) reported
occasional erectile problems and 11/28 (39 %) uncertainty regarding ejaculation (p=0.032 and
p=0.0054 vs distal, ns vs control).
CONCLUSIONS
Adolescents with proximal hypospadias showed no differences in psychosocial and sexual outcome
in most regards. Despite concerns regarding penile length, sexual experiences were comparable
to other adolescents.