Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood

Abstract

Introduction: Potential long-term sequelae of hypospadias and its surgical correctioninclude difficulties in voiding, sexual function, psychosexual adjustmentand self-appraisal. These difficulties often evolve long after surgical repairas children grow to adulthood. Despite this, patient-driven data on long-termfunctional outcomes and satisfaction are limited, leaving the true success ofhypospadias surgery essentially unknown. The aim of this study was to addressthese deficiencies.Methods: We conducted a chart review for all patients operated on by a singleurologist from 1981 to 1988. Extensive efforts were made to obtain accuratecurrent address information for patients. A database of patient demographicsand pathology, operative details and complications was created. A 22-itemquestionnaire was mailed to study subjects. Telephone follow-up by an independentresearch nurse bolstered response rates. Responses from returned questionnaireswere pooled and analyzed.Results: The chart review included 115 patients. Of 100 patients (with addressinformation) who were sent questionnaires, 28 ultimately responded. The chartreview group was comparable to groups in other published studies. Despitea slightly higher initial major complication rate (57.2%), respondents reportedfew long-term complications (11% fistula, 29% persistent chordee and 10%stricture) and excellent urinary and sexual functional results. The most commonfunctional complaints were spraying and hesitancy during micturition.Overall, 86% of patients were satisfied with their surgical result, and 52% wishedthey had been provided longer follow-up.Conclusion: Long-term outcomes data are critical to an honest account of successrates for hypospadias surgery. Obtaining these data remains challenging. In thisseries, despite high initial complication rates, most patients reported excellentlong-term functional results and were quite satisfied with their overall outcome.