Long-Term Follow-Up in Hypospadias Repair: What Is It and Are We There Yet?

Abstract

In spite of 100s of publications on hypospadias every year, debates continue on many aspects of hypospadias. The quality and duration of the numerous follow-up reports in literature are lacking and limit our ability to make progress for these patients. The overall complication rate for distal hypospadias ranges from 5 to 20%. This discrepancy in complication rate varies by institution, surgeon, repair type, and duration of follow-up. The follow-up period in 50% of the published papers is less than 1 year. Several studies showed that about 50% of complications occur beyond the first postoperative year. Patient-reported outcome measures (PROMs) aim to incorporate the patient, parental, and surgeon input into the outcome assessment. There are currently five validated questionnaires in the literature. These include the Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Score (PPPS), Penile Perception Score (PPS), Genital Perception Scale (GPS) for adults, and the Genital Perception Scale (GPS) for children. There is a clear lack of focus on the long term urinary function, sexual function, and the psychological element of the repair.