Long term follow-up on young adults that underwent hypospadias repair through urethral advancement in childhood

Seguimiento a largo plazo de adultos jóvenes con reparación de hipospadias mediante avance uretral en la infancia

Assess the long-term outcome on cosmetic appearance, voiding, sexual function, and psychological impact of young adults operated by urethral advance (UA) technique in childhood. Patients over 14 years old, who underwent UA hypospadias repair in our centre (2000–2010) were evaluated. All patients presented mid-distal hypospadias with subcoronal or penile meatus and curvature lower than 20◦. The cosmetic appearance, urinary and sexual function, body perception and overall satisfaction were assessed through 5 questionnaires. From 2000 to 2010, 143 children underwent UA hypospadias repair. 36 patients between 14 and 27 years were evaluated. The Hypospadias Objective Penile Evaluation (HOPE) showed an average of 8.75 (+/− 0.97), which indicates a good aesthetic result. Voiding dysfunction symptoms were assessed through the American Urological Association Symptom Index (AUASI) where 80.6% had none or mild symptoms and 19.4% had moderate symptoms. Only 11/36 patients were sexually active, according to the International Index of Erectile Function (IIEF-15) scale, none had erectile dysfunction, and their relationships were satisfactory. Assessment of the body perception through the Genital Perception Scale (GPS) was positive or very positive in 88.9% of the patients. However, the perception of their genitals was positive or very positive in 77.8%, there is a negative correlation between the perception of their body and genitals in 13.9% of the patients. Our results indicate that UA technique for hypospadias repair might be a valid option for the correction of mid-distal hypospadias when indicated.

Resumen

Evaluar el resultado a largo plazo sobre el aspecto cosmético, la micción, la función sexual y el impacto psicológico de adultos jóvenes operados con la técnica de avance uretral (AU) en la infancia. Se evaluaron pacientes mayores de 14 años, intervenidos de hipospadias mediante AU en nuestro centro (2000–2010). Todos los pacientes presentaban hipospadias medio-distal con meato subcoronal o peneano y curvatura menor de 20◦. El objetivo se evaluó a través de 5 cuestionarios. De 2000 a 2010, 143 niños se sometieron a reparación de hipospadias mediante AU. Se evaluaron 36 pacientes entre 14 y 27 años. La Evaluación Peneana Objetiva de Hipospadias (HOPE) mostró un promedio de 8.75 (SD +/− 0.97), lo que indica un buen resultado estético. Los síntomas de disfunción miccional se evaluaron mediante el índice de síntomas de la Asociación Urológica Estadounidense, donde el 80.6% no presentó síntomas o presentó síntomas leves y el 19.4% presentó síntomas moderados. Solo 11/36 pacientes eran sexualmente activos. Según la escala International Index of Erectile Function (IIEF-15), ninguno presentaba disfunción eréctil y sus relaciones eran satisfactorias. La percepción de sus genitales fue positiva o muy positiva en el 77.8%. Existe una correlación negativa entre la percepción de su cuerpo y los genitales en el 13.9% de los pacientes. Nuestros resultados indican que la técnica AU para la reparación del hipospadias podría ser una opción válida para la corrección del hipospadias medio-distal.

Hypospadias repair; Urethral mobilization; Urethral advancement; Sexual assessment; Psychological assessment

Palabras Clave

Reparación de hipospadias; Movilización uretral; Avance uretral; Valoración sexual; Valoración psicológica

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