| Purpose: To investigate the penile appearance,voiding function,quality of life and sexual function of adult patients who had undergone hypospadias repair surgery in their minors,which might provide clues for the treatment and prognosis judgment of hypospadias.Method: This research included adult hypospadias patients who underwent surgery in this treatment group from May 2005 to August 2018,and the age at the time of operation < 18 years old.Patients’ data were collected by telephone follow-up,face-to-face interview and related scales(HOSE,PPPS,IPSS,SF-36,EHS,IIEF-5,SEAR),and normal adults of the same age were selected as the control group.The correlation and consistency between objective appearance(HOSE)and subjective appearance satisfaction(PPPS)were analyzed.Univariate analysis and multivariate regression analysis were performed on the factors that may affect the results.Result: A total of 148 patients completed a brief assessment over the phone,56 postoperative adult patients and 60 normal adults completed the scale evaluation.There was no significant difference in general quality of life,micturition function(IPSS score,weak urinary stream)and erectile function(IIEF score)(n=36)between the two groups.However,the objective score of penile appearance(HOSE)and the score of subjective satisfaction(PPPS)in the hypospadias group were significantly lower than those in the control group(P < 0.01).The proportion of dripping after micturition was significantly higher than that in the normal group(P < 0.01)and the proportion of hypospadias patients with inferiority(thinking that they had penile physiological defects)was significantly higher than that in the normal group(P = 0.019).The penis hardness(EHS score)of both groups was above grade 3,but the proportion of grade 4 hardness in hypospadias group was significantly lower than that in normal group(P < 0.05).The total score of self-esteem and relationship scale(SEAR)(n=29)and the scores of relationship dimension,self-esteem dimension and overall relationship dimension in hypospadias group were significantly lower than those in normal control group(P <0.01).The Univariate analysis of related factors showed that the length of neourethra≥ 3 cm was the risk factors of HOSE score.The number of operations > 1 and postoperative complications were the risk factors affecting the results of PPPS score.However,there is only a weak correlation between HOSE score and PPPS score,and the consistency is poor.The operation times > 1,the length of neourethra ≥ 3 cm,postoperative complications and the unsatisfactory result of HOSE score are the risk factors of inferiority complex.The results of multivariate analysis showed that the unsatisfactory appearance of penis(HOSE score)was an independent risk factor affecting the mental state of patients(P = 0.021).The unsatisfactory result of subjective penile appearance evaluation,postoperative complications,the length of neourethra ≥ 3cm and psychological state of inferiority were the risk factors of low SEAR score of sexual function.Further multivariate analysis showed that the length of neourethra(P =0.044)and subjective satisfaction of penile appearance(P = 0.023)were independent factors affecting sexual function.Conclusions: The satisfaction with penile appearance and total sexual function of postoperative hypospadias patients were worse than those of normal adults of the same age.Dissatisfaction with the penile appearance can easily lead to patients’ inferiority complex,which in turn affects the sexual function.The postoperative penile appearance is of great significance to the long-term psychological state and sexual function of patients.Surgeons should pay attention to the penile appearance in the operation of hypospadias. |
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