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

Authors

  • Chris C. Hoag Department of Pediatric Urology, University of British Columbia, Vancouver, BC
  • Geoff T. Gotto Department of Pediatric Urology, University of British Columbia, Vancouver, BC
  • Kevin B. Morrison Department of Pediatric Urology, University of British Columbia, Vancouver, BC
  • Gerald U. Coleman Department of Pediatric Urology, University of British Columbia, Vancouver, BC
  • Andrew E. MacNeily Department of Pediatric Urology, University of British Columbia, Vancouver, BC

DOI:

https://doi.org/10.5489/cuaj.521

Abstract

Introduction: Potential long-term sequelae of hypospadias and its surgical correction
include difficulties in voiding, sexual function, psychosexual adjustment
and self-appraisal. These difficulties often evolve long after surgical repair
as children grow to adulthood. Despite this, patient-driven data on long-term
functional outcomes and satisfaction are limited, leaving the true success of
hypospadias surgery essentially unknown. The aim of this study was to address
these deficiencies.

Methods: We conducted a chart review for all patients operated on by a single
urologist from 1981 to 1988. Extensive efforts were made to obtain accurate
current address information for patients. A database of patient demographics
and pathology, operative details and complications was created. A 22-item
questionnaire was mailed to study subjects. Telephone follow-up by an independent
research nurse bolstered response rates. Responses from returned questionnaires
were pooled and analyzed.

Results: The chart review included 115 patients. Of 100 patients (with address
information) who were sent questionnaires, 28 ultimately responded. The chart
review group was comparable to groups in other published studies. Despite
a slightly higher initial major complication rate (57.2%), respondents reported
few long-term complications (11% fistula, 29% persistent chordee and 10%
stricture) and excellent urinary and sexual functional results. The most common
functional complaints were spraying and hesitancy during micturition.
Overall, 86% of patients were satisfied with their surgical result, and 52% wished
they had been provided longer follow-up.

Conclusion: Long-term outcomes data are critical to an honest account of success
rates for hypospadias surgery. Obtaining these data remains challenging. In this
series, despite high initial complication rates, most patients reported excellent
long-term functional results and were quite satisfied with their overall outcome.

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Author Biographies

Chris C. Hoag, Department of Pediatric Urology, University of British Columbia, Vancouver, BC

Geoff T. Gotto, Department of Pediatric Urology, University of British Columbia, Vancouver, BC

Kevin B. Morrison, Department of Pediatric Urology, University of British Columbia, Vancouver, BC

Gerald U. Coleman, Department of Pediatric Urology, University of British Columbia, Vancouver, BC

Andrew E. MacNeily, Department of Pediatric Urology, University of British Columbia, Vancouver, BC

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How to Cite

Hoag, C. C., Gotto, G. T., Morrison, K. B., Coleman, G. U., & MacNeily, A. E. (2013). Long-term functional outcome and satisfaction of patients with hypospadias repaired in childhood. Canadian Urological Association Journal, 2(1), 23–31. https://doi.org/10.5489/cuaj.521

Issue

Vol. 2 No. 1 (2008): CUAJ February

Section

Original Research

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