Comparative Study of Sexual Function Between Post-hypospadias Repair and Post-circumcision Patients
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Abstract
Background: Hypospadias is characterised by an ectopic ventrally positioned urethral meatus, ventral chordee, and excessive dorsal foreskin. The objective of hypospadias repair is to provide a straight penis with an external urethral opening at the tip that is functionally and cosmetically normal. Literature on long-term sexual function outcome post-hypospadias repair is scarce, especially in the Southeast Asian population. This study compares the sexual function between hypospadiacs post-repair and healthy circumcised males. This study compares sexual function between adults who underwent hypospadias repair and healthy circumcised males.
Methods: This study was conducted in Hospital Pakar Universiti Sains Malaysia (HPUSM). Convenience sampling of patients who underwent hypospadias repair surgery from 1995 to 2005 in HPUSM was done. Healthy circumcised males were recruited as controls among Universiti Sains Malaysia (USM) staff, students, and their relatives via convenience sampling. Recruitment stopped once the required sample size was achieved. This questionnaire-based study utilised an adaptation of three instruments: the Global Sexual Functioning (GSF) questionnaire, the Sexual Satisfaction Score (SSS) questionnaire, and the Penile Perception Score (PPS).
Results: A total of 49 questionnaires were sent to eligible subjects after screening for inclusion and exclusion criteria, while 80 questionnaires were sent to suitable controls. Among them, 26 subjects and 75 controls responded. The control group was older than the subject group [34.43 (±5.789) years vs 28.92 (±7.255) years]. Both groups have similar educational levels. The control group reported having more children (2.0 vs 0.5) and better scores in sexual function, sexual satisfaction, and penile cosmesis. There was no significant difference between one-stage and two-stage repairs. The GSF scores showed a low negative correlation with SSS (r = –0.384) when both groups were analysed together. A similar pattern was seen in the control group but not in the hypospadias group. The correlation between SSS and PPS differed between the control group and the subject group, indicating a discordant pattern across groups.
Conclusion: This study revealed that post-hypospadias repair patients demonstrated poorer sexual function compared to circumcised controls based on GSF scores. The SSS appears to be a reliable tool for assessing sexual satisfaction in hypospadias patients. There is a low negative correlation between GSF score and SSS. Better penile cosmesis assessed using PPS translates to better sexual satisfaction in circumcised controls, but the result is discordant in hypospadiacs.
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