Aspects of adult satisfaction with the result of surgery for hypospadias performed in childhood.

OBJECTIVES Our aim was to ascertain whether the short-term results and the frequency of complications of corrective surgery in hypospadias correlate with patients' opinions on their sexual life and voiding ability as adults, as well as to establish what kind of problems underlie dissatisfaction with the result of surgery. METHODS Between 1963 and 1975, 64 hypospadias patients, had been operated and their treatment completed in the Division of Paediatric Surgery at Tampere University Hospital. Their patient records were analyzed retrospectively, and a detailed questionnaire was mailed to 61 of them. RESULTS 43 (70.5%) patients returned the questionnaire. Of the respondees, 62.8% expressed satisfaction with the result of the operation. Among those who were satisfied, 22.2% had had complications after the operation, whereas 57.1% of those expressing dissatisfaction with the result had had complications (p < 0.05). Satisfied subjects had fewer problems in voiding and erection than those who were unsatisfied. They were also more often satisfied with the appearance of their penis and their sexual life. Fifteen patients would have preferred a longer follow-up. CONCLUSIONS There is a correlation between the frequency of complications following hypospadias surgery and long-term results. Good short-term results also predict good long-term ones. There is no straight correlation between the presence of voiding abnormalities and overall satisfaction with the result. It seems that the overall appearance as perceived by the patient and patients' satisfaction with their sexual function are more important. This study shows that the 1-stage methods currently used, represented here by the Mathieu technique, give superior results compared to older methods, at least partly because complications occur less often.