Patient-reported sexual function after oral mucosa graft urethroplasty for hypospadias
Caleb P Nelson1, David A Bloom, Robert Kinast
1James Buchanan Brady Urological Institute, Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. cnelso32@jhmi.edu
Objectives:
To evaluate sexual function after oral mucosa graft urethroplasty (OMGU) for hypospadias. Few long-term patient-reported data are available regarding sexual function after surgery for hypospadias.
Methods:
We identified patients aged 18 years or older at the time of this survey who had undergone OMGU for hypospadias between 1992 and 2003. We evaluated sexual function and satisfaction using the 15-item International Index of Erectile Function (IIEF-15).
Results:
Of the 16 adult patients, we located 14, of whom 11 (79%) participated. Previous hypospadias repair had failed in all 11 before OMGU. The median age at OMGU was 17.5 years. The median follow-up time was 4.7 years. Of the 10 sexually active patients, the mean score on the IIEF-15 was 64.6 +/- 11.9 (maximal possible score 75). Erectile function was excellent, with all 10 able to achieve an erection most or all of the time (mean erection domain score 26.8 +/- 6.1). All 10 experienced sensation of orgasm most or all the time, although 1 never ejaculated and 2 ejaculated rarely (mean orgasm domain score 8.9 +/- 1.8). All 10 reported that they were moderately (n = 6) or very (n = 4) satisfied with their overall sex life (mean satisfaction domain score 8.3 +/- 1.9). Neither occurrence of post-OMGU complications nor satisfaction with penile appearance was significantly associated with the IIEF-15 scores or overall sexual satisfaction.
Conclusions:
Long-term sexual function and satisfaction was excellent in these patients after OMGU for hypospadias. Adolescent boys and men with failed hypospadias repairs, as well as parents of boys with hypospadias, can be counseled that most patients who undergo OMGU are likely to have satisfactory sexual function as adults.
