Sexual dysfunction in patients with late complications of hypospadias surgery

Most hypospadias cases are successfully treated in childhood. Still, patients with sequelae of failed hypospadias repair and sexual dysfunction may be encountered. We evaluated 112 patients with a history of failed hypospadias repair, defined as the presence of voiding symptoms or cosmetic problems remaining despite previous surgery or caused by it. Patients' median age was 29.5 years (range: 18-62). There were no intersex cases. Only 9.8% (11/112) underwent single attempt at surgical reconstruction, the median number of attempts was 3.5 (range: 1-9). Patients with IIEF-EF score ≤25 were considered to have erectile dysfunction; those with IIEF-EF ≤16 underwent penile doppler ultrasound, penile electromyography and endocrine assessment. About 64.2% of patients (72/112) were dissatisfied with penile appearance, 40.2% (45/112) had ED, 71.4% (80/112) had ejaculation disorders. Psychogenic ED was diagnosed in 21 patients with preserved non-coital erections and no evidence of organic ED. Median IIEF-EF in ED patients was 20 (range: 8-25). Asthenic ejaculation, delayed ejaculation and anejaculation were present in 63.4% (71/112), 7.1% (8/112) and 3.5% (4/112) patients respectively. Premature ejaculation was present in 28.6% (32/112) patients, but its association with hypospadias or previous surgery is unlikely.