Genital perception of children, adolescents, and adults operated on for hypospadias: A comparative study

Genital perception of patients operated on for hypospadias, a congenital anomaly of the penis, was studied through a standardized self‐report questionnaire. Genital perception of 73 adults (18 to 38 years) and 116 children and adolescents with hypospadias (9 to 18 years) was compared with that of 50 and 88 age‐matched comparison males, respectively, treated for an inguinal hernia. The relationships of patient age, coping with genital appearance, severity of hypospadias, number of operations, age at final surgery, or type of surgical treatment for hypospadias with genital perception of hypospadias patients were also investigated. Hypospadias patients had a more negative genital perception than comparison males, predominantly because they were less satisfied with the size and shape of their penis and with the position of the meatus. Genital perception was not related to patient age or type of surgical treatment for hypospadias, but was significantly more negative when penile appearance was judged to be different from that of other males and when dissatisfaction with circumcised status occurred as a result of surgery. We recommend informing parents and patients that hypospadias surgery will not enlarge penile size and that after surgery the penis will have a circumcised appearance. In countries where circumcision is uncommon, hypospadias repairs that save the foreskin should be offered as an alternative.