OBJECTIVETo evaluate the long-term outcomes of hypospadias surgery relating to penile appearance, sexual function and sexual satisfaction, and analyze the influencing factors by comparing them with those of healthy male adults.

METHODSWe conducted follow-up visits to 128 hypospadias patients surgically treated in our hospital between January 1990 and June 1994. We retrospectively analyzed their clinical data in comparison with 136 healthy male adults.

RESULTSThe rate of satisfaction with penile appearance was significantly lower in the hypospadia patients than in the healthy men, and the main reason for the patients'dissatisfaction was inadequate penile size. There were no statistically significant differences between the two groups in sexual function and sexual satisfaction. The rate of sexual satisfaction was lower in the patients treated for proximal and middle shaft hypospadias but higher in those treated for distal shaft hypospadias than in the healthy adults, particularly high in those successfully treated by one-stage surgery at the age of < or = 3 years. The factors influencing postoperative sexual satisfaction included penile appearance, severity of hypospadias, surgical complications, surgical stage, age of surgery, and premature ejaculation. However, sexual satisfaction was not affected by surgical complications and surgical staging in those successfully treated by one-stage surgery at the age of < or = 3 years.

CONCLUSIONImportance should be attached to the long-term follow-up of hypospadias patients after surgery. Sexual satisfaction could be achieved by successful one-stage urethroplasty at the age of < or = 3 years. Appropriate surgical procedures based on the characteristics of different cases may help the patients to establish confidence in their future sexual activities.