OBJECTIVETo assess the functional result of a "Two in One" urethroplasty which combined oral mucosa graft and local flap.

METHODS17 patients with hypospadias underwent a "Two in One" urethroplasty, which combined buccal mucosa and local flap for urethral reconstruction. Uroflowmetry was performed 1 day before and 1 year after operation. The urine flow rate, voided volume and urine flow curves were detected using a rotating sensor. The results of maximum urine flow rate (Qmax) were expressed as percentiles and compared to the Toguri value from normal children.

RESULTSBefore corrective operation, 12 of 17 patients (70.6%) produced a plateau urine flow curve. 5 patients (29.4%) produced a very low flow curve. The average maximum flow rate was (7.89 +/- 2.29) ml/s per second compared to Toguri values, 12 of 17 patients (70.6%) had a Qmax below the normal 5th percentile. After a "Two in One" urethroplasty, a hell-shaped curve was obtained in 10 patients (58.8%). The maximum flow rate was (11.30 +/- 3.01) mL/s per second. 7 of 17 patients (41.2%) had a Qmax above the normal 25th percentile, 8 patients (47.1%) had a Qmax between the normal 25th percentile and 5th percentile, only 2 patients (11.8%) had a Qmax below the 5th percentile.

CONCLUSIONSThe functional result of the "Two in One" urethroplasty is ideal. The maximum urine flow rate of the patients increases after the operation.

Child, Preschool ; Humans ; Hypospadias ; physiopathology ; surgery ; Male ; Treatment Outcome ; Urethra ; physiopathology ; surgery

Pubertal development may be altered in boys with cryptorchidism and hypospadias, but existing knowledge is inconsistent. Therefore, we investigated the association between cryptorchidism and hypospadias and pubertal development in a large cohort study. Boys in the Puberty Cohort, a cohort nested within the Danish National Birth Cohort, were included in this study. Information on cryptorchidism and hypospadias was retrieved from the Danish National Patient Register. From 11 years until 18 years or full pubertal development, information on physical markers of pubertal development was provided biannually, including Tanner stages, axillary hair, acne, voice break, and first ejaculation. In multivariate regression models for interval censored data, the mean (95% confidence intervals [CIs]) differences in months in obtaining the pubertal markers between boys with and without the anomalies were estimated. Among 7698 boys, 196 (2.5%) had cryptorchidism and 60 (0.8%) had hypospadias. Boys with hypospadias experienced first ejaculation and voice break 7.7 (95% CI: 2.5-13.0) months and 4.5 (95% CI: 0.3-8.7) months later than boys without hypospadias. The age at attaining the Tanner stages for gonadal and pubic hair growth was also higher, though not statistically significant. Pubertal development seemed unaffected in boys with mild as well as severe cryptorchidism. In conclusion, hypospadias may be associated with delayed pubertal development, but pubertal development seems unaffected by cryptorchidism. The relation between hypospadias and later pubertal development may be due to the underlying shared in utero risk or genetic factors.
Adolescent ; Age Factors ; Child ; Cohort Studies ; Cryptorchidism/physiopathology* ; Denmark ; Humans ; Hypospadias/physiopathology* ; Male ; Puberty/physiology*

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.

Adolescent ; Adult ; Case-Control Studies ; Follow-Up Studies ; Humans ; Hypospadias ; physiopathology ; surgery ; Male ; Patient Satisfaction ; Penis ; Postoperative Period ; Retrospective Studies ; Sexual Behavior ; Surveys and Questionnaires ; Young Adult