FEATURES OF TREATMENT OF PRIMARY HYPOSPADIAS IN ADOLESCENTS
- Authors: Lagutina V.A.1
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Affiliations:
- Yaroslavl State Medical University
- Issue: Vol 12, No 1 (2023): Материалы XVII Международной научно-практической конференции молодых ученых-медиков
- Pages: 86-87
- Section: СОВА (Архив)
- URL: https://new.vestnik-surgery.com/index.php/2415-7805/article/view/8755
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Abstract
Hypospadias are one of the most frequent congenital pathologies of the penis, which is characterized by the presence of an ectopically located myatus, accompanied by a violation of urination, as well as quite often a curvature of the cavernous bodies. The purpose of the correction is to restore the anatomically normal appearance of the penis, to ensure free, unhindered urination and the return of full sexual function. We present the results of the analysis of the treatment of hypospadias in 512 adolescents aged 12-17 years. The examination included a Hypospadias objective scoring evaluation (HOSE) scale, specially designed for this developmental anomaly, consisting of 4 items showing satisfaction with the surgical intervention performed to correct hypospadias (the position and shape of the myatus, the shape of the glans penis and the overall cosmetic result). This study is aimed at studying the psychosexual development of adolescents who underwent correction of hypospadias, compared with boys who underwent surgery at an early age. A later onset of sexual activity and less satisfaction with the overall cosmetic appearance was found in patients with hypospadias correction in adolescence. Adolescents with hypospadias demonstrate a more negative self-perception of the penis.
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Relevance.From 2001 to 2010, 10,929 cases per 5871855 newborns were registered in Europe, with a total incidence of 18.61/10000 newborns[1].One of the controversial issues is the evaluation of treatment results; most tools are aimed at assessing satisfaction with cosmetic results, and only one scale allows you to determine the function of urination. None of the scales includes sexual function and psychological consequences[2].
The purpose of the study.To evaluate the results of treatment of hypospadias in adolescence.
Material and methods.The analysis of the results of treatment of 514 patients with hypospadias operated in the period 2006-2022, primary adolescent patients - 12-17 years – 24 (4.6%), including distal stem forms - 6, head forms– 18.The following interventions were performed –Matthew urethroplasty– 6, TIP– 14, non–dissecting urethroplasty with spongioplasty– 4. The Hypospadiasobjectivescoringevaluation(HOSE) scale was used for evaluation.The assessment was carried out in the period of 1-10 years by a urologist/pediatric urologist of the outpatient center who did not participate in the treatment of the patient at the inpatient stage, which allowed to avoid subjectivity.
Results.The average score was 11.7, including 12.5 for head forms, 10.2 for distal stem forms.When subjectively evaluating the result of the operation, patients rated it as good (n=6), satisfactory (n=15) and unsatisfactory (n=3). The timing of the beginning of sexual life is analyzed:18 patients – earlier than 16 years – 1, 16-18 years– 2, 18-21 years – 4, 21-25 years– 9, did not come– 2.
Conclusions.Primary correction of hypospadias in adolescence is more significant than in early childhood for the patient from the position of social and sexual adaptation. The onset of sexual activity occurs later than in patients operated at an early age. Subjective satisfaction with the cosmetic results of the performed surgical intervention is lower than in patients operated at an early age (provided that the operation results are objectively satisfactory – the absence of curvature, the typical location of the meatus on the head, etc.).
About the authors
Victoria Alekseevna Lagutina
Yaroslavl State Medical University
Author for correspondence.
Email: izgor.vika@mail.ru
ORCID iD: 0009-0004-4461-9363
Russian Federation, 5, Revolutionary str., Yaroslavl, 150000, Russia
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