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Sexuality and fertility in men with hypospadias; improved outcome.

Journal article
Authors L Örtqvist
M Fossum
Marie Andersson
A Nordenström
L Frisén
Gundela Holmdahl
A Nordenskjöld
Published in Andrology
Volume 5
Issue 2
Pages 286-293
ISSN 2047-2927
Publication year 2017
Published at Institute of Clinical Sciences, Department of Pediatrics
Pages 286-293
Language en
Links dx.doi.org/10.1111/andr.12309
www.ncbi.nlm.nih.gov/entrez/query.f...
Keywords Adult, Fertility, physiology, Gender Identity, Humans, Hypospadias, physiopathology, psychology, Male, Middle Aged, Personal Satisfaction, Sexual Behavior, physiology, psychology, Sexuality, physiology, psychology, Surveys and Questionnaires, Young Adult
Subject categories Clinical Medicine

Abstract

The aim of this study was to investigate sexual function and fertility in adult men born with hypospadias. Patients born with hypospadias, age-matched controls, and a group of circumcised men completed a questionnaire constructed to reflect their psychosexual situation and fertility. Core gender identity, sexual orientation, and gender role behavior was also assessed. 167 patients [63% distal, 24% mid shaft and 13% proximal, mean age 34 (19-54) years], 169 controls from the general population [mean age 33 (19-48) years] and 47 controls circumcised because of phimosis (mean age 26 [19-44]) participated and completed the questionnaire. There were no differences in having a partner, reported fertility, age at sexarche (mean age 17.8), number of sex partners or sexual interest between the patients and controls. More patients than controls reported anejaculation. Reported glanular sensitivity was lower in hypospadias patients and circumcised controls compared with non-circumcised controls. The odds of being satisfied with their sexual life increased with a higher penile perception score in patients (OR = 1.54, p = 0.01). There was no association with penile length. Sexual orientation, core gender identity and gender role behavior were sex-typical in both patients and controls. Patients with proximal hypospadias had a lower reported fertility, experienced anejaculation more often, and were less satisfied with their sexual life. Men born with hypospadias have a good long-term outcome concerning sexual function and fertility. Men born with proximal hypospadias have a more impaired outcome concerning both sexual function and fertility. As satisfaction with genital appearance is important for sexual life satisfaction, clinical, and psychological follow-up into adulthood is especially important in boys born with proximal hypospadias.

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