Post-pubertal outcomes of hypospadias surgery performed during infancy: High satisfaction with urinary function and minimal lower urinary tract symptoms.

Objectives: To assess long-term lower urinary tract symptoms (LUTS) in post-pubertal patients operated on for hypospadias during infancy.

Patients and methods: We analysed patient-reported LUTS in 176 post-pubertal patients born between 1991 and 2003, who underwent early hypospadias repair at a median age of 1.4 years (IQR 1.1-1.9). At their last follow-up visit, patients returned pre-mailed questionnaires evaluating LUTS before transitioning from the pediatric unit. The results were compared to a healthy control group. We also assessed the impact of hypospadias severity on voiding and storage symptoms.

Results: At a median age of 16.3 years, 19 % of patients had undergone stricture treatment following hypospadias repair. Frequent (often/always) or severely disturbing (moderate/major) voiding or storage symptoms were rare and comparable to controls according to DAN-PSS questionnaire (p > 0.05 for all comparisons). Most symptoms were mild, and the occurrence of mild symptoms varied between patients and controls. The severity of hypospadias did not affect the occurrence of voiding or storage symptoms. The occurrence of bothersome LUTS was also similar between patients with and without prior stricture treatment (p > 0.5 for all).

Conclusion: Most patients reported satisfaction with their urinary function after urethroplasty, indicating that long-term LUTS do not significantly increase following hypospadias when complications including strictures are identified and managed. To enable long-term outcomes after childhood hypospadias surgery, structured follow-up is essential to detect and treat such complications.