Health-Related Quality Of Life And Psychological Adjustment Of Children And Adolescents With Hypospadias

Main Category: Urology / Nephrology
Also Included In: Clinical Trials / Drug Trials
Article Date: 13 Jun 2008 - 3:00 PDT

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UroToday.com - A study out of Zurich, Switzerland addressed the quality of life and psychological adjustments of children and adolescents with hypospadias who underwent hypospadias repair. In this study there were 77 boys between the ages of 7 to 17 years who underwent surgery for hypospadias. Both child and mother rated quality of life was evaluated by the TNO-AZL Child Quality of Life Questionnaire with psychological adjustments by the Child Behavior Checklist. Scores were then compared with age-matched cohort group consisting of 77 boys after hernia repairs that were utilized as a control.

The studied showed that when compared to the control subjects, the self reported quality of life of patients with hypospadias was lower in most dimensions. Interestingly the mother reported health related quality of life and psychological adjustment did not differ between the two groups. The older patients had a better self reported quality of life. The factors that contributed to better mother reported quality of life were positive penile self perception in the patient, the patient's experience of not having being teased about his penis, and a more severe hypospadias. The psychological adjustment was predicted by higher age, Swiss nationality, a more severe hypospadias, and the patient's experience of not having being teased about his penis.

The group concluded that in contrast to psychological adjustment, the self reported quality of life in boys with hypospadias is diminished. It seems overall the psychosocial factors are more important predictors than medical variables in this situation. It stands to reason, however, that one would believe that those with a more severe form of hypospadias would have greater difficulty in a psychosocial setting since typically the penis after reconstruction of a penoscrotal hypospadias typically looks different from those very mild distal hypospadias patients.

I feel the study would have even more of an impact if one sub-categorized the patients into proximal and distal hypospadias. It would be hard to believe that the proximal hypospadias patients who typically require more than one reconstruction and are usually not cosmetically superior to those with distal hypospadias not to have more of a psychosocial issue.

Schönbucher VB, Landolt MA, Gobet R, Weber DM

J Pediatr. 2008 Jun;152(6):865-72
doi: 10.1016/j.jpeds.2007.11.036

Reported by UroToday.com Medical Editor Pasquale Casale, MD

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