Health-related quality of life and psychological adjustment of children and adolescents with hypospadias

Abstract

OBJECTIVE: To assess health-related quality of life (HRQoL) and psychological adjustment of children and adolescents after hypospadias repair and to identify sociodemographic, medical, and psychosocial predictors of outcome. STUDY DESIGN: 77 boys (7-17 years old) who underwent surgery for hypospadias were investigated in a cross-sectional study. Child- and mother-rated HRQoL was evaluated by the TNO-AZL Child Quality of Life Questionnaire, psychological adjustment by the Child Behavior Checklist. Scores were compared with an age-matched control group consisting of 77 boys after hernia repair. RESULTS: Compared with the control subjects, self-reported HRQoL of patients with hypospadias was lower in most dimensions. In contrast, mother-reported HRQoL and psychological adjustment did not differ in the 2 groups. Higher age and "being less ashamed of penile appearance" predicted better self-reported HRQoL, whereas positive penile self-perception, the patient's experience of not having been teased about his penis, and more severe hypospadias contributed to better mother-reported HRQoL. Psychological adjustment was predicted by higher age, Swiss nationality, more severe hypospadias, and the patient's experience of not having been teased about his penis. CONCLUSIONS: In contrast to psychological adjustment, self-reported HRQoL of boys with hypospadias can be diminished. Psychosocial factors are more important predictors than medical variables.