Impact of the Age at Distal Hypospadias Surgery on Behavioral Problems, Somatic Symptoms and Irritability Levels in Children

J Pediatr Surg. 2024 Jun;59(6):1163-1169. doi: 10.1016/j.jpedsurg.2023.10.063. Epub 2023 Nov 3.

Abstract

Background: To assess the effect of age at hypospadias surgery on emotional and behavioural problems, somatic symptoms, irritability, and penile perception.

Methods: We retrospectively identified the patients who underwent single distal hypospadias surgery and age-matched healthy controls were included. There were two further subgroups according to the age at the time of hypospadias repair (<2 vs. >2 years). The Strengths and Difficulties Questionnaire (SDQ), Revised Children's Anxiety and Depression Scale (RCADS), Affective Reactivity Index (ARI), Level 2 Somatic Symptom Scale, and Penile Perception Score (PPS) scale were used. The groups were compared using multivariate variance analysis (MANOVA).

Results: Both groups consisted of 70 patients (mean age 14.0 ± 0.2 years, for both), while there were 34 patients in the hypospadias groups who underwent surgery at <2 years of age. Depressive, panic, separation anxiety, social phobia, and somatic complaint symptom scores of the hypospadias group were lower than those of the control group. Obsessive-compulsive symptom levels were significantly higher in patients who underwent hypospadias surgery at >2 vs. <2 years of age. Additionally, PPSs rated by the surgeon were significantly higher in the former. A multivariate linear regression model indicated that panic disorder symptom scores predicted child PPS in the hypospadias group. Limitations include retrospective design.

Conclusions: Single hypospadias surgery seems not to have a negative impact on emotional and behavioural status. Children who underwent distal hypospadias surgery after 2 years of age had higher levels of obsessive-compulsive symptoms. Following emotional status may help the early diagnosis of future psychopathologies.

Type of study: Retrospective comparative study.

Level of evidence: III.

Keywords: Anxiety; Behavioral problems; Depression; Hypospadias; Obsessive compulsive disorder; Penile perception.

MeSH terms

  • Adolescent
  • Age Factors
  • Case-Control Studies
  • Child
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / etiology
  • Child, Preschool
  • Humans
  • Hypospadias* / psychology
  • Hypospadias* / surgery
  • Infant
  • Irritable Mood*
  • Male
  • Retrospective Studies