Long-term sexual activity status and influencing factors in men after surgery for hypospadias.

The aim of this study was to compare the long-term postoperative status of hypospadiac patients by analysing their sexual psychology, sexual behaviour, sexual function and influencing factors. A total of 130 hypospadiac patients hospitalized between January 1988 and December 2007 were followed up with questionnaires using Zung's Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS), a self-designed sexual function questionnaire and a 5-item version of the International Index of Erectile Function (IIEF-5). The surveys served to evaluate the effects of hypospadias type, number of operations and surgical procedures on sexual psychology, sexual behaviour and sexual function. The control group consisted of 50 healthy adults. The postoperative SDS / SAS scores and occurrences of depression/anxiety in hypospadiac patients were significantly higher than those of normal controls (P < 0.001). Patients with proximal hypospadias and multiple procedures differed from those with distal hypospadias and a single procedure in all parameters of sexual psychology (P < 0.05). The average penile lengths and circumferences of hypospadiac patients under either erect or flaccid conditions were significantly shorter than those of normal controls (P < 0.001). A similar difference existed between patients with distal and proximal hypospadias (P < 0.01). There was no significant difference in any parameter of sexual function between patients with different numbers of operations and surgical procedures. Hypospadiac patients were clearly impaired in sexual psychology and penile development. The severity of hypospadias and number of operations were key factors that influenced the sexual psychology of patients. This finding indicated the importance of long-term follow-up and psychological counselling for hypospadiac patients postoperatively.

Laparoscopic management of Müllerian duct remnants: four case reports and review of the literature.

Several experiences with laparoscopic management of müllerian duct remnants (MDRs) have been reported to date. This report outlines our experience and reviews the present literature to evaluate the results of laparoscopic excision of MDR. Between April 2003 and December 2007, 4 male patients (age range, 6-20 years) with MDR underwent laparoscopic excision in our center. A literature search revealed 5 additional reports of laparoscopic excision of MDR, comprising 13 patients (age range, 1.5-48 years). For the 4 patients in our center, the operative time was 135-200 minutes (mean, 159 minutes) and the estimated blood loss was 20-100 mL (mean, 48 mL). For the 13 patients in the literature reviewed, the operative time was 105-360 minutes (mean, 190 minutes) and the estimated blood loss was 50-200 mL. All of these 17 patients recovered uneventfully with no complications. A small prostatic diverticulum had been found in 1 case at 6 years postoperatively; no recurrent evidence or voiding dysfunction had been found in the other 16 patients during 3-50 months of follow-up. No patient had required any further operative therapy. Laparoscopic excision of MDR is a safe and effective surgical procedure, associated with minimal invasion, minimal postoperative morbidity, and rapid recovery for the patient.