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Reply to Editorial Comment on “Adult Sexual Function Following Hypospadias Repair in Childhood: A Systematic Review and Meta-Analysis of Long-Term Patient Outcomes”
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2025-10-31
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1-s2.0-S0090429525006065-main.pdf
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Abstract
We appreciate the insightful editorial commentary on our review.1 We appreciate their insightful thoughts on the variability in reported outcomes and the key factors that might influence adult sexual function in this population. In particular, they noted how patient-related factors, such as the severity of hypospadias (proximal vs distal), requirement of multiple surgeries, and management of foreskin may all influence differing results, points that we fully recognize and agree with.
Heterogeneity in patient populations and surgical complexities has likely led to this variation in long-term results between studies.1 We agree that proximal hypospadias, particularly cases requiring staged or multiple surgeries, are associated with increased incidence of sexual problems over distal cases. While patients with distal hypospadias generally report favorable sexual outcomes, those with proximal hypospadias may face a greater risk of complications such as erectile dysfunction, diminished genital self-image, or sexual anxiety.1, 2 These findings support the comments on considering hypospadias severity and surgical history when interpreting long-term results.