Psychosocial Adjustment, Health-Related Quality of Life, and Psychosexual Development of Boys with Hypospadias: A Systematic Review

Objective A systematic review of studies on psychosocial adjustment, HRQoL (health-related quality of life), and psychosexual development of boys with hypospadias. Methods Research was conducted on several online bibliographic databases. Articles were selected on the basis of predefined criteria. Methodological quality was assessed by two independent reviewers who applied a standardized checklist. When possible, data analyses were performed by calculating effect sizes. Results Thirteen studies met the criteria for inclusion, whose methodological standard ranged from low to high quality. None of them has focused on HRQoL. Findings with regard to psychosocial and psychosexual adjustment were inconsistent, though they clearly showed that boys with hypospadias suffer from negative genital appraisal and sexual inhibitions. Overall, medical factors exerted a rather small influence. Psychosocial risk factors have hardly been examined so far. Conclusions The identification of psychosocial risk factors in methodologically sound studies is necessary to guarantee a comprehensive treatment for boys with hypospadia

Adolescent perspectives on social support received in the aftermath of sexual abuse: a qualitative study

The extent and quality of social support provided to young survivors of sexual abuse (SA) have only rarely been examined. This qualitative study aimed to investigate adolescent perspectives on social support received in the aftermath of SA. A total of 26 sexually victimized adolescents (15-18 years old) participated in a qualitative face-to-face, in-depth interview that focused on perceived social support. Qualitative content analysis was conducted as per Mayring (2008) using the qualitative data analysis program ATLAS.ti. In addition, quantitative correlational analyses were conducted to identify characteristics of SA and their associations with perceived social support. Although participants perceived parental support as the most necessary type of support, they were much more satisfied with support from peers. In particular, adolescents stated that they wished they had received more emotional support from their parents in order to better cope with the abuse. About half of participants reported having received counseling, and counseling was seen as very helpful in dealing with the consequences of SA. Only a few adolescents mentioned their school as a source of support. Intra-familial abuse, younger victim age at the time of abuse, an adult perpetrator, and severe abuse were all negatively associated with satisfaction with perceived support. Our results suggest that support for young survivors of SA needs to be improved. Prevention of SA needs particular focus on improving parental reactions to SA, facilitating access to professional support, and raising teacher awareness of the importance of their role in the provision of support for sexually victimized children

Psychosexual development of children and adolescents with hypospadias

INTRODUCTION: Hypospadias is the most common malformation of the penis. Despite the common assumption that hypospadias may affect children's psychosexual development, only a few studies report on the patients' psychosexual adjustment during childhood and adolescence. AIM: A comprehensive, cross-sectional investigation of the psychosexual development of boys operated on for hypospadias in comparison to a healthy control group. METHODS: Sixty-eight children and adolescents (7-17 years) operated on for hypospadias were examined by means of a standardized interview assessing penile self-perception, gender-role behavior, sexual experiences, and sexual attitude. Scores were compared to an age-matched control group consisting of 68 boys after hernia repair. Predictive values of medical variables as well as the patients' knowledge of hypospadias were assessed. MAIN OUTCOME MEASURES: The Pediatric Penile Perception Score, the Gender-Role Questionnaire by Ijntema and Cohen-Kettenis, and a self-developed questionnaire on first sexual experiences and sexual attitude comprised the standardized assessment instruments. RESULTS: Boys with hypospadias did not significantly differ from the control subjects with regard to penile self-perception, gender-role behavior, first sexual experiences, and sexual attitude. Younger age and the patient's knowledge of hypospadias predicted a more positive penile self-perception, while a more pronounced masculine gender-role behavior was best predicted by younger age at final surgery. CONCLUSIONS: Boys with corrected hypospadias may show a psychosexual development that is similar to healthy children. Puberty could be a critical time for the patients, however, during which they might require regular urological follow-ups and may benefit from age-appropriate information about their penile condition. Moreover, the later corrective surgery is completed, the more likely the patients may become insecure with regard to gender-role behavior