Mondaini Nicola, Ponchietti Roberto, Bonafè Massimiliano, Biscioni Stefano, Di Loro Filippo, Agostini Paolo, Salvestrini Francesco, Rizzo Michelangelo
Department of Urology, University of Florence, Italy.
Urol Int. 2002;68(2):81-5. doi: 10.1159/000048423.
We evaluated the incidence of hypospadias and its effects on psychosexual development in a sample of 11,649 young Italian males. Over the last 30 years only about 30 major publications have addressed these issues and the results of many studies have been contrasting. Some defects in methodology, such as low response rates, heterogeneity of age ranges and the choice of controls, have been the main limitations. Our study was designed to take these problems into account.
Forty-two hypospadic subjects and a random sample of 500 nonaffected males selected from the large sample of 11,649 young men (>90% of the 18-year-old males living in the Italian region of Tuscany) were screened by the Minnesota Multiphasic Personality Inventory (MMPI) test, psychological interview and clinical evaluation.
The incidence of hypospadias in this representative group of Italian men is 3.6/1,000. No difference was noted in the percentage with altered MMPI compared with the control group. The age at surgical corrections and the number of operations are not related to an abnormal global psychological adjustment. Severity of disease influences a more negative genital appraisal and the number of operations is correlated only with more difficulty in initiating contact with the opposite sex.
Surgery for hypospadias has to be strongly pursued in as many cases as possible. In addition, we strongly recommend following up all hypospadics, independently of the severity of their genital malformations, through adolescence to early adulthood, to ensure early detection of subjects with impaired psychological profiles.
我们评估了11649名意大利年轻男性样本中尿道下裂的发病率及其对心理性发育的影响。在过去30年里，仅有约30篇主要出版物探讨了这些问题，且许多研究结果相互矛盾。方法学上的一些缺陷，如低应答率、年龄范围的异质性以及对照的选择，一直是主要限制因素。我们的研究旨在考虑这些问题。
通过明尼苏达多相人格调查表（MMPI）测试、心理访谈和临床评估，对42名尿道下裂患者以及从11649名年轻男性大样本（居住在意大利托斯卡纳地区的18岁男性中超过90%）中随机抽取的500名未患病男性进行筛选。
在这一具有代表性的意大利男性群体中，尿道下裂的发病率为3.6/1000。与对照组相比，MMPI改变的百分比无差异。手术矫正的年龄和手术次数与整体心理调适异常无关。疾病严重程度影响更负面的生殖器评价，手术次数仅与开始与异性接触时的更多困难相关。
必须尽可能多地对尿道下裂进行手术治疗。此外，我们强烈建议，无论生殖器畸形的严重程度如何，对所有尿道下裂患者在青春期至成年早期进行随访，以确保早期发现心理状况受损的患者。
