Partners may not spot penis repair for common birth defect

Men don't need to live in fear of ridicule over the appearance of their penis after getting surgery to correct a birth defect that causes urine to come out in the wrong place, a Swiss study suggests.

Researchers focused on a condition known as hypospadias, a birth defect that affects around 1 in 200 boys and causes the urethra to form abnormally with an opening for urine anywhere from just below the end of the penis to the scrotum.

Men with corrected hypospadias - a surgery typically done between ages 3 months and 18 months - often suffer from sexual inhibition and fear of being ridiculed for their penile appearance, researchers note in the Journal of Pediatric Urology.

But when researchers asked 175 adults unfamiliar with this condition to assess pictures of penises, people didn't rate the men who had surgery to repair hypospadias any differently than men who had been circumcised.

"This information is important for hypospadias patients and their parents because it might reduce possible worries," lead study author Dr. Norma Ruppen-Greeff of the University Children's Hospital Zurich said by email.

To see how people perceived hypospadias, Ruppen-Greeff and colleagues recruited men and women aged 16 to 45 and asked them to rate non-erect genitals they saw in photos.

Participants looked at 10 photo sets of circumcised genitals and 10 photo sets of penises with hypospadias repairs, pairing images of similar penile size, age, and body weight.

They were asked to rate the images on a 4-point scale from very satisfactory to very unsatisfactory and assess penile length, girth, position and shape of the meatus, shape of the glans, appearance of the scrotum, shape of the penile skin and appearance of pubic hair.

Overall, participants rated genitals of men with what's known as distal hypospadias - the most common and less severe form - similarly to circumcised men without hypospadias.

People viewed the rarer, more severe form known as proximal hypospadias less favorably, but there still wasn't a clinically relevant difference, the researchers conclude.

One shortcoming of the study, the authors acknowledge, is that they lacked data about the perception of curvature of the penis that can occur with hypospadias because they used images of non-erect genitals.

It's also possible that the results might be different when genitals with hypospadias repairs are compared to uncircumcised penises, noted Kimihiko Moriya, a researcher at Hokkaido University in Japan who wasn't involved in the study.

"Circumcision is not a universally accepted custom," Moriya said by email.

Still, the findings should comfort the majority of men who have had surgery to repair less severe hypospadias, said Dr. Alexander Springer, a pediatric urology researcher at Medical University Vienna in Austria who wasn't involved in the study.

"Generally speaking, minor forms of hypospadias may not be a major problem," Springer said by email. "We have to take care of children with severe hypospadias and follow them up to adolescence and beyond because we know that those are the ones that might need help and counseling later in life."