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Purpose <p>Hypospadias affects roughly 1 in 125 live male births, yet subjective outcome assessment is infrequent. We compared child- and parent-reported cosmetic satisfaction after repair and quantified inter-rater agreement.</p> Methods <p>In this cross-sectional study, all boys aged 7–15&#xa0;years who attended follow-up at Hospital Sultanah Bahiyah, Malaysia (repairs 2017–2019), were invited. Each child–parent dyad independently completed the Paediatric Penile Perception Score (PPPS; four domains, 1 = very dissatisfied to 4 = very satisfied). Paired Wilcoxon tests examined child-parent differences. Concordance was analysed with Spearman’s ρ and quadratic-weighted Cohen’s κ.</p> Results <p>Sixty-three dyads participated (median child age 10.6&#xa0;years). Median satisfaction for every domain was 3 [IQR 2–3] in both cohorts. Children rated penile-skin appearance one Likert step lower than parents (median difference − 1; <i>p</i> = 0.033); no other paired differences reached significance. Correlations between raters were moderate (<i>ρ</i> = 0.49–0.61). Agreement was fair for penile skin (κ = 0.27) and moderate for meatus position (κ = 0.56, 95% CI 0.29–0.77), glans shape (κ = 0.43) and overall appearance (κ = 0.45).</p> Conclusion <p>High overall satisfaction was reported despite surgical delays. Only moderate concordance emerged, with children less pleased with penile skin than their parents. Pre-operative counselling and longitudinal follow-up should explicitly address child-centred aesthetic concerns to enhance psychosocial well-being.</p>

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Intradyadic analysis of child parent perceptions of penile appearance post-hypospadias repair using the Paediatric Penile Perception Score (PPPS) in a middle-income country setting

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  • 发表日期：

    2025年7月22日

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  • Anand Sanmugam,
  • Tharisinidevi Kunasekaran,
  • Wei Sheng Tan,
  • Srihari Singaravel,
  • Yew-Wei Tan,
  • Shireen Anne Nah

摘要

Purpose

Hypospadias affects roughly 1 in 125 live male births, yet subjective outcome assessment is infrequent. We compared child- and parent-reported cosmetic satisfaction after repair and quantified inter-rater agreement.

Methods

In this cross-sectional study, all boys aged 7–15 years who attended follow-up at Hospital Sultanah Bahiyah, Malaysia (repairs 2017–2019), were invited. Each child–parent dyad independently completed the Paediatric Penile Perception Score (PPPS; four domains, 1 = very dissatisfied to 4 = very satisfied). Paired Wilcoxon tests examined child-parent differences. Concordance was analysed with Spearman’s ρ and quadratic-weighted Cohen’s κ.

Results

Sixty-three dyads participated (median child age 10.6 years). Median satisfaction for every domain was 3 [IQR 2–3] in both cohorts. Children rated penile-skin appearance one Likert step lower than parents (median difference − 1; p = 0.033); no other paired differences reached significance. Correlations between raters were moderate (ρ = 0.49–0.61). Agreement was fair for penile skin (κ = 0.27) and moderate for meatus position (κ = 0.56, 95% CI 0.29–0.77), glans shape (κ = 0.43) and overall appearance (κ = 0.45).

Conclusion

High overall satisfaction was reported despite surgical delays. Only moderate concordance emerged, with children less pleased with penile skin than their parents. Pre-operative counselling and longitudinal follow-up should explicitly address child-centred aesthetic concerns to enhance psychosocial well-being.