Observational studyPediatric surgery international2025
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.
Observational study in Pediatric surgery international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- An improved surgical technique for penoscrotal transposition: the penile upward migration method.BMC surgery · 2026Article
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6 authors.
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Abstract
purposeHypospadias 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.
methodsIn 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.
resultsSixty-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).
conclusionHigh 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.
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