Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Intracavernosal pressure of the erect penis in children with hypospadias

International Journal of Impotence Research volume 36, pages 68–71 (2024)Cite this article

Subjects

Abstract

This study objective is to examine the intracavernosal pressure (ICP) in hypospadias boys with and without previous corporotomies. Retrospectively, the ICPs that were measured routinely as part of the artificial erection test in boys who underwent hypospadias repair were collected. The measurement (mmHg) included a slow manual saline instillation and a 21-gauge needle in the corpora cavernosa, which was connected to a pressure monitor. The full and rigid erections were defined according to the Erection Hardness Score by agreement between the two surgeons operating on the patient. Included were 61 boys with a median age of 15 months (IQR 8–27). Group A included 32 boys with coronal, subcoronal, or penile hypospadias. Group B included 29 boys with penoscrotal, scrotal, and perineal hypospadias. The median pressures at full erection for Groups A and B were 71.5 (IQR 59–79) and 62.5 (IQR 48–71) (p = 0.036), respectively, and at rigid erection were 283 (IQR 219-310) and 237 (IQR 182–278) (p = 0.032), respectively. In group B, median pressures at full erection for boys with and without previous corporotomies were 53.5 (IQR 45–65) and 69 (IQR 57–82), respectively (p = 0.001), and at rigid erection were 189.5 (IQR 113–263) and 264.5 (IQR 226–298), respectively (p = 0.003). In a comparison between group A boys to 18 boys in group B who did not have corporotomies, the median pressures at full erection were 71.5 (IQR 59–79) and 69 (IQR 57–82), respectively (p = 0.9), and at rigid erection were 283 (IQR 219–310) and 264 (IQR 226–298), respectively (p = 0.86). In conclusion, ICPs of artificial erections are lower in proximal hypospadias and in boys with previous corporotomies. The durability and the implications of these pressures require further research.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Artificial erection during hypospadias repair.
Fig. 2: Intracavernosal pressures of group A vs. group B.
Fig. 3: Intracavernosal pressures of patients in group B who had coroporotomies vs. patients in group B with no prior corporotomies.

Similar content being viewed by others

Data availability

The datasets generated during and analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Sattar AA, Salpigides G, Vanderhaeghen JJ, Schulman CC, Wespes E. Cavernous oxygen tension and smooth muscle fibers: relation and function. J Urol. 1995;154:1736–9.

    Article  CAS  PubMed  Google Scholar 

  2. Meehan JP, Goldstein AM. High pressure within corpus cavernosum in man during erection. Its probable mechanism. Urology. 1983;21:385–7. https://doi.org/10.1016/0090-4295(83)90158-9.

    Article  CAS  PubMed  Google Scholar 

  3. Snodgrass W, Bush N. Staged Tubularized Autograft Repair for Primary Proximal Hypospadias with 30-Degree or Greater Ventral Curvature. J Urol. 2017;198:680–6.

    Article  PubMed  Google Scholar 

  4. Tack LJW, Springer A, Riedl S, Tonnhofer U, Hiess M, Weninger J. et al. Adolescent and Young Adult Urogenital Outcome following Childhood Hypospadias Repair: Perfection Revisited. J Urol. 2021;206:734–44. https://doi.org/10.1097/JU.0000000000001869.

    Article  PubMed  Google Scholar 

  5. Gul M, Hildorf S, Silay MS. Sexual functions and fertility outcomes after hypospadias repair. Int J Impot Res. 2021;33:149–63. https://doi.org/10.1038/s41443-020-00377-5.

    Article  PubMed  Google Scholar 

  6. Mulhall JP, Goldstein I, Bushmakin AG, Cappelleri JC, Hvidsten K. Validation of the erection hardness score. J Sex Med. 2007;4:1626–34. https://doi.org/10.1111/j.1743-6109.2007.00600.x.

    Article  PubMed  Google Scholar 

  7. Koraitim M. Predicting risk of erectile dysfunction after pelvic fracture urethral injury in children. J Urol. 2014;192:519–23.

    Article  PubMed  Google Scholar 

  8. Ritenour CW, Seidel KD, Leisenring W, Mertens AC, Wasilewski-Masker K, Shnorhavorian M, et al. Erectile Dysfunction in Male Survivors of Childhood Cancer—A Report From the Childhood Cancer Survivor Study. J Sex Med. 2016;13:945–54.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Gamé X, Moscovici J, Gamé L, Sarramon JP, Rischmann P, Malavaud B. Evaluation of sexual function in young men with spina bifida and myelomeningocele using the International Index of Erectile Function. Urology. 2006;67:566–70. https://doi.org/10.1016/j.urology.2005.09.014.

    Article  PubMed  Google Scholar 

  10. Mulhall JP, Luo X, Zou KH, Stecher V, Galaznik A. Relationship between age and erectile dysfunction diagnosis or treatment using real-world observational data in the USA. Int J Clin Pr. 2016;70:1012–8. https://doi.org/10.1111/ijcp.12908.

    Article  CAS  Google Scholar 

  11. Husmann DA. Erectile dysfunction in patients undergoing multiple attempts at hypospadias repair: Etiologies and concerns. J Pediatr Urol. 2021;17:166.e1–166.e7.

    Article  CAS  PubMed  Google Scholar 

  12. NA: NIH Consensus Conference. Impotence. NIH Consensus Development Panel on Impotence. JAMA. 1993;270:83–90.

    Article  Google Scholar 

  13. Anatomy and physiology of erection: pathophysiology of erectile dysfunction. Int J Impot Res. 2003;15S5-S8. https://doi.org/10.1038/sj.ijir.3901127.

  14. Cellek S, Cameron NE, Cotter MA, Muneer A. Pathophysiology of diabetic erectile dysfunction: potential contribution of vasa nervorum and advanced glycation endproducts. Int J Impot Res. 2013;25:1–6. https://doi.org/10.1038/ijir.2012.30.

    Article  CAS  PubMed  Google Scholar 

  15. Xu CC, Pan YN, Tang YF, Zhang J, Wang GY, Huang QL. Comprehensive assessment of cavernosography with 320-row dynamic volume CT versus conventional cavernosography in erectile dysfunction patients caused by venous leakage. Biosci Rep. 2017;37:BSR20170112. https://doi.org/10.1042/BSR20170112.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Lucas-Herald AK, Montezano AC, Alves-Lopes R, Haddow L, Alimussina M, O’Tooleet S, et al. Vascular dysfunction and increased cardiovascular risk in hypospadias. Eur Heart J. 2022;43:1832–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Urology Unit, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel

    David Ben-Meir & Michael Frumer

  2. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    David Ben-Meir, Firas Abu Sbaih & Michael Frumer

  3. Anesthesiology department, Schneider Children’s Medical Center of Israel, Petah Tikva, Israel

    Firas Abu Sbaih

Authors
  1. David Ben-Meir
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Firas Abu Sbaih
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Michael Frumer
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

DB-M: conceptualization, methodology, investigation, data curation, writing—original draft. FAS: methodology, investigation. MF: formal analysis, data curation, writing—review and editing, visualization. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Michael Frumer.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

IRB approval number 0267-22 RMC.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ben-Meir, D., Abu Sbaih, F. & Frumer, M. Intracavernosal pressure of the erect penis in children with hypospadias. Int J Impot Res 36, 68–71 (2024). https://doi.org/10.1038/s41443-023-00788-0

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41443-023-00788-0

This article is cited by

Search

Advanced search

Quick links