Parental Decisional Regret after Primary Distal Hypospadias Repair: Family and Surgery Variables, and Repair Outcomes
Parental Decisional Regret after Primary Distal Hypospadias Repair: Family and Surgery Variables, and Repair Outcomes
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DOI：
10.1016/j.juro.2015.10.118
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发表时间：
2016-03-01
影响因子：
6.6
通讯作者：
Castagnetti, Marco
中科院分区：
文献类型：
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作者：
Ghidini, Filippo;Sekulovic, Sasa;Castagnetti, Marco
目的：决定性后悔被定义为在做出医疗保健选择后的痛苦，对于为儿子选择远端尿道下裂修复术的父母来说，这可能是一个问题。我们评估了与家庭、手术和结局相关的变量对决定性后悔的影响。材料和方法：回顾了2005年至2012年期间接受原发性远端尿道下裂修复术的372例患者的图表，并向父母发放了经验证的问卷，包括决定性后悔量表、小儿阴茎感知评分和功能障碍排尿和勃起评分系统。372个家庭中有172个家庭的数据可用（应答率46.2%）。在323名父母中，128名（39.6%）表现出中等程度的决策后悔，夫妻之间的一致性很好。决策后悔的预测因素包括父母的中等教育水平（OR 3.19，95% CI 1.52-6.69），患者不是第一胎（OR 2.01，95%CI 1.07-3.78），尿道下裂家族史（OR 4.42，95% CI 1.96-9.97），最初希望避免手术（OR 2.07，95% CI 1.04-4.12），随访时年龄较小（OR 0.81，95% CI 0.72-0.91），存在下尿路症状（OR 4.92，95% CI 1.53-15.81）和儿童阴茎知觉评分较低（OR 0.86，95% CI 0.75-0.99）。决定性的遗憾是无关的父母的愿望，以避免包皮环切术，手术变量，并发症的发展和follow-up.Conclusions持续时间：决定性的遗憾是一个问题，在一个显着比例的父母选择远端尿道下裂修复他们的儿子。根据我们的经验，家庭变量似乎是决定性后悔的预测因子，而手术变量则不是。决定性后悔的预测因素包括父母对阴茎外观的感知较差和下尿路症状的存在。然而，后者可能与手术无关。无论随访时间长短，老年患者的父母的决定性后悔似乎减少了。
Purpose: Decisional regret is defined as distress after making a health care choice and can be an issue for parents electing distal hypospadias repair for their sons. We assessed the influence on decisional regret of variables related to the family, surgery and outcomes.Materials and Methods: Charts for 372 patients undergoing primary distal hypospadias repair between 2005 and 2012 were reviewed, and validated questionnaires, including the Decisional Regret Scale, Pediatric Penile Perception Score and Dysfunctional Voiding and Incontinence Scoring System, were administered to parents.Results: Data were available for 172 of 372 families (response rate 46.2%). Of 323 parents 128 (39.6%) presented with moderately strong decisional regret, with good agreement within couples. Predictors of decisional regret included intermediate parental educational level (OR 3.19, 95% CI 1.52-6.69), patient not being the first born (OR 2.01, 95% CI 1.07-3.78), family history of hypospadias (OR 4.42, 95% CI 1.96-9.97), initial desire to avoid surgery (OR 2.07, 95% CI 1.04-4.12), younger age at followup (OR 0.81, 95% CI 0.72-0.91), presence of lower urinary tract symptoms (OR 4.92, 95% CI 1.53-15.81) and lower Pediatric Penile Perception Score (OR 0.86, 95% CI 0.75-0.99). Decisional regret was unrelated to parental desire to avoid circumcision, surgical variables, development of complications and duration of followup.Conclusions: Decisional regret is a problem in a significant proportion of parents electing distal hypospadias repair for their sons. In our experience family variables seemed to be predictors of decisional regret, while surgical variables did not. Predictors of decisional regret included worse parental perception of penile appearance and the presence of lower urinary tract symptoms. However, the latter could be unrelated to surgery. Irrespective of the duration of followup, decisional regret seems decreased in parents of older patients.