Long-Term Outcomes of Interventions for Reproductive Dysfunction

生殖功能障碍干预措施的长期结果

• 批准号: 10112271
• 负责人: Larry L. Mullins
• 金额: $ 54.51万
• 依托单位: OKLAHOMA STATE UNIVERSITY STILLWATER
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-05 至 2023-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10112271
• 关键词: 5 year old; Adult; Affect; Age; Animals; Area; Behavioral; Benefits and Risks; Biological Assay; Brain; Caring; Child; Child Development; Childhood; Clinical; Cognitive; Communities; Complication; Consensus; Cosmetics; Data; Decision Making; Development; Diagnosis; Endocrinology; Etiology; Family Physicians; Fathers; Female; Feminization; Functional disorder; Future; Gender; Genital; Genitalia; Goals; Incontinence; Individual; Infant; Infection; Informed Consent; Institution; Intervention; Investigation; Longitudinal prospective study; Masculine; Measures; Medical; Medicine; Modernization; Monitor; Mothers; Natural History; Operative Surgical Procedures; Outcome; Parents; Pattern; Phenotype; Physicians; Postoperative Complications; Procedures; Psychological adjustment; Psychology; Public Health; Quality of life; Reaction; Recording of previous events; Regrets; Research Personnel; Residual state; Sex Functioning; Sexual Dysfunction; Social Development; Standardization; Surgeon; Surgical complication; Techniques; Time; Toilet Training; Translating; Uncertainty; Urethra; Urinary tract infection; Urination; Urology; ambiguous genitalia; anxiety symptoms; base; boys; care outcomes; cohort; depressive symptoms; early childhood; experience; girls; male; novel; novel marker; otoacoustic emission; patient population; post-traumatic symptoms; predictive marker; prospective; psychological outcomes; psychosocial adjustment; reproductive; reproductive function; sex; sex development disorder; social stigma; statistics; urinary

PROJECT SUMMARY/ABSTRACT Whether or not to surgically “correct” ambiguous genitalia in young children is an area of pediatric medicine that is highly controversial. Suboptimal outcomes such as poor cosmesis and sexual dysfunction following outdated surgical procedures have driven intense controversy in the medical community over how, or if, surgery should be used in the treatment of young children with ambiguous genitalia. To help resolve this debate, a prospective study of long-term outcomes of current surgical procedures, including complication rates associated with these procedures, is needed among individuals who receive masculinizing or feminizing surgery during early childhood. Additionally, studies of parents who decide to proceed, or not, with such surgeries for their young child are necessary to understand how these controversial decisions impact parents’ reactions to their child. Finally, better understanding of cognitive, behavioral, and social development in children born with ambiguous genitalia, including identification of novel markers for predicting gender development, is needed. The overall goal of this proposal is to assess the outcomes of modern surgical techniques with a consideration of the psychological outcomes of affected children and their parents. This information is crucial for physicians to provide guidance to parents regarding the optimal approach for the management of ambiguous genitalia in young children, including the possibility that no surgery is best. The interdisciplinary group of clinicians and researchers included in the proposed studies span the fields of psychology, statistics, pediatric endocrinology, and pediatric urology. The collective experience of our group optimizes our ability to translate findings from the proposed studies to a clinical setting in a timely manner.

项目总结/摘要 是否对年幼儿童的不明确生殖器进行手术“矫正”是儿科医学的一个领域 这是非常有争议的。不理想的结果，如美容效果差和性功能障碍， 过时的外科手术在医学界引起了激烈的争论，关于如何，或者是否， 对于有不明生殖器的幼儿，应采用手术治疗。以帮助解决此 辩论，一项关于当前外科手术长期结局的前瞻性研究，包括并发症发生率 在接受男性化或女性化治疗的个体中， 儿童早期的外科手术此外，对决定继续或不继续进行这种教育的父母的研究表明， 为他们年幼的孩子做手术是必要的，以了解这些有争议的决定是如何影响父母的 对孩子的反应。最后，更好地理解认知，行为和社会发展， 出生时生殖器不明确的儿童，包括确定用于预测性别的新标记 发展，是必须的。该提案的总体目标是评估现代外科手术的结果， 考虑到受影响儿童及其父母的心理后果的技术。这 信息对于医生向父母提供关于最佳方法的指导至关重要。 处理年幼儿童的不明生殖器，包括最好不要手术的可能性。的 拟议研究中包括的跨学科临床医生和研究人员小组涵盖以下领域： 心理学、统计学、儿科内分泌学和儿科泌尿学。我们小组的集体经历 优化我们及时将拟议研究结果转化为临床环境的能力。