Spyropoulos Evangelos, Galanakis Ioannis, Dellis Athanasios
Department of Urology, Naval and Veterans Hospital of Athens, Athens, Greece.
Urology. 2007 Aug;70(2):221-6. doi: 10.1016/j.urology.2007.03.053.
To introduce a novel questionnaire by which we attempted to identify the most suitable candidates for augmentation phalloplasty surgery for penile dysmorphophobia and to objectively estimate the outcome.
A total of 45 physically normal young adult men who presented with complaints of a "small penis" and were seeking surgical correction were included in the study. In addition to the ordinary evaluation, all completed the questionnaire devised by our department, the Augmentation Phalloplasty Patient Selection and Satisfaction Inventory (APPSSI). The APPSSI aims to quantitatively assess the severity of the condition and the degree of the patient's willingness to undergo penile augmentation and to numerically measure the postoperative result. The APPSSI consists of four questions, with each having five possible answers (scale 0 to 4). Questions 1 through 3 were asked preoperatively (suitability assessment) and questions 1, 2, and 4 postoperatively (outcome evaluation). The eligibility threshold for surgery was a preoperative score of 6 or less. The preoperative scores ranged from 0 (surgery justified) to 12 (surgery not justified), and the postoperative scores ranged from 0 (disappointed) to 12 (excited). The Student t test was used for statistical analysis, and P <0.05 was considered to indicate statistical significance.
Of the 45 patients, 13 (28.8%) with an APPSSI score of 6 or less (mean 3.18) underwent penile lengthening (n = 7), lengthening-enlargement (n = 4), or celioplasty-penile lengthening (n = 2). Postoperatively, the score increased by 4.36 (mean 7.54, P <0.001), and the condition improved by 25% to 50% in 11 patients, 66.6% in 1, and remained unchanged (0%) in 1 patient.
The APPSSI questionnaire properly identified patients who significantly benefited from augmentation phalloplasty. Nevertheless, because of the small sample size and nonrandomized study, the questionnaire's validation requires a larger number of patients tested in a randomized manner by more researchers to become a valuable clinical instrument and patient eligibility criterion for this type of surgery.
引入一种新型问卷，通过该问卷我们试图确定阴茎畸形恐惧症患者中最适合阴茎增大成形手术的候选人，并客观评估手术结果。
共有45名身体正常的年轻成年男性纳入本研究，他们主诉“阴茎短小”并寻求手术矫正。除常规评估外，所有患者均完成了由本部门设计的问卷，即阴茎增大成形患者选择与满意度量表（APPSSI）。APPSSI旨在定量评估病情严重程度和患者接受阴茎增大手术的意愿程度，并以数值方式衡量术后结果。APPSSI由四个问题组成，每个问题有五个可能的答案（0至4分）。问题1至3在术前询问（适用性评估），问题1、2和4在术后询问（结果评估）。手术的合格阈值是术前得分6分及以下。术前得分范围为0（手术合理）至12分（手术不合理），术后得分范围为0（失望）至12分（兴奋）。采用Student t检验进行统计分析，P<0.05被认为具有统计学意义。
45例患者中，13例（28.8%）APPSSI得分6分及以下（平均3.18分）接受了阴茎延长术（n = 7）、延长增粗术（n = 4）或腹壁成形阴茎延长术（n = 2）。术后，得分增加了4.36分（平均7.54分，P<0.001），11例患者病情改善25%至50%，1例改善66.6%，1例患者病情无变化（0%）。
APPSSI问卷正确识别了从阴茎增大成形术中显著受益的患者。然而，由于样本量小且研究未随机化，该问卷的验证需要更多研究人员以随机方式测试更多患者，才能成为此类手术有价值的临床工具和患者合格标准。
