Marte A, Pintozzi L, Prezioso M, Borrelli M, Pisano S
Pediatr Med Chir. 2014 Mar-Apr;36(2):77-9. doi: 10.4081/pmc.2014.14.
Although the long-term outcomes ofhypospadias surgery are considered important for psychosexual development, only a few attempts have been made to evaluate patient psico-pathology.
20 out 40 patients who received under sealed cover two envelopes--the first containing the assessment tools, the other empty and prepaid for the answer--joined the study. The results came from the analysis of anamnestic interview specially created in order to gather information on how to access to surgery and the degree of information that the parents had from the surgeon, from the analysis of the CBCL (Child Behavior CheckList 2001:4-16 years) and TMA (Multidimensional self-esteem Test: the Italian version of the MSCS Multidimensional Self-Concept Scale). Of the 20 patients recruited, 15, aged from 9 to 18 years (mean age 12.5), age at operation between 2 and 5 years (mean age 3.3 yrs), have returned the questionnaires correctly compiled. Patient data were compared with those of a control group not suffering from genital pathology.
From the CBCL: the area of the identification of the problems showed no significant differences between the study group and the control. The area of competence, altered in both groups, did not show statistically significant differences. From the analysis of TMA: there were no statistically significant differences between the two groups in sub-domains: Social, Competence, Affect, Family and Physical. Within the subdomain school the two groups differed significantly for low self-esteem in the group of surgical patients.
The MST test indicate that hypospadias surgery does not change the global self-esteem but, surprisingly, at least in this patient population, only a lower self-esteem in school performance in the age group considered. This study may indicate the importance of psychological support during the transition from adolescence to adulthood.
虽然尿道下裂手术的长期结果被认为对心理性发育很重要，但仅有少数研究尝试评估患者的心理病理学状况。
40名患者中有20名参与了该研究，他们收到两个密封信封，第一个装有评估工具，另一个为空信封且已预付回信邮资。研究结果来自于专门设计的回忆性访谈分析，该访谈旨在收集有关手术获取途径以及父母从外科医生处获得的信息程度的信息，还来自于儿童行为检查表（CBCL，适用于2001年4至16岁儿童）和多维自尊测试（TMA，MSCS多维自我概念量表的意大利语版本）的分析。在招募的20名患者中，15名年龄在9至18岁之间（平均年龄12.5岁），手术年龄在2至5岁之间（平均年龄3.3岁），他们正确填写并返还了问卷。将患者数据与未患生殖器疾病的对照组数据进行比较。
从CBCL来看：问题识别领域在研究组和对照组之间没有显著差异。两组中均出现改变的能力领域，未显示出统计学上的显著差异。从TMA分析来看：两组在社会、能力、情感、家庭和身体等子领域没有统计学上的显著差异。在学校子领域内，手术患者组在自尊方面明显低于对照组。
MST测试表明尿道下裂手术不会改变整体自尊，但令人惊讶的是，至少在该患者群体中，仅在所考虑的年龄组的学业表现方面自尊较低。本研究可能表明在从青春期到成年期的过渡过程中提供心理支持的重要性。
