Even L, Bouali O, Moscovici J, Huyghe E, Pienkowski C, Rischmann P, Galinier P, Game X
Service d'urologie, transplantation rénale et andrologie, CHU Rangueil, 1, allée du Pr-J.-Poulhès, TSA 50032, 31059 Toulouse cedex 9, France.
Service de chirurgie pédiatrique, hôpital des enfants, 330, avenue de Grande-Bretagne, 31059 Toulouse cedex 9, France.
Prog Urol. 2015 Sep;25(11):655-64. doi: 10.1016/j.purol.2015.04.006. Epub 2015 Jun 3.
To evaluate outcomes and long-term sexual quality of life after hypospadias surgery. Seventeen-years-old patients operated for a posterior hypospadias in childhood were included in a transversal study.
Fifteen patients, among the forty children treated since 1997, accepted to participate. These young men (mean age at the first surgery was 27.9±20months) were clinically reviewed and responded to questionnaires (EUROQOL 5, IIEF15 and non-validated questionnaire). This study arises about 8.4±5years after the last visit in paediatric department.
Mean study age was 21.2±4.7years. One third of patients thought that global quality of life was distorted. Although 33% of the patients had erectile dysfunction, 80% were satisfied with their sexual quality of life. The most important complains were relative to the penile appearance. Number of procedures was not predictive of patient's satisfaction about penile function and appearance. Thirty-three percents of the patients would have been satisfied to have psychological and medical support. They would be interested in having contact with patients who suffered from the same congenital abnormality.
These patients had functional and esthetical disturbances. This visit leads to a specific visit in 20% cases. In this study, medical follow-up does not seem to be counselling and had to be adapted. Adequate follow-up transition between paediatric and adult departments especially during adolescence seems to be necessary.
评估尿道下裂手术后的结果及长期性生活质量。对17岁时在儿童期接受过阴茎后型尿道下裂手术的患者进行了一项横断面研究。
在1997年以来接受治疗的40名儿童中，有15名患者同意参与。这些年轻男性（首次手术时的平均年龄为27.9±2.0个月）接受了临床检查并回答了问卷（欧洲五维健康量表、国际勃起功能指数15项以及一份未经验证的问卷）。本研究是在儿科最后一次就诊约8.4±5年后开展的。
研究对象的平均年龄为21.2±4.7岁。三分之一的患者认为总体生活质量受到了影响。尽管33%的患者存在勃起功能障碍，但80%的患者对其性生活质量感到满意。最主要的抱怨与阴茎外观有关。手术次数并不能预测患者对阴茎功能和外观的满意度。33%的患者表示若能获得心理和医疗支持会感到满意。他们有兴趣与患有相同先天性异常的患者取得联系。
这些患者存在功能和美学方面的问题。此次就诊导致20%的病例需要进行专项就诊。在本研究中，医疗随访似乎缺乏咨询服务，必须加以改进。儿科和成人科室之间进行充分的随访过渡，尤其是在青春期，似乎很有必要。
