Liu Mona M Y, Holland Andrew J A, Cass Danny T
Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney Medical School, The University of Sydney, Westmead, Australia.
Department of Paediatric Surgery, The Children's Hospital at Westmead, Sydney Medical School, The University of Sydney, Westmead, Australia.
J Pediatr Surg. 2015 Dec;50(12):2071-4. doi: 10.1016/j.jpedsurg.2015.08.047. Epub 2015 Sep 1.
A standardized assessment for the optimal repair of hypospadias remains elusive. This study utilized validated questionnaires to assess the postoperative functional, cosmetic, and psychosocial outcomes of hypospadias repair.
172 patients who underwent hypospadias repair under the care of a single surgeon were identified. 25 agreed for follow-up using the validated questionnaires of Hypospadias Objective Scoring Evaluation (HOSE), Pediatric Penile Perception Scale (PPPS), and Pediatric Quality of Life Inventory (PedsQL™4.0).
Mean follow-up was 59months postoperatively (range 7-113months). Techniques used included tubularized incised plate urethroplasty, meatal advancement and glanuloplasty, and a 2-stage repair. 23 of 25 patients achieved a HOSE score of 14 or more (maximum of 16). The PPPS scores correlated with severity of the hypospadias. Those with glanular hypospadias (mean score=10) scored higher than those with coronal (mean score=9) and penile/penoscrotal hypospadias (mean score=7). There was no correlation between PedsQL™4.0 scores and the severity of hypospadias or procedure used.
Validated questionnaires revealed generally good functional, cosmetic, and early psychosocial outcomes after hypospadias repair. The use of validated questionnaires in routine follow-up sessions may facilitate objective assessment of both functional outcomes and patient satisfaction.
目前仍缺乏用于尿道下裂最佳修复的标准化评估方法。本研究采用经过验证的问卷来评估尿道下裂修复术后的功能、外观及心理社会结局。
确定了172例在单一外科医生治疗下接受尿道下裂修复的患者。其中25例同意使用经过验证的尿道下裂客观评分评估(HOSE)问卷、小儿阴茎感知量表(PPPS)和小儿生活质量量表(PedsQL™4.0)进行随访。
术后平均随访时间为59个月(范围7 - 113个月)。所采用的技术包括管状切开板尿道成形术、尿道口前移和龟头成形术以及两阶段修复。25例患者中有23例HOSE评分达到14分或更高(满分16分)。PPPS评分与尿道下裂的严重程度相关。龟头型尿道下裂患者(平均评分 = 10)的得分高于冠状沟型(平均评分 = 9)和阴茎/阴茎阴囊型尿道下裂患者(平均评分 = 7)。PedsQL™4.0评分与尿道下裂的严重程度或所采用的手术方法之间无相关性。
经过验证的问卷显示尿道下裂修复术后的功能、外观及早期心理社会结局总体良好。在常规随访中使用经过验证的问卷可能有助于对功能结局和患者满意度进行客观评估。