Vavilov Sergey, Smith Grahame, Starkey Malcolm, Pockney Peter, Deshpande Aniruddh V
Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia.
Department of Surgery, John Hunter Hospital, Newcastle, New South Wales, Australia.
J Paediatr Child Health. 2020 Oct;56(10):1514-1520. doi: 10.1111/jpc.15075. Epub 2020 Sep 3.
We conducted a systematic review of the literature to establish the prevalence of and predictive factors for parental decision regret in hypospadias surgery. A search strategy without language restrictions was developed with expert help, and two reviewers undertook independent study selection. Five studies were included in this review (four for quantitative analysis) with a total of 783 participants. The mean overall prevalence of parental decision regret was 65.2% (moderate to severe - 20.3%). Although significant predictors of regret were identified (post-operative complications, small size glans, meatal location, decision conflict between parents, parental educational level and others), they had unexplained discordance between studies. Parental decision regret after proximal hypospadias surgery and refusing surgery was inadequately reported. In conclusion, even though the prevalence of parental decision regret after consenting for the hypospadias repair appears to be high, risk factors associated with it were discordant suggesting imprecision in estimates due to unknown confounders.
我们对文献进行了系统综述，以确定尿道下裂手术中父母决策后悔的发生率及预测因素。在专家的帮助下制定了无语言限制的检索策略，两名评审员独立进行研究筛选。本综述纳入了五项研究（四项用于定量分析），共有783名参与者。父母决策后悔的总体平均发生率为65.2%（中度至重度为20.3%）。虽然确定了后悔的显著预测因素（术后并发症、龟头小、尿道口位置、父母之间的决策冲突、父母教育水平等），但各研究之间存在无法解释的不一致。近端尿道下裂手术后父母的决策后悔及拒绝手术的情况报告不足。总之，尽管同意进行尿道下裂修复术后父母决策后悔的发生率似乎很高，但与之相关的风险因素不一致，这表明由于未知的混杂因素，估计存在不精确性。
