Dos Reis Margareth de Mello Ferreira, Barros Eduardo Augusto Corrêa, Pollone Marilisa, Molina Maria Beatriz Gracia, Westin Caio Pereira de Vasconcellos, Glina Sidney
Psychologist, Coordinator of the Psychological Care, Sexual Medicine Outpatient Clinic, Urology Department, Faculdade de Medicina do ABC, Santo André (SP), Brazil.
Urologist, Director of the Sexual Medicine Outpatient Clinic, Urology Department, Faculdade de Medicina do ABC, Santo André (SP), Brazil.
Sex Med. 2021 Apr;9(2):100311. doi: 10.1016/j.esxm.2020.100311. Epub 2021 Mar 11.
Patients may remain dissatisfied after penile prosthesis implantation for the treatment of erectile dysfunction. Studies showing the results of standardized protocols for preoperative psychological evaluation are lacking.
To estimate the rate of patients considered psychologically unfit for penile prosthesis implantation and to compare their characteristics with those considered fit after the implementation of a standardized psychological profile evaluation protocol for men with erectile dysfunction.
Cross-sectional evaluation of men referred for penile prosthesis implantation by their urologists, based on organic causes for the erectile dysfunction, including a semi-structured (sexual and relational anamnesis of the patient and their partner, information about expectations about the results of the penile prosthesis implantation and possible complications) and a structured instrument including validated tools for the evaluation of depression and/or anxiety symptoms. These were the Self Reporting Questionnaire (SRQ-20), the 36-Item Short-Form Health Survey for quality of life, and the Five-Factor Model (FFM) for behavioral tendencies. After at least 3 interviews, the psychology team rated the patients as fit or unfit for surgery. Unfit patients were those with any of a set of warning signals indicating risk for dissatisfaction even after penile implantation.
The prevalence of patients considered "unfit for surgery."
The quality of life scores were good, but 27.6% of patients (95% confidence interval, CI: 16.7-40.9%) were unfit for surgery. Being unfit was associated with obesity (P = .027), anxiety and/or depression symptoms (P < .001) and high levels of neuroticism (P = .001).
The preoperative evaluation protocol combining standardized and validated tools shows that more than one-quarter of patients with a medical indication for penile prosthesis implantation were not in good psychological conditions for the surgery. The development of psychological evaluation protocols can help identify patients in need of adequate care before penile implantation. M de Mello Ferreira dos Reis, EA Corrêa Barros, M Pollone, et al. Preoperative Psychological Evaluation for Patients Referred for Penile Prosthesis Implantation. Sex Med 2021;9:100311.
阴茎假体植入治疗勃起功能障碍后，患者可能仍不满意。目前缺乏显示术前心理评估标准化方案结果的研究。
评估被认为心理上不适合阴茎假体植入的患者比例，并将其特征与勃起功能障碍男性实施标准化心理特征评估方案后被认为适合的患者特征进行比较。
基于勃起功能障碍的器质性原因，对泌尿科医生转诊进行阴茎假体植入的男性进行横断面评估，包括半结构化（患者及其伴侣的性和关系问诊，关于阴茎假体植入结果及可能并发症的期望信息）和结构化工具，其中包括用于评估抑郁和/或焦虑症状的经过验证的工具。这些工具包括自填式问卷调查（SRQ-20）、用于生活质量评估的36项简短健康调查以及用于行为倾向评估的五因素模型（FFM）。经过至少3次访谈后，心理团队将患者评定为适合或不适合手术。不适合手术的患者是指具有一组警示信号中的任何一项，这些信号表明即使阴茎植入后仍有不满意风险的患者。
被认为“不适合手术”的患者患病率。
生活质量评分良好，但27.6%的患者（95%置信区间，CI：16.7-40.9%）不适合手术。不适合手术与肥胖（P = 0.027）、焦虑和/或抑郁症状（P < 0.001）以及高神经质水平（P = 0.001）相关。
结合标准化和经过验证工具的术前评估方案显示，超过四分之一有阴茎假体植入医学指征的患者心理状况不佳，不适合进行手术。心理评估方案的制定有助于在阴茎植入前识别需要适当护理的患者。M·德·梅洛·费雷拉·多斯·雷斯、EA·科雷亚·巴罗斯、M·波洛内等。阴茎假体植入患者的术前心理评估。《性医学》2021年；9：100311。
