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板状物目标评分工具:一种新的预测儿童远端型尿道下裂阴茎弯曲度的术前指标。

Plate Objective Scoring Tool: A new preoperative indicator of penile curvature degree in children with distal hypospadias.

机构信息

Pediatric Urology Section, Sidra Medicine, Doha, Qatar.

College of Medicine, Qatar University, Doha, Qatar.

出版信息

Int J Urol. 2022 Jun;29(6):511-515. doi: 10.1111/iju.14822. Epub 2022 Mar 1.

Abstract

OBJECTIVES

There is an unmet need for preoperative methods that surgeons can use to objectively quantify hypospadias anatomic variables and determine risk of penile curvature. We, therefore, assessed whether Plate Objective Scoring Tool measurements were correlated with degree of ventral curvature in affected children.

METHODS

Patients undergoing distal hypospadias repair were enrolled into the study between January 2018 and December 2020 and were categorized independently by at least two surgeons using Plate Objective Scoring Tool. Scores were compared statistically to determine the degree of ventral curvature and requirement for correction.

RESULTS

Sixty-five patients with a median age of 18 months (interquartile range 13-26) were enrolled into the study prior to surgery for primary distal hypospadias. Patient probability of significant postoperative curvature (>20°) was determined with moderate confidence using a cutoff Plate Objective Scoring Tool score of 1 (sensitivity 75%, specificity 60%). Presurgery Plate Objective Scoring Tool scores were negatively correlated with subsequent degree of curvature (r = -0.37, P = 0.003), with values <1.0 predicting >20° curvature.

CONCLUSIONS

Plate Objective Scoring Tool scoring offers a succinct method of describing hypospadias severity and correlates well with postoperative outcomes. The Plate Objective Scoring Tool system can therefore be used to objectively predict the likelihood of penile curvature and aid communication between surgeons and researchers, as well as improving parental counseling.

摘要

目的

目前需要一种术前方法,以便外科医生能够客观地量化尿道下裂的解剖变量,并确定阴茎弯曲的风险。因此,我们评估了 Plate 客观评分工具的测量值是否与受影响儿童的腹侧弯曲程度相关。

方法

本研究于 2018 年 1 月至 2020 年 12 月间纳入行远端尿道下裂修复术的患者,并由至少两名外科医生使用 Plate 客观评分工具独立进行分类。对评分进行统计学比较,以确定腹侧弯曲的程度和矫正的必要性。

结果

65 例中位年龄为 18 个月(四分位间距 13-26)的患者在接受原发性远端尿道下裂初次手术前纳入本研究。使用 1 分的 Plate 客观评分工具截断值,可中度确定患者术后出现明显弯曲(>20°)的可能性(敏感度 75%,特异性 60%)。术前 Plate 客观评分工具评分与后续弯曲程度呈负相关(r=-0.37,P=0.003),<1.0 的评分值预测>20°的弯曲。

结论

Plate 客观评分工具评分提供了一种简洁的尿道下裂严重程度描述方法,与术后结果相关性良好。因此,Plate 客观评分工具系统可用于客观预测阴茎弯曲的可能性,辅助外科医生和研究人员之间的沟通,并改善对父母的咨询。

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