Bar-Yaakov Noam, Mano Roy, Ekstein Margaret, Savin Ziv, Dekalo Snir, Ben-Chaim Jacob, Bar-Yosef Yuval
Pediatric Urology Department, Dana-Dwek Children's Hospital, Tel-Aviv Medical Center, Tel-Aviv, Israel.
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Front Pediatr. 2022 Mar 9;10:855893. doi: 10.3389/fped.2022.855893. eCollection 2022.
Revision surgery for the removal of excess foreskin after circumcision is a common procedure. The decision regret scale (DRS) is a validated questionnaire which assesses regret after medical decision making. The aim was to evaluate parental regret by means of the DRS and querying about factors associated with regret about deciding to revise their child's circumcision.
Included were all pediatric patients who underwent revision of neonatal circumcision in a single center between 2010 and 2016. Excluded were children who underwent revision for reasons other than excess foreskin, those who underwent additional surgical procedures during the same anesthetic session, and those who had undergone previous penile surgery other than circumcision. Response to the DRS questionnaire was by a telephone call with the patient's parent. Regret was classified as none (a score of 0), mild (1-25), or moderate-to-strong (26-100). Surgical and baseline demographic data were obtained from the departmental database and compared between the no regret and regret groups.
Of the 115 revisions of circumcisions performed during the study period, 52 fulfilled the inclusion criteria, and the parents of 40 (77%) completed the DRS questionnaire. Regret was reported by 11/40 [28%: nine as mild (23%) and two as moderate-to-strong (5%)]. The average age of the child in the regret group was 17 months compared to 18 months in the no regret group ( = 0.27). The median weight percentile was 43% in both groups. Surgical variables, including anesthesia type (caudal vs. no block, = 0.65), suture type (polyglactin vs. poliglecaprone, = 0.29), operation time (28 vs. 25 min, = 0.59), and anesthesia time (55 vs. 54 min, = 0.57) were not significantly different between the groups.
Regret for deciding upon revision surgery for removal of excess foreskin post-circumcision was reported by 27.5% of parents of children who underwent revision. No clinical, surgical, or demographic characteristics predicted parental decisional regret.
包皮环切术后切除多余包皮的修复手术是一种常见的手术。决策后悔量表(DRS)是一种经过验证的问卷,用于评估医疗决策后的后悔程度。本研究旨在通过DRS评估父母的后悔程度,并探究与决定为孩子进行包皮环切修复手术后悔相关的因素。
纳入2010年至2016年间在单一中心接受新生儿包皮环切修复手术的所有儿科患者。排除因包皮过长以外原因进行修复手术的儿童、在同一麻醉过程中接受额外手术的儿童以及除包皮环切术外曾接受过阴茎手术的儿童。通过与患者父母电话沟通的方式获取DRS问卷的回复。后悔程度分为无(得分为0)、轻度(1 - 25分)或中度至重度(26 - 100分)。手术和基线人口统计学数据从科室数据库中获取,并在无后悔组和后悔组之间进行比较。
在研究期间进行的115例包皮环切修复手术中,52例符合纳入标准,40例(77%)患儿的父母完成了DRS问卷。11/40(28%)报告有后悔情绪:9例为轻度后悔(23%),2例为中度至重度后悔(5%)。后悔组患儿的平均年龄为17个月,无后悔组为18个月(P = 0.27)。两组的体重百分位数中位数均为43%。手术变量,包括麻醉类型(骶管阻滞与无阻滞,P = 0.65)、缝合类型(聚乙醇酸与聚乙交酯丙交酯,P = 0.29)、手术时间(28分钟对25分钟,P = 0.59)和麻醉时间(55分钟对54分钟,P = 0.57)在两组之间无显著差异。
接受修复手术的患儿父母中,27.5%报告对决定进行包皮环切术后切除多余包皮的修复手术感到后悔。没有临床、手术或人口统计学特征能够预测父母的决策后悔。