Dartmouth Hitchcock Medical Center, Lebanon, NH; Boston Medical Center, Boston, MA.
Boston Medical Center, Boston, MA.
Urology. 2023 Aug;178:91-97. doi: 10.1016/j.urology.2023.03.048. Epub 2023 May 23.
To determine whether preoperative partner involvement at clinic appointments is associated with deviation from a standardized postoperative care pathway for patients undergoing an inflatable penile prosthesis placement.
This is a retrospective study of 170 patients undergoing primary inflatable penile prosthesis placement performed by a single surgeon between 2017 and 2020. A standardized postoperative clinical pathway was used, including planned follow-up visits at 2 weeks (for wound check and device deflation) and 6 weeks (for device teaching). Patient characteristics, including demographics, partner involvement, and the number of follow-up visits were obtained from the medical record. Logistic regression modeling was performed to determine whether partner involvement was associated with unanticipated follow-up visits.
Partners were involved in preoperative visits for 92 patients (54%). Additional unplanned follow-up visits were observed for 58 patients (34%) between 0 and 6 weeks and for 28 patients (16%) after 6 weeks from surgery. Partner involvement was associated with reduced odds of unanticipated follow-up visits, both between 0 and 6 weeks (odds ratios 0.37, 95% CI 0.18-0.75) and after 6 weeks (odds ratios 0.33, 95% CI 0.13-0.81) in adjusted models.
Having a patient's partner involved during the preoperative period is associated with a significant reduction in unanticipated follow-up. We would recommend that urologists routinely encourage patients considering the insertion of a penile prosthesis to involve their partners in perioperative visits. Further research needed is needed to determine how to best support patients during surgical decision-making and through the postoperative period.
确定在诊所就诊时,患者的伴侣是否参与与接受可膨胀 penile 假体植入的患者偏离标准化术后护理路径有关。
这是一项回顾性研究,共纳入 170 例 2017 年至 2020 年间由一位外科医生行初次可膨胀 penile 假体植入术的患者。采用标准化术后临床路径,包括术后 2 周(伤口检查和装置放气)和 6 周(装置教学)时计划的随访。从病历中获取患者特征,包括人口统计学资料、伴侣参与情况和随访次数。Logistic 回归模型用于确定伴侣参与是否与意外随访有关。
92 例患者(54%)的伴侣参与了术前就诊。58 例患者(34%)在术后 0-6 周内和 28 例患者(16%)在术后 6 周后出现了额外的未计划随访。在调整后的模型中,伴侣参与与术后 0-6 周(比值比 0.37,95%CI 0.18-0.75)和术后 6 周后(比值比 0.33,95%CI 0.13-0.81)未计划随访的可能性降低有关。
在术前阶段让患者的伴侣参与可显著降低意外随访的发生。我们建议泌尿科医生常规鼓励考虑植入 penile 假体的患者让其伴侣参与围手术期就诊。需要进一步研究如何在手术决策和术后期间为患者提供最佳支持。