Parental Decisional Regret after Primary Distal Hypospadias Repair: Family and Surgery Variables, and Repair Outcomes

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• 作者：Filippo Ghidini ; Sasa Sekulovic ; Marco Castagnetti ; ^{marcocastagnetti@hotmail.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：decision making ; hypospadias ; informed consent ; reconstructive surgical procedures ; urethra
• 刊名：The Journal of Urology
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：195
• 期：3
• 页码：720-724
• 全文大小：93 K

文摘

Decisional regret is defined as distress after making a health care choice and can be an issue for parents electing distal hypospadias repair for their sons. We assessed the influence on decisional regret of variables related to the family, surgery and outcomes.

bsSec_2">Materials and Methods

bspara0015">Charts for 372 patients undergoing primary distal hypospadias repair between 2005 and 2012 were reviewed, and validated questionnaires, including the Decisional Regret Scale, Pediatric Penile Perception Score and Dysfunctional Voiding and Incontinence Scoring System, were administered to parents.

bsSec_3">Results

bspara0020">Data were available for 172 of 372 families (response rate 46.2%). Of 323 parents 128 (39.6%) presented with moderately strong decisional regret, with good agreement within couples. Predictors of decisional regret included intermediate parental educational level (OR 3.19, 95% CI 1.52–6.69), patient not being the first born (OR 2.01, 95% CI 1.07–3.78), family history of hypospadias (OR 4.42, 95% CI 1.96–9.97), initial desire to avoid surgery (OR 2.07, 95% CI 1.04–4.12), younger age at followup (OR 0.81, 95% CI 0.72–0.91), presence of lower urinary tract symptoms (OR 4.92, 95% CI 1.53–15.81) and lower Pediatric Penile Perception Score (OR 0.86, 95% CI 0.75–0.99). Decisional regret was unrelated to parental desire to avoid circumcision, surgical variables, development of complications and duration of followup.

bsSec_4">Conclusions

bspara0025">Decisional regret is a problem in a significant proportion of parents electing distal hypospadias repair for their sons. In our experience family variables seemed to be predictors of decisional regret, while surgical variables did not. Predictors of decisional regret included worse parental perception of penile appearance and the presence of lower urinary tract symptoms. However, the latter could be unrelated to surgery. Irrespective of the duration of followup, decisional regret seems decreased in parents of older patients.