Liu Zhaoquan,Wu Xuemin,Xu Yingrui,et al.Risk factors for pediatric penile perception scores after hypospadias repair[J].Journal of Clinical Pediatric Surgery,2023,22(06):544-548.[doi:10.3760/cma.j.cn101785-202211016-009]
尿道下裂手术后小儿阴茎感知量表评分结果的相关因素分析
- Title:
- Risk factors for pediatric penile perception scores after hypospadias repair
- Keywords:
- Hypospadias; Treatment Outcome; Physical Appearance; Body; Pediatric Penile Perception Score; Surveys and Questionnaires
- 摘要:
- 目的 探讨尿道下裂手术后小儿阴茎感知量表（pediatric penile perception score，PPPS）评分的相关因素。方法 回顾性分析2012年1月至2021年12月山东省立医院收治的首次尿道下裂手术后患儿临床资料，并对术后时间≥ 6个月者采用PPPS进行随访；随访时年龄<10岁者仅由家长填写量表，≥ 10岁者由家长与患儿分别填写量表。评分总分≥ 12分者纳入高分组，<12分者纳入低分组。收集两组患儿手术时年龄、随访时间、随访时年龄、术前尿道口位置、术前阴茎头直径、脱套前阴茎下弯度数、脱套后阴茎下弯度数、首次手术方式、是否采取背侧白膜紧缩矫正阴茎下弯、是否多次手术、是否分期手术、成形后阴茎头直径、成形后冠口距（成形后冠状沟至尿道外口距离）、成形后阴茎长度、手术后是否出现并发症以及随访时是否存在并发症等临床资料，分析影响尿道下裂手术后阴茎外观PPPS评分结果的相关因素。结果 本研究共收集110份来自患儿家长以及27份来自患儿的PPPS评分结果。110份家长PPPS评分总得分为（13.07±3.26）分，27例患儿PPPS评分总得分为（13.15±3.99）分，家长及患儿的各个评分项目中，阴茎长度得分均最低。27例由家长与患儿分别评分的病例中，家长及患儿的PPPS总评分差异无统计学意义（P=0.986）。110份家长评分量表中，因术中测量数据完整的患儿仅77例（对应77份PPPS评分结果），故按上述家长评分结果将患儿分为高分组64例、低分组13例。单因素分析结果显示，高分组与低分组术前阴茎头直径[14.25（13.00，16.00） mm比13.50（12.25，14.00） mm]、成形后阴茎头直径[13.00（11.13，14.00） mm比11.50（10.50，12.75） mm]及阴茎长度[36.00（34.25，40.00） mm比35.00（31.00，35.00） mm]、手术后是否出现并发症及随访时是否存在并发症差异均具有统计学意义（P<0.05）；多因素Logistic回归分析结果显示，随访时存在并发症（OR=5.401，95%CI：1.170~24.927）是PPPS评分低的独立危险因素（P<0.05）。结论 尿道下裂手术后患儿及家长的PPPS评分结果整体较好，两者PPPS评分结果整体一致；随访时仍然存在并发症是影响尿道下裂手术后患儿家长PPPS评分结果的独立危险因素。
- Abstract:
- Objective To evaluate the cosmetic outcomes of hypospadias repair with pediatric penile perception score (PPPS) by parents and children and explore the risks facfors for PPPS results.Methods A retrospective analysis was performed for hypospadiacs operated from January 2012 to December 2021.Parents and children aged over 10 years were surveyed by a questionnaire of PPPS.Surgical data of previous repair and postoperative follow-ups were recorded.Surgical data included surgical age, duration of follow-up, age at follow-up, preoperative meatal location, preoperative glan width, penile curvature before/after degloving, surgical procedure, dorsal plication, multiple operations, staged repair, postoperative glan width, postoperative distance between meatus and corona, postoperative penile length, postoperative complications and the presence of complications during follow-up.The postoperative PPPS results were analyzed.Results A total of 110 questionnaires from parents and 27 questionnaires from children were collected.High score group was defined by PPPS ≥ 12 points.The total PPPS score of 110 parents and 27 children was 13.07±3.2 and 13.15±3.99 points respectirely, and the score for penis length wasthe lowesf.Among the 27cases evaluated by both patients and parents, there was no statistical difference in scores(P=0.986).Based upon parental scores from 77 cases with defailed operative records, they were assigned into two groups of high score (n=64) and low score (n=13).In univariate analysis, preoperative glan width[14.25(13.00, 16.00) vs.13.50(12.25, 14.00) mm], postoperative glan width[13.00(11.13, 14.00) vs.11.50(10.50, 12.75) mm] and penile length[36.00(34.25, 40.00) vs.35.00(31.00, 35.00) mm], postoperative complications[45% vs.85%] and current complications[19% vs.69%] had significant inter-group differences.Multiple Logistic regression revealed that current complications (OR=5.401, 95%CI:1.170~24.927) were the independent risk factors of unsatisfactory cosmetics (P<0.05). Conclusion The overall PPPS scores of both parents and children are satisfactory and consistent after hypospadias repair.And the presence of complications during follow-up is an independent risk factor of parental PPPS results.
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备注/Memo
收稿日期:2022-11-07。
通讯作者:刘伟,Email:lemontree1119@126.com