尿道下裂未矫正的长期后果:范围界定综述。

E Bohane, M Murphy, F Chierigo, G Mantica, J Adamowicz, F Campos-Juanatey, A Cocci, M Frankiewicz, C M Rosenbaum, W Verla, M Waterloos, Ł Białek, F X Madec, M Oszczudłowski, M W Vetterlein, E J Redmond
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引用次数: 0

摘要

导言:尿道下裂修复术的目的是优化排尿和性功能,改善外观,尽量减少阴茎畸形带来的社会心理影响。然而,在尿道下裂程度较轻、畸形不明显且预计不会影响功能的情况下,手术的作用尚不明确。本研究旨在回顾尿道下裂未矫正男性的长期功能、外观和社会心理影响。这些信息可能对那些为决定如何正确治疗尿道下裂而烦恼的父母有所帮助:方法:根据 PRISMA 指南,对 PubMed、EMBASE 和 CINAHL + 数据库进行了范围审查。结果:患有轻度尿道下裂而未矫正的男性,其尿道下裂程度较轻:结果:患有轻度未矫正尿道下裂的男性与无尿道下裂的男性具有相似的功能结果,他们更喜欢站立排尿,并报告了相似的IPSS评分。然而,那些患有严重尿道下裂且未得到治疗的患者会出现严重的排尿困难,IPSS评分较高,排尿时更倾向于坐着。他们的SHIM评分更差,腹侧弯曲更多,性交困难更大。大多数意外发现尿道下裂的男性并不知道自己的病情,并对自己的阴茎外观感到满意。未矫正尿道下裂的男性与未矫正尿道下裂的男性在达到社会心理里程碑方面没有差异:关于尿道下裂未矫正成年男性的经历,目前还缺乏相关研究。不过,有一些证据支持对轻度尿道下裂进行非手术治疗。因此,在决定是否推迟婴儿期手术时,应平衡父母的意愿和医生的指导,尤其是在功能障碍风险较低的情况下。
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Long term outcomes from uncorrected hypospadias: a scoping review.

Introduction: The goal of hypospadias repair is to optimize urinary and sexual function, improve cosmesis and minimise the psychosocial effects associated with a penile anomaly. However, a lack of clarity exists regarding the role of surgery in milder hypospadias where the anomaly is inconspicuous and there is no anticipated impact on function. The aim of this study was to review the long term functional, cosmetic and psychosocial outcomes in men with uncorrected hypospadias. This information may be helpful for parents who are burdened with deciding the correct treatment for their child's hypospadias.

Methods: A scoping review of PubMed, EMBASE, and CINAHL + databases was performed in adherence with PRISMA guidelines. Eight studies were identified for inclusion in the review.

Results: Men with mild uncorrected hypospadias have similar functional outcomes to those without hypospadias, preferring to void standing and reporting similar IPSS scores. However, those with severe untreated hypospadias experience significant urinary difficulties, higher IPSS scores, and are more likely to sit when voiding. They reported worse SHIM scores, more ventral curvature, and greater difficulty with intercourse. Most men with incidentally identified hypospadias are unaware of their condition and are satisfied with their penile appearance. There was no difference in the attainment of psychosocial milestones between men with uncorrected hypospadias versus no hypospadias.

Conclusion: There is a lack of research regarding the experiences of adult men with uncorrected hypospadias. However, there is some evidence to support the non-operative management of mild hypospadias. Therefore, the decision to defer surgery in infancy should balance parental wishes and physician guidance, particularly in cases where the risk of functional impairment is low.

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