Application of pediatric penile perception score in assessment of penile appearance after concealed penis surgery
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摘要: 目的 分析小儿阴茎感知量表(PPPS)在隐匿阴茎术后阴茎外观评价的应用价值。方法 以2019年12月—2020年11月手术治疗的隐匿阴茎患儿为研究对象，收集其临床资料，患儿家长及非手术医生运用PPPS对隐匿阴茎术后外观进行满意度调查，对比分析评估结果。结果 非手术医生对隐匿阴茎术后的阴茎整体外观、勃起时阴茎伸直、阴茎头形状、尿道外口位置及形状、阴茎皮肤外观、阴茎长度等评估满意度均显著高于患儿家长，差异有统计学意义(P＜0.05)；医方评分中，非手术医生对阴茎外观的各项满意度差异无统计学意义(P＞0.05)；患方评分中，患儿家长对阴茎长度满意度最低(P＜0.001)；不同年龄患儿，家长与非手术医生对阴茎外观的各项满意度均差异无统计学意义(P＞0.05)。结论 PPPS可作为评估隐匿阴茎术后阴茎外观较为实用的标准化工具，医方与患方在阴茎外观满意度调查存在差异，其中以阴茎长度主。Abstract: Objective To evaluate the role of pediatric penile perception score (PPPS) in the assessment of penile appearance after concealed penis operations.Methods From December 2019 to November 2020, the clinical data of children with concealed penis treated by surgery in our hospital were collected. The PPPS were used to investigate the satisfaction of the penile appearance by parents and non-surgical doctors, and the evaluation results were assessed and analyzed.Results The postoperative satisfaction of urologists on the general penis appearance, penile straightness upon erection, the shape of glan, urethral opening position, penile skin appearance and penile length evaluation after concealed penis surgery were significantly higher than those of the parents (P< 0.05). In the doctor evaluation results, the satisfaction of urologists on penile appearance has no statistical difference (P> 0.05). In the parents evaluation results, penile length has the lowest parental satisfaction (P< 0.001). There was no statistical difference both in the satisfaction of parents and non-surgical doctors with penis appearance among different age groups (P> 0.05).Conclusion PPPS can be used as a practical standardized instrument for assessing the postoperative outcome of concealed penis surgeries. There are differences in satisfaction with the penile appearance between urologists and patients, especially in penile length.
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表 1 隐匿阴茎术后医患双方评价结果
例 项目 非常满意 满意 不满意 非常不满意 秩均值 Z值 P值 医方 患方 医方 患方 医方 患方 医方 患方 医方 患方 阴茎整体外观 44 29 4 18 1 2 0 0 56.90 42.10 -3.395 0.001 勃起时阴茎伸直 45 27 4 22 0 0 0 0 58.50 40.50 -4.097 ＜0.001 阴茎头形状 48 30 1 18 0 1 0 0 58.51 40.49 -4.488 ＜0.001 尿道口位置及形状 47 29 2 20 0 0 0 0 58.50 40.50 -4.336 ＜0.001 阴茎皮肤外观 46 29 2 14 1 6 0 0 57.98 41.02 -3.991 ＜0.001 阴茎长度 47 17 2 20 0 12 0 0 64.74 34.26 -6.306 ＜0.001 
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表 2 隐匿阴茎术后随访期间医患双方各项目满意度评价结果
项目 阴茎整体外观 勃起时阴茎伸直 阴茎头形状 尿道口位置及形状 阴茎皮肤外观 阴茎长度 P值 医方评分(秩均值) 140.93 144.08 153.02 150.04 146.89 150.04 0.537 患方评分(秩均值) 155.57 152.71 159.71 158.29 150.14 108.57 ＜0.05
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表 3 不同年龄组间患儿家长术后各项目满意度评价结果
分组 例数 阴茎整体外观(秩均值) 勃起时阴茎伸直(秩均值) 阴茎头形状(秩均值) 尿道口位置及形状(秩均值) 阴茎皮肤外观(秩均值) 阴茎长度(秩均值) 1~3岁 18 24.00 22.39 23.83 21.39 24.33 23.19 3~6岁 20 23.93 27.43 24.43 26.43 26.48 24.05 >6岁 11 28.59 24.86 27.95 28.32 23.41 29.68 P值 0.547 0.452 0.649 0.262 0.776 0.411
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表 4 不同年龄组间非手术医生术后各项目满意度评价结果
分组 例数 阴茎整体外观(秩均值) 勃起时阴茎伸直(秩均值) 阴茎头形状(秩均值) 尿道口位置及形状(秩均值) 阴茎皮肤外观(秩均值) 阴茎长度(秩均值) 1~3岁 18 24.83 24.28 25.50 26.00 23.83 26.00 3~6岁 20 25.10 24.55 24.28 23.55 25.23 24.78 ＞6岁 11 25.09 27.00 25.50 26.00 26.50 23.77 P值 0.993 0.535 0.484 0.227 0.490 0.476
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