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

Decisional regret (DR) is a distress after a health-care decision and can be an issue in parents electing distal hypospadias repair for their sons. We assessed the influence on DR of variables related to the family, the surgery, and the outcomes.

Charts of 372 patients undergoing primary distal hypospadias repairs between 2005 and 2012 were reviewed and validated questionnaires including the Decisional Regret Scale, the Pediatric Penile Perception Score (PPPS), and the Dysfunctional Voiding and Incontinence Scoring System administered to parents.

Data were available in 172/372 families, response rate 46. 2%. 128/323 (39. 6%) parents presented with moderate-strong DR, with good agreement within couples. Predictors of DR included intermediate parental educational level [OR(95%CI) 3. 19(1. 52-6. 69)], not being first born [OR(95%CI) 2. 01(1. 07-3. 78)], family history of hypospadias [OR(95%CI) 4. 42(1. 96-9. 97)], initial desire to avoid surgery [OR(95%CI) 2. 07(1. 04-4. 12)], younger age at follow-up [OR(95%CI) 0. 81(0. 72-0. 91)], presence of lower urinary tract symptoms [OR(95%CI) 4. 92(1. 53-15. 81)], and lower PPPS [OR(95%CI) 0. 86(0. 75-0. 99)]. DR was unrelated to parental desire to avoid circumcision, surgical variables, development of complications, and duration of follow-up.

DR is a problem in a significant proportion of parents electing distal hypospadias repair for their sons. In our experience, family variables seemed major predictors of DR, which was instead largely unrelated to surgical factors. Among outcomes, predictors of DR included poorer parent perception of penile appearance, and presence of lower urinary tract symptoms. The latter, however, could be unrelated to surgery. Irrespective of the duration of follow-up, DR seems lower in parents of older patients.

The Journal of urology. 2015 Oct 27 [Epub ahead of print]

Filippo Ghidini, Sasa Sekulovic, Marco Castagnetti

Section of Paediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy. , Section of Paediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy. , Section of Paediatric Urology, Urology Unit, University Hospital of Padova, Padua, Italy. 

PubMed

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