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

Abstract

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.

Shaping parents, shaping penises: How medical teams frame parents’ decisions in response to hypospadias

“…Ghidini, Sekulovic, and Castagnetti (2016) also followed up 323 parents who had all consented for their sons to go through distal hypospadias surgery. 39.6% of participants expressed moderate-to-strong regret (Ghidini et al, 2016). As in Lorenzo et al (2014), parental regret was predicted by several factors, including initial desire to avoid surgery, but not by surgical variables (techniques and practices) or the development of complications.…”

“…Ghidini, Sekulovic, and Castagnetti () also followed up 323 parents who had all consented for their sons to go through distal hypospadias surgery. 39.6% of participants expressed moderate‐to‐strong regret (Ghidini et al ., ). As in Lorenzo et al .…”

Concordance of Expert and Parental Opinion about Hypospadias Surgical Outcome Is Severity Dependent

“…In the case of pediatric patients, it has been shown that postoperative complications, parental desire to avoid circumcision and initial decisional conflict level are predictors of parental decisional regret after hypospadias repair of their children ( 16 ). For the case of distal hypospadias repair, a more recent study found that factors unrelated to the surgical procedure in itself – parental educational level, not being first born, family history of hypospadias, initial desire to avoid surgery, younger age at follow-up, presence of lower urinary tract symptoms, and lower PPPS scores – are associated with parental decisional regret ( 17 ). Therefore, it is of interest for future work to assess the reasons for parental dissatisfaction and to address the relationships between decisional regret and parental satisfaction with hypospadias repair according to severity.…”

Preputial reconstruction in hypospadias repair

“…These authors also commented that the percentage of parents wanting PR seemed to be growing [13]. Although controversial, the desire to avoid circumcision was suggested to be one major reason causing regret in parents of hypospadias patients regarding their decision to elect for hypospadias repair in their sons [26,27].…”