1
|
Arabiat D, Mörelius E, Hoti K, Hughes J. Pain assessment tools for use in infants: a meta-review. BMC Pediatr 2023; 23:307. [PMID: 37337167 DOI: 10.1186/s12887-023-04099-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 05/28/2023] [Indexed: 06/21/2023] Open
Abstract
BACKGROUND Identifying pain in infants is challenging due to their inability to self-report pain, therefore the availability of valid and reliable means of assessing pain is critical. OBJECTIVE This meta-review sought to identify evidence that could guide the selection of appropriate tools in this vulnerable population. METHODS We searched Scopus, Medline, Embase, CINAHL, MIDRIS, EMCare and Google Scholar for eligible systematic reviews. Eligible reviews documented psychometric properties of available observational tools used to assess pain in infants. RESULTS A total of 516 reviews were identified of which 11 met our inclusion criteria. We identified 36 pain assessment tools (evaluated in 11 reviews) of which seven were reported in at least three reviews. The level of evidence reported on the psychometric properties of pain assessment tools varied widely ranging from low to good reliability and validity, whilst there are limited data on usability and clinical utility. CONCLUSIONS Currently, no observer administered pain assessment tool can be recommended as the gold standard due to limited availability and quality of the evidence that supports their validity, reliability and clinical utility. This meta-review attempts to collate the available evidence to assist clinicians to decide on what is the most appropriate tool to use in their clinical practice setting. It is important that researchers adopt a standard approach to evaluating the psychometric properties of pain assessment tools and evaluations of the clinical utility in order that the highest level of evidence can be used to guide tool selection.
Collapse
Affiliation(s)
- Diana Arabiat
- Maternal and Child Nursing Department, Faculty of Nursing, The University of Jordan, Amman, Jordan.
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia.
| | - Evalotte Mörelius
- School of Nursing and Midwifery, Edith Cowan University, Joondalup, Western Australia, Australia
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Kreshnik Hoti
- Faculty of Medicine, University of Prishtina, Pristina, Kosovo
| | - Jeffery Hughes
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Bentley, WA, Australia
| |
Collapse
|
2
|
Shahrbabaki RM, Nourian M, Farahani AS, Nasiri M, Heidari A. Effectiveness of listening to music and playing with Lego on children's postoperative pain. J Pediatr Nurs 2022; 69:e7-e12. [PMID: 36543727 DOI: 10.1016/j.pedn.2022.11.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 11/19/2022] [Accepted: 11/19/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE The present study aimed to compare the effectiveness of music and playing with Lego in postoperative management pain in children. DESIGN AND METHODS In this three-group quasi-experimental study, the participants in this interventional study were 96 children aged 6 to 12 years admitted to the pediatric surgery ward of Mofid Hospital and Medical Center in Tehran. The participants were selected using convenience sampling. They were then randomly placed into three intervention groups. Pain intensity was measured for the participants in all three groups before the intervention. The intervention was performed in two 15-min sessions with an interval of 5 min in three intervention groups. Then pain intensity was measured using the Oucher Pain Scale before the intervention and in four intervals: Immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively. Pain intensity was also measured at the same time intervals for the participants in the control group. The collected data were analyzed with SPSS-25 software using descriptive statistics, the Bonferroni test, and Tukey's test. RESULTS The data showed that the three groups were identical in terms of demographic characteristics (p > 0.05).A comparison of the music listening group and the control group showed statistically significant difference in terms of postoperative pain (P < 0.05).However, the data showed significant differences between the control group and the Lego group in terms of pain intensity immediately after the intervention, half an hour, one hour, and 3 h after the intervention, respectively (p < 0.05).The data also revealed a significant difference between the children in the music group and the Lego group at all phases (p < 0.05), and the children in the Lego group reported less pain after the intervention compared to the children in the music listening group. Nevertheless, there was a statistically significant difference between the three groups in terms of reported pain intensity half an hour, one hour, and three hours after the intervention (p < 0.05). CONCLUSION The results showed that playing with Legos had a greater effect on reducing postoperative pain in children than listening to music. Thus, nurses are recommended to make arrangements for children to play with Legos after surgery. PRACTICE IMPLICATION Playing with Legos can be used to control postoperative pain in school-age children in medical centers and wards of pediatric hospitals.
Collapse
Affiliation(s)
- Reihane Moghimian Shahrbabaki
- MSc in Pediatric Nursing, Department of Pediatric Nursing & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Manijeh Nourian
- PhD in Nursing, Associate Professor, Department of Pediatric Nursig & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Azam Shirinabadi Farahani
- PhD in Nursing, Associate Professor, Department of Pediatric Nursig & Neonatal Intensive Care Nursing, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Biostatics, Faculty of Paramedic, Shahid Beheshti University, Tehran, Iran
| | - Amir Heidari
- Heidar Amir, Department of Cardiovascular, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
3
|
Pain Reported by Chinese Children During Cancer Treatment: Prevalence, Intensity, Interference, and Management. Cancer Nurs 2021; 45:E345-E354. [PMID: 34010216 DOI: 10.1097/ncc.0000000000000958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pain is a frequently reported and distressing symptoms during cancer treatment. However, there is limited evidence on pain reported by Chinese children with cancer. OBJECTIVES This study aimed to investigate the prevalence, intensity, interference, and management of pain reported by Chinese children during cancer treatment and explore the predictors of pain interference. METHODS We conducted a cross-sectional survey to investigate the pain intensity, pain interference, co-occurring symptoms (anger, anxiety, depression, fatigue), and pain management strategies reported by children 8 years and older undergoing active cancer treatment in 4 Chinese hospitals. RESULTS Data were analyzed for 187 children. The prevalence of moderate to severe pain (≥4/10) was 38.50%, with an average pain interference score of 52.97 out of 100. Approximately 24% of children were prescribed pain medicine. Pain interference and pain intensity were marginally correlated (r = 0.047, P < .01) and were both positively correlated with pain duration and co-occurring symptoms and negatively correlated with perceived pain alleviation (all P < .01). Multiple regression analyses suggested that severe pain intensity (B = 2.028, P = .003) and fatigue (B = 0.440, P < .001) significantly predicted higher levels of pain interference (R2 = 0.547, F = 23.102, P < .001). CONCLUSION Chinese children with cancer reported a low pain intensity score but a relatively high level of pain interference. According to the children's reports, pain has not been sufficiently addressed through Chinese pediatric oncology supportive care. IMPLICATIONS FOR PRACTICE There is an urgent requirement for comprehensive pain assessment and standardized, targeted interventions in Chinese pediatric oncology pain management.
Collapse
|
4
|
Assessment of four pain scales for evaluating procedural pain in premature infants undergoing heel blood collection. Pediatr Res 2021; 89:1724-1731. [PMID: 32599608 DOI: 10.1038/s41390-020-1034-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 06/11/2020] [Accepted: 06/15/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Procedural pain is underestimated in hospitalized preterm infants. The aim of this study was to assess the reliability, validity, and clinical utility of the Neonatal Facial Coding System (NFCS), Douleur Aiguë du Nouveau-né (DAN) scale, Neonatal Infant Pain Scale (NIPS), and Premature Infant Pain Profile (PIPP) in premature infants undergoing heel blood collection. We assume that the four scales were similar in reliablility and validity (but different in clinical utility). METHODS The pain assessments were performed on 111 premature infants using the four scales. Internal consistency was determined by Cronbach's α, and the reliability was determined by the intraclass correlation coefficients. Concurrent validity was evaluated by Spearman's rank correlations. Bland-Altman plots were used to investigate the convergent validity. RESULTS The internal consistency and their reliability of the scales were high (p < 0.001). Scores were significantly higher at the time of blood collection (p < 0.001). Mean scores of clinical utility of PIPP were significantly higher than NFCS and DAN (p < 0.05) but not higher than the NIPS (p > 0.05). CONCLUSIONS The four scales were reliable and valid. This study suggests that the PIPP and NIPS has good clinical utility and are better choice for evaluating procedural pain in premature infants. IMPACT The aim of this study was to assess the reliability, validity, and clinical utility of NFCS, DAN, NIPS, and PIPP in premature infants undergoing heel blood collection. The results showed that the four scales have high reliability and internal consistency; the PIPP and NIPS have good clinical utility and are better choice for evaluating procedural pain in premature infants. Our study results provided a reference for clinical workers in choosing pain assessment scales and conduction intervention.
Collapse
|
5
|
Bringuier S, Macioce V, Boulhais M, Dadure C, Capdevila X. Facial expressions of pain in daily clinical practice to assess postoperative pain in children: Reliability and validity of the facial action summary score. Eur J Pain 2021; 25:1081-1090. [PMID: 33428820 DOI: 10.1002/ejp.1729] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 01/08/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Behavioural pain scales are recommended to assess postoperative pain for children who are too young to use self-report tools. Their main limitation is underestimation of pain in the days following an intervention. Although relevant, facial expression is not used in daily clinical practice. This prospective study aimed to assess the validity and reliability of the Facial Action Summary Score (FASS), a five-item scale, to assess postoperative pain until hospital discharge in children <7 years. METHODS Assessments of pain and anxiety of 123 children using FASS and validated scales were used to study the psychometric validity of the FASS in clinical practice. RESULTS The content validity was previously investigated in a development study. The internal validity of the FASS was high with excellent reliability (intraclass coefficient = 0.94) and a high Cronbach α (0.89). Convergent validity with pain scales (FLACC [Face, Legs, Activity, Cry, Consoling] and FPS-R [Faces Pain Scale - Revised]) was high (r > 0.8). Sensitivity to change was verified by a significant decrease in the score after rescue analgesia. For a threshold of 2/5, the FASS shows excellent specificity (97%) and sensitivity (82%). The low number of false negatives is the main strength of this tool. CONCLUSIONS This work highlights the interest in using facial expression in daily clinical practice to manage postoperative pain. The FASS is easy to use with excellent psychometric properties and is particularly sensitive to measure pain in the days following surgery. SIGNIFICANCE The aim of this study was to prove that facial expression of pain can be used in clinical practice to measure postoperative pain in children. The reduced number of false negatives is the main strength of this tool.
Collapse
Affiliation(s)
- Sophie Bringuier
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France.,Clinical Research and Epidemiology Unit, La Colombière University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Valerie Macioce
- Clinical Research and Epidemiology Unit, La Colombière University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Myriam Boulhais
- Clinical Research and Epidemiology Unit, La Colombière University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Christophe Dadure
- Department of Paediatric and Gynaecology Anaesthesia, Lapeyronie University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France.,Inserm Unit Functional Genomics Institute, University of Montpellier, Montpellier, France
| | - Xavier Capdevila
- Department of Anesthesiology and Critical Care Medicine, Lapeyronie University Hospital, CHU Montpellier, University of Montpellier, Montpellier, France.,Inserm Unit Montpellier NeuroSciences Institute, University of Montpellier, Montpellier, France
| |
Collapse
|
6
|
Effect of Personalized Music Intervention in Mechanically Ventilated Children in the PICU: A Pilot Study. Pediatr Crit Care Med 2020; 21:e8-e14. [PMID: 31652195 DOI: 10.1097/pcc.0000000000002159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the feasibility of a personalized music intervention with mechanically ventilated patients in the PICU. DESIGN Pilot study with a quasi-experimental design. SETTING Tertiary children's hospital in China with a 40-bed PICU. PATIENTS Children, 1 month to 7 years, with mechanical ventilation were recruited and assigned to music group (n = 25) and control group (n = 25). INTERVENTIONS Children in the music group received their own favorite music and listened for 60 minutes three times a day. The control group receive routine care without music. MEASUREMENTS AND MAIN RESULTS Primary outcome measure was comfort measured with the COMFORT Behavior scale 5 minutes before and after the music. Secondary outcome measures were physiologic variables; heart rate, respiration, blood pressure, oxygen saturation. Mechanical ventilation time, length of stay, and sedation medication were also collected. Qualitative analysis revealed that nurses had a positive attitude in delivering the interventions and identified improvements for the main trial. Children in the music group had lower COMFORT Behavior scores (15.7 vs 17.6; p = 0.011). Children in the music group had better physiologic outcomes; heart rate (140 vs 144; p = 0.039), respiration rate (40 vs 43; p = 0.036), systolic blood pressure (93 vs 95 mm Hg; p = 0.031), oxygen saturation (96% vs 95%; p < 0.001), diastolic blood pressure was not significantly (52 vs 53 mm Hg; p = 0.11). Children in the music group had a shorter ventilation time (148.7 vs 187.6; p = 0.044) and a shorter length of stay, but not significant (11.2 vs 13.8; p = 0.071). Children in the control group had higher total amount of on-demand midazolam (29 vs 33 mg; p = 0.040). CONCLUSIONS Our pilot study indicates that personalized music intervention is feasible and might improve the comfort of children with mechanical ventilation. Further studies are needed to provide conclusive evidence in confirming the effectiveness of music interventions comforting critically ill children in PICUs.
Collapse
|
7
|
Ebrahimpour F, Pashaeypoor S, Salisu WJ, Cheraghi MA, Sadat Hosseini AS. Children's description of pain through drawings and dialogs: A concept analysis. Nurs Open 2019; 6:301-312. [PMID: 30918682 PMCID: PMC6419297 DOI: 10.1002/nop2.211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Revised: 08/16/2018] [Accepted: 09/17/2018] [Indexed: 12/31/2022] Open
Abstract
AIM To present a concept analysis of pain in children's drawings and dialogs. INTRODUCTION The complexity and subjectivity of the concept of pain in children remain ambiguous. As a result, children are exposed to inappropriate diagnosis and inadequate treatment. Children can describe or draw their painful experiences. Analysing the concept of pain based on children's experiences can help identify, assess and properly manage and treat pain in children. DESIGN Concept analysis. METHODS Walker and Avant's framework for concept analysis was used in this current study. RESULTS Major aspects of pain revealed in this concept analysis are affected by children's different concerns about pain. The description of pain in children with chronic diseases or chronic pain is completely different from that in healthy children. Children perceive pain to be internal, external and emotional. Pain in children is associated with poor psychological and emotional conditions, which add new features and aspects to the concept of pain. Children's descriptions and drawings of pain indicate different concepts of pain in their minds. From the perspective of children, pain has an identity that is formed based on reality. CONCLUSION When developing pain evaluation tools, it is necessary to address the characteristics of pain. In the case of chronic pain, emotional effects of pain on children's psyche need extra attention. Child-based pain management guidelines can then be formulated with the results of relevant concept analyses. Pain assessment is a major part of pain management in children. By considering the characteristics of the concept of pain, the efficiency and usefulness of developed tools can be enhanced to create advancement in paediatric pain management.
Collapse
Affiliation(s)
- Fatemeh Ebrahimpour
- School of Nursing & MidwiferyTehran University of Medical SciencesTehranIran
| | - Shahzad Pashaeypoor
- School of Nursing & MidwiferyTehran University of Medical SciencesTehranIran
| | - Waliu Jawula Salisu
- School of Nursing & MidwiferyTehran University of Medical SciencesTehranIran
| | | | | |
Collapse
|
8
|
Marti F, Paladini A, Varrassi G, Latina R. Evaluation of Psychometric and Linguistic Properties of the Italian Adolescent Pain Assessment Scales: A Systematic Review. Pain Ther 2018; 7:77-104. [PMID: 29470789 PMCID: PMC5993683 DOI: 10.1007/s40122-018-0093-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Indexed: 01/26/2023] Open
Abstract
INTRODUCTION Adolescents' pain experiences are complex and multidimensional, and evaluating pain only from a sensory and affective point of view may be in many instances limiting and inadequate; this is the reason why it is of paramount importance to identify the tools which can better assess the pain experienced by young patients. A person-oriented approach is highly encouraged, as it may better investigate the cognitive and behavioral development typical of this age group. The aim of this review paper is to describe the available tools which are able to adequately assess pain intensity in adolescents, in particular those validated in Italian. METHODS We conducted a systematic review using four databases: CINAHL, PsycINFO, PubMed and Cochrane, and selected all the articles published between January 1970 and November 2017. We selected all the papers reporting the validation process of pain assessment tools specifically tailored for adolescent patients (age range 10-18 years) and based on psychometric and linguistic parameters, and focused especially on the tools available in Italian and able to measure acute and chronic pain. RESULTS The results of our investigation have revealed the existence of 40 eligible tools, 17 of which are monodimensional and the remaining 23 multidimensional, more specifically tailored to assess both acute and chronic pain. Some of the instruments (26) were self-reports while others were classified as behavioral (13) and/or mixed. Only one tool turned out to be suitable for fragile adolescents, while six adopted a person-oriented approach that better emphasized the cognitive and behavioral process typical of the adolescent population. None of them has ever been validated in Italian. CONCLUSION Valid and reliable psychometric tools specifically organized to provide a cultural and linguistic evaluation of the patient are indeed the most recommended instruments to assess the intensity of the pain experienced by the patient, as they may provide useful information to implement a health policy aimed at identifying the best assistance programs.
Collapse
Affiliation(s)
- Flavio Marti
- Neurosurgery Unit, Health Professions Department, AO S. Camillo-Forlanini Hospital, Rome, Italy.
| | | | - Giustino Varrassi
- Department of MESVA, University of L'Aquila, L'Aquila, Italy
- President-Elect of World Institute of Pain, Winston-Salem, NC, USA
| | - Roberto Latina
- School of Nursing, Sapienza University & Health Professions Department, AO S. Camillo-Forlanini Hospital, Rome, Italy
| |
Collapse
|
9
|
The measurement properties of pediatric observational pain scales: A systematic review of reviews. Int J Nurs Stud 2017; 73:93-101. [DOI: 10.1016/j.ijnurstu.2017.05.010] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Revised: 04/23/2017] [Accepted: 05/15/2017] [Indexed: 01/05/2023]
|
10
|
Bai J, Swanson KM, Santacroce SJ. Observational Coding Systems of Parent-Child Interactions During Painful Procedures: A Systematic Review. Pain Pract 2017; 18:130-145. [PMID: 28467677 DOI: 10.1111/papr.12588] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 02/19/2017] [Accepted: 03/12/2017] [Indexed: 12/21/2022]
Abstract
BACKGROUND Parent interactions with their child can influence the child's pain and distress during painful procedures. Reliable and valid interaction analysis systems (IASs) are valuable tools for capturing these interactions. The extent to which IASs are used in observational research of parent-child interactions is unknown in pediatric populations. OBJECTIVES To identify and evaluate studies that focus on assessing psychometric properties of initial iterations/publications of observational coding systems of parent-child interactions during painful procedures. METHODS To identify and evaluate studies that focus on assessing psychometric properties of initial iterations/publications of observational coding systems of parent-child interactions during painful procedures. Computerized databases searched included PubMed, CINAHL, PsycINFO, Health and Psychosocial Instruments, and Scopus. Timeframes covered from inception of the database to January 2017. Studies were included if they reported use or psychometrics of parent-child IASs. First assessment was whether the parent-child IASs were theory-based; next, using the Society of Pediatric Psychology Assessment Task Force criteria IASs were assigned to one of three categories: well-established, approaching well-established, or promising. RESULTS A total of 795 studies were identified through computerized searches. Eighteen studies were ultimately determined to be eligible for inclusion in the review and 17 parent-child IASs were identified from these 18 studies. Among the 17 coding systems, 14 were suitable for use in children age 3 years or more; two were theory-based; and 11 included verbal and nonverbal parent behaviors that promoted either child coping or child distress. Four IASs were assessed as well-established; seven approached well-established; and six were promising. CONCLUSIONS Findings indicate a need for the development of theory-based parent-child IASs that consider both verbal and nonverbal parent behaviors during painful procedures. Findings also suggest a need for further testing of those parent-child IASs deemed "approaching well-established" or "promising".
Collapse
Affiliation(s)
- Jinbing Bai
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, U.S.A
| | | | - Sheila J Santacroce
- School of Nursing, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A
| |
Collapse
|
11
|
Ozcan S, Bagcioglu M, Karakan T, Diri MA, Demirbas A. Efficacy of using Zaontz urethral stent in hypospadias repair by the Face, Legs, Activity, Cry, Consolability (FLACC) scale: A prospective study. Can Urol Assoc J 2017; 11:E15-E18. [PMID: 28163807 DOI: 10.5489/cuaj.3944] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
INTRODUCTION The developments in hypospadias surgical techniques and materials are intended to improve surgery outcomes and patient comfort. The aim of this study is to determine the effect of the Zaontz urethral stent (ZUS) (Cook Medical) on patient comfort and surgical success rates in children undergoing hypospadias surgery. METHODS A feeding tube was used to repair 46 cases of primary distal hypospadias, and ZUS (6F, 8F, and 10F in diameter) was used to repair to 31 cases of primary distal hypospadias between December 2009 and June 2011 in our clinic. ZUS was compared with the feeding tube in terms of surgical success rates and patient comfort in assessments made during postoperative periods. RESULTS The patients with ZUS were followed with a stent for seven days postoperatively, as were the patients with the feeding tube. There was no statistical difference between the two groups in terms of fistula formation (p>0.05). Patient comfort was evaluated by the Face, Legs, Activity, Cry, Consolability (FLACC) scale on the first and third postoperative days, and a statistically significant difference was observed in favour of ZUS on the third postoperative day (p<0.05). CONCLUSIONS Compared with a feeding tube in hypospadias repair, ZUS does not make any contribution to the urinary fistula rates. However, ZUS may have an advantage in terms of patient comfort in the postoperative followup. On the other hand, the small number of patients and the high price of the ZUS were the most important limitations. Prospective, randomized trials are needed to assess efficacy and cost.
Collapse
Affiliation(s)
- Serkan Ozcan
- Artvin State Hospital, Urology Department, Artvin, Turkey
| | - Murat Bagcioglu
- Kafkas University, Faculty of Medicine, Urology Department, Kars, Turkey
| | - Tolga Karakan
- Ankara Training and Research Hospital, Urology Department, Ankara, Turkey
| | - Mehmet Akif Diri
- Ankara Training and Research Hospital, Urology Department, Ankara, Turkey
| | - Arif Demirbas
- Ankara Training and Research Hospital, Urology Department, Ankara, Turkey
| |
Collapse
|