■虽然鞘膜积液是最常见的泌尿系病变之一,它很少被研究,主要的泌尿外科协会没有成人鞘膜积液的管理指南。
■描述成人鞘膜积液治疗的国际惯例变化。
■针对比利时泌尿科医师的鞘膜积液管理进行了一项国际调查,丹麦,芬兰,冰岛,Japan,以及2020年9月至12月的荷兰。我们邀请了来自每个国家(冰岛除外)的170名泌尿科医师的随机样本。
■泌尿科医生的治疗方案,与决策相关的因素,预期患者满意度,并评估了误吸与手术后的结局.
■在联系的864名泌尿科医师中,437人(51%)参加。在受访者中,202例(53%)同时进行了水力旋切术和抽吸术,147例(39%)仅进行了水力旋切术,和30(8%)仅进行了抽吸。比利时(83%)荷兰(75%)丹麦(55%)泌尿科医师主要只进行了积水切除术,而在芬兰(84%),日本(61%),冰岛(91%)泌尿科医师进行了水切除术和抽吸术。泌尿科医师倾向于对大的鞘膜积液(78.8%和37.5%为小的),年轻患者(<50岁的患者为66.0%,≥70岁的患者为41.2%),很少或没有合并症的患者(62.3%vs23.1%有多种合并症),和未使用抗血栓药的患者(53.5%vs36.5%使用抗血栓药)。大多数泌尿科医师认为患者满意度最高(53.8%,抽吸后9.9%),尽管认为水切除术更容易引起并发症(血肿77.8%,抽吸后8.8%)。各国的估计各不相同。
■我们发现在国家内部和国家之间对成人鞘膜积液的治疗存在很大差异。全球鞘膜积液管理的优化将需要未来的研究。
■我们的国际调查显示,成人鞘膜积液的治疗方法在国家内部和国家之间差异很大。
UNASSIGNED: Although
hydrocele is one of the most common urologic pathologies, it is seldom studied, and the major urologic associations have no guidelines for the management of adult hydroceles.
UNASSIGNED: To characterize international practice variation in the treatment of adult hydroceles.
UNASSIGNED: An international survey was conducted addressing the management of hydroceles among urologists in Belgium, Denmark, Finland, Iceland, Japan, and the Netherlands from September to December 2020. We invited a random sample of 170 urologists from each country (except Iceland).
UNASSIGNED: Urologists\' treatment options, factors relevant for decision-making, expected patient satisfaction, and outcomes after aspiration versus surgery were assessed.
UNASSIGNED: Of the 864 urologists contacted, 437 (51%) participated. Of the respondents, 202 (53%) performed both hydrocelectomies and aspiration, 147 (39%) performed hydrocelectomies only, and 30 (8%) performed aspiration only. In Belgium (83%), the Netherlands (75%), and Denmark (55%), urologists primarily performed hydrocelectomies only, whereas in Finland (84%), Japan (61%), and Iceland (91%), urologists performed both hydrocelectomies and aspiration. Urologists favored hydrocelectomy for large hydroceles (78.8% vs 37.5% for small), younger patients (66.0% for patients <50 yr vs 41.2% for ≥70 yr), patients with few or no comorbidities (62.3% vs 23.1% with multiple comorbidities), and patients without antithrombotic agents (53.5% vs 36.5% with antithrombotic agents). Most urologists considered patient satisfaction to be highest after hydrocelectomy (53.8% vs 9.9% after aspiration) despite believing that hydrocelectomy is more likely to cause complications (hematoma 77.8% vs 8.8% after aspiration). Estimates varied between countries.
UNASSIGNED: We found a large variation in the treatment of adult hydroceles within and between countries. Optimization of
hydrocele management globally will require future studies.
UNASSIGNED: Our international survey shows that treatment of adult
hydrocele varies considerably within and between countries.