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Megaprepuce associated with vesicoureteric reflux
Objective:
To describe 4 patients in whom megaprepuce was associated with vesicoureteric reflux (VUR).
Patients And Methods:
Four boys aged 6, 4, 5 and 7 months, respectively, presented with dribbling of urine, gross penile swelling and inability to void spontaneously. The first 3 patients had a history of documented urinary tract infection. Micturating cystourethrogram (MCUG) revealed grade III VUR on the right in the first patient, grade V on the left in the second patient, grade III on the right and grade IV in both moieties of left duplex system in the third patient and bilateral grade III in the fourth patient. All patients underwent circumcision.
Results:
Follow-up MCUG demonstrated complete resolution of VUR in 2 patients after circumcision. One patient with bilateral VUR showed resolution of VUR on right side but persistence of VUR into the lower moiety of left duplex system after circumcision. Vesicoureteric reflux was downgraded from grade 5 to grade 3 after circumcision in one patient.
Conclusion:
These cases demonstrate for the first time the association of megaprepuce with VUR. VUR associated with megaprepuce is usually resolved after circumcision.
Insights
This study highlights the link between megaprepuce and vesicoureteric reflux (VUR) in infants. Circumcision often resolves VUR associated with megaprepuce, improving urinary tract health.
Area of Science:
- Pediatric Urology
- Medical Case Studies
- Urinary Tract Disorders
Background:
- Megaprepuce, a condition characterized by an abnormally large foreskin, is rarely associated with other urological abnormalities.
- Vesicoureteric reflux (VUR) is a condition where urine flows backward from the bladder to the ureters, often leading to urinary tract infections.
Observation:
- Four male infants presented with symptoms including urine dribbling, penile swelling, and voiding difficulties.
- Diagnostic imaging, specifically micturating cystourethrogram (MCUG), revealed varying grades of VUR in all four patients.
- Three of the patients had a documented history of urinary tract infections.
Findings:
- Following circumcision, two patients experienced complete resolution of VUR.
- One patient showed partial resolution of VUR after circumcision, with improvement on one side but persistence on the other.
- In another case, VUR severity was reduced following circumcision.
Implications:
- This study suggests a potential association between megaprepuce and VUR in pediatric patients.
- Circumcision may be an effective treatment for VUR when it is associated with megaprepuce.
- Further research is warranted to understand the underlying mechanisms and long-term outcomes.