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Surgical Management of Meatal Stenosis with Meatoplasty
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Paediatric preputial pathology: are we circumcising enough?

I E Yardley1, C Cosgrove, A W Lambert

  • 1Department of Surgery, Derriford Hospital, Plymouth, UK.

Annals of the Royal College of Surgeons of England
|February 24, 2007
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Balanitis xerotica obliterans (BXO) may be more common in children than previously thought. This study found a higher prevalence of BXO in boys referred for preputial problems.

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Area of Science:

  • Pediatric Surgery
  • Dermatology
  • Urology

Background:

  • Preputial problems are a frequent reason for pediatric surgical referrals.
  • Many referred boys do not require surgery.
  • Balanitis xerotica obliterans (BXO) is a serious condition, historically considered rare in childhood.

Purpose of the Study:

  • To investigate the prevalence of balanitis xerotica obliterans (BXO) in boys referred for preputial issues.
  • To analyze the diagnostic outcomes and histological findings in this cohort.

Main Methods:

  • A 4-year retrospective review of consecutive boys referred for preputial problems.
  • Recording of outpatient diagnoses and management.
  • Histological analysis of all excised foreskins.

Main Results:

  • 422 boys were referred; over half needed only reassurance.
  • 186 boys (44.1%) underwent surgery (circumcision, adhesiolysis, frenuloplasty).
  • Histological abnormalities were found in 84.8% of specimens, including chronic inflammation (46.6%) and BXO (34.5%). The overall prevalence of BXO was 12.1%.

Conclusions:

  • The prevalence of BXO and the rate of circumcision in this series were higher than previously reported.
  • BXO might be more prevalent and occur at younger ages than previously recognized.