[Application of preputial endoscopy in the treatment of phimosis]
Yun-Long Li1, Le-Yi Liu1, Jun-Chao Zhu1
1Department of Urology, Kunshan First People's Hospital, Kunshan, Jiangsu 215300, China.
Objective:
To explore the application value of preputial endoscopy in the treatment of phimosis.
Methods:
The clinical data were obtained on 58 cases of phimosis with an obvious narrow ring at the prepuce mouth and unable to reveal the glans penis when pushed up, which were treated in hour department from October 2018 to May 2020. The patients underwent preputial endoscopic examination followed by circumcision (group A, n = 30) or simple circumcision (group B, n = 28). A ureteroscope was used for preputial endoscopy, and the foreign matter removed with forceps to prepare for later circumcision. Under surface anesthesia, the ureteroscope was entered into the preputial cavity to observe the intactness and smoothness of the right, left and anterior walls and the frenulum side, as well as possible bleeding, tumor or hypospadias.
Results:
Preputial endoscopy was successfully performed in all the 30 cases, which revealed 1 case of adhesive integration of the inner preputial lamina to the glans, 1 case of hypospadias, 2 cases of preputial adhesion and 2 cases of glans hemorrhage. Pathological biopsy confirmed penile cancer in 1 of the 6 cases. Lateral wall hemorrhage was found in 4 cases, preputial stones in 3, which was removed with foreign matter forceps, and preputial infection in 5 cases, which was treated by intrapreputial irrigation and antibiotic anti-inflammation therapy. The preputial endoscopic examinations lasted (6.52 ± 2.03) min. The operation time was significantly shorter in group A than in B (［37.81 ± 4.09］ vs ［48.04 ± 5.48］ min, P < 0.01), and so were the postoperative pain duration (［110.74 ± 22.09］ vs ［121.43 ± 26.80］ min, P < 0.01) and postoperative recovery time (［7.96 ± 1.83］ vs ［12.04 ± 3.28］ d, P < 0.01).
Conclusions:
Preputial endoscopy is a safe and efficient method for the diagnosis and treatment of phimosis, with the advantages of simple operation, short examination time and less intraoperative pain, making essential preparations for subsequent circumcision.
