Mattioli G, Repetto P, Carlini C, Granata C, Gambini C, Jasonni V
Department of Pediatric Surgery, Giannina Gaslini and Clinical Institute, Largo G. Gaslini 5, 16100 Genova, Italy.
Pediatr Surg Int. 2002 May;18(4):273-5. doi: 10.1007/s003830100699.
This prospective study was designed to evaluate the incidence of lichen sclerosus et atrophicus (LSA) in a pediatric population with hypospadias and phimosis in order to discuss the indications for circumcision and utilization of preputial skin for urethral surgery. All 115 boys, 55 with congenital phimosis, 45 with acquired phimosis, 13 with hypospadias, and 2 with recurrent chronic balanitis, underwent full-thickness biopsies of the foreskin that were examined by a single pathologist. Of the patients with acquired phimosis, 88% showed inflammatory features in the foreskin; 60% had LSA. Of the patients with congenital phimosis, 82% showed inflammatory disease in the prepuce; 30% had LSA. Of the patients operated upon for hypospadias, 61% showed histologic findings of chronic inflammation of the foreskin and LSA was evident in 15%. The high incidence of LSA in the prepuce of patients with phimosis suggests that circumcision should be performed to correct this disease. The frequent presence of chronic inflammation is a possible cause of stenosis when the foreskin is used to perform a urethroplasty in patients with hypospadias.
本前瞻性研究旨在评估患有尿道下裂和包茎的儿科人群中硬化性萎缩性苔藓（LSA）的发病率，以便讨论包皮环切术的适应症以及利用包皮进行尿道手术的情况。115名男孩，其中55名患有先天性包茎，45名患有后天性包茎，13名患有尿道下裂，2名患有复发性慢性龟头炎，均接受了包皮全层活检，由一名病理学家进行检查。在后天性包茎患者中，88%的包皮显示有炎症特征；60%患有LSA。在先天性包茎患者中，82%的包皮有炎症疾病；30%患有LSA。在接受尿道下裂手术的患者中，61%显示包皮慢性炎症的组织学表现，15%有明显的LSA。包茎患者包皮中LSA的高发病率表明应进行包皮环切术以纠正这种疾病。当在尿道下裂患者中使用包皮进行尿道成形术时，慢性炎症的频繁存在可能是狭窄的一个原因。
