Gargollo Patricio C, Kozakewich Harry P, Bauer Stuart B, Borer Joseph G, Peters Craig A, Retik Alan B, Diamond David A
Department of Urology, Children's Hospital Boston, Boston, Massachusetts 02115, USA.
J Urol. 2005 Oct;174(4 Pt 1):1409-12. doi: 10.1097/01.ju.0000173126.63094.b3.
Balanitis xerotica obliterans (BXO) is a chronic dermatitis of unknown etiology most often involving the glans and prepuce but sometimes extending into the urethra. We report our 10-year experience with BXO in pediatric patients.
Our pathology database was queried for all tissue diagnoses of BXO from 1992 to 2002. Available charts were reviewed and patient presentation, clinical and referral history, operative procedure(s) and postoperative course were recorded.
A total of 41 patients had a tissue confirmed diagnosis of BXO. Median patient age was 10.6 years. Of the patients 85% were 8 to 13 years old and all had referrals available for review. The most common referral diagnoses were phimosis (52%), balanitis (13%) and buried penis (10%). No patient had the diagnosis of BXO at referral. Of the patients 19 (46%) underwent curative circumcision or redo circumcision and had no recurrence at a mean followup of 12.5 months (range 1 to 57). A total of 11 patients (27%) had BXO involvement of the meatus and underwent circumcision combined with meatotomy or meatoplasty. Nine patients (22%) required extensive plastic operation(s) of the penis, including buccal mucosa grafts in 2.
The incidence of BXO in pediatric patients may be higher than previously reported, with the diagnosis rarely made by pediatricians. Our study demonstrates that older patients, those with BXO involvement of the meatus and those with a history of surgery for BXO tend to have a more severe and morbid clinical course.
闭塞性干燥性龟头炎（BXO）是一种病因不明的慢性皮炎，最常累及龟头和包皮，但有时会延伸至尿道。我们报告了我们在儿科患者中治疗BXO的10年经验。
查询我们的病理数据库，获取1992年至2002年所有BXO的组织诊断结果。回顾可用的病历，记录患者的表现、临床和转诊病史、手术操作及术后病程。
共有41例患者经组织确诊为BXO。患者的中位年龄为10.6岁。其中85%的患者年龄在8至13岁之间，所有患者均有转诊记录可供审查。最常见的转诊诊断为包茎（52%）、龟头炎（13%）和埋藏阴茎（10%）。转诊时无患者被诊断为BXO。19例（46%）患者接受了根治性包皮环切术或再次包皮环切术，平均随访12.5个月（范围1至57个月）无复发。共有11例患者（27%）的尿道口受累，接受了包皮环切术联合尿道口切开术或尿道口成形术。9例患者（22%）需要进行广泛的阴茎整形手术，其中2例采用颊黏膜移植。
儿科患者中BXO的发病率可能高于先前报道，儿科医生很少做出该诊断。我们的研究表明，年龄较大的患者、尿道口受累的患者以及有BXO手术史的患者往往有更严重和病态的临床病程。
