Baron M, Heloury Y, Stalder J F, Bureau B, Bouchot O, Auvigne J
Service de Chirurgie Infantile, C.H.R. Hôtel Dieu, Nantes.
J Chir (Paris). 1991 Aug-Sep;128(8-9):368-71.
From 1979 to 1988, 8 cases of balanitis xerotica obliterans were histologically demonstrated in children at Nantes University Hospital. In 6 of these 8 patients, whose average age at the time of consultation was 9.4 years, the phimosis was obviously acquired or recurrent, and the prepuce was sclerous, thick, and produced a tight distal phimosis. One child coming to consultation for relapsing urinary infections at once presented with a long, tight stenosis of the anterior ureter, associated with a dilatation of the upstream ureter and a filiform stream of urine. All the children were circumcised, and the histological study of the specimen demonstrated characteristic lesions in the superficial derma. During the same operation, meatostomy was performed in two children presenting with meatal stenosis. Six of 8 children were followed up with an average time lapse of 6 months: one of them presented with an involvement of the glans penis and a moderate meatal stenosis, which disappeared spontaneously. No improvement occurred for the child presenting with an extensive stenosis of the anterior ureter, in spite of the local instillation of androgens then of corticoids, but his left kidney was dilated on sonograms. Balanitis xerotica obliterans in children is often not recognized and regarded as a common phimosis; it can be suspected because of the clinical features of the phimosis. The condition must be confirmed by the histological study of a circumcision specimen, then followed up regularly to prevent any risk of involvement of the glans, of the ureteral meatus or of the anterior ureter.
1979年至1988年期间，南特大学医院经组织学证实有8例儿童患闭塞性干燥性龟头炎。在这8例患者中的6例，就诊时平均年龄为9.4岁，包茎明显为后天获得性或复发性，包皮硬化、增厚，导致远端包茎狭窄。一名因复发性泌尿系统感染前来就诊的儿童立即表现出前尿道长而狭窄，伴有上游输尿管扩张及尿线呈丝状。所有儿童均接受了包皮环切术，标本的组织学研究显示表皮有特征性病变。在同一手术中，对2例有尿道口狭窄的儿童进行了尿道口切开术。8例儿童中有6例进行了随访，平均随访时间为6个月：其中1例出现阴茎头受累及中度尿道口狭窄，但自行消失。尽管局部先后滴注雄激素和皮质类固醇，但前尿道广泛狭窄的患儿病情无改善，不过其左肾在超声检查时显示有扩张。儿童闭塞性干燥性龟头炎常未被认识，而被视为普通包茎；因其包茎的临床特征可怀疑为此病。必须通过包皮环切标本的组织学研究来确诊，然后定期随访，以预防阴茎头、尿道口或前尿道受累的任何风险。
