Eckert K, Janssen N, Franz M, Liedgens P
Klinik für Kinderchirurgie, Elisabeth-Krankenhaus Essen, Klara-Kopp-Weg 1, 45138, Essen, Deutschland.
Praxis für Kinderchirurgie, Essen, Deutschland.
Urologe A. 2017 Mar;56(3):351-357. doi: 10.1007/s00120-016-0232-0.
Removing boys' foreskins, even for medical reasons, is increasingly and critically discussed. The aim of this study is to retrospectively verify if the indication for the removal of boys' foreskins was justified. The study is based on the records of boys who underwent preputial operation in an outpatient medical office for pediatric surgery.
Preoperative clinical findings, complaints, applied conservative and/or surgical procedures and histological results of the resected foreskins of boys, who underwent preputial operation between 2013-2015, were retrospectively analyzed.
A total of 176 boys (age 5 on average) underwent a preputial operation. In 85 % of the cases it was completely removed. Most frequent clinical findings (80 %) were that the prepuce was simply not retractable. 86 % of the boys were free of complaints. The most frequent histological findings were a discrete to moderately pronounced chronic fibrous posthitis (69 %) and subepithelial fibrosis (18 %), In the first case 78 % of the boys had been free of complaints, in the latter 72 %.
The majority of the treated boys were free of complaints; however, most of them underwent a complete removal of their foreskin simply because it was nonretractable. The foreskin represents the most sensitive part of the male genital, preputiolysis is a natural process that can go on until early adolescence. Irreversible surgical procedures, such as a complete foreskin removal, should thus be restricted to a clear medical indication.
切除男孩的包皮，即使是出于医学原因，也越来越受到批判性讨论。本研究的目的是回顾性验证切除男孩包皮的指征是否合理。该研究基于在儿科外科门诊接受包皮环切手术的男孩的记录。
回顾性分析2013年至2015年间接受包皮环切手术的男孩的术前临床检查结果、主诉、应用的保守和/或手术方法以及切除包皮的组织学结果。
共有176名男孩（平均年龄5岁）接受了包皮环切手术。其中85%的病例包皮被完全切除。最常见的临床检查结果（80%）是包皮单纯不能上翻。86%的男孩无主诉。最常见的组织学检查结果是轻度至中度慢性纤维性阴茎头炎（69%）和上皮下纤维化（18%），在第一种情况中78%的男孩无主诉，在第二种情况中72%的男孩无主诉。
大多数接受治疗的男孩无主诉；然而，他们中的大多数仅仅因为包皮不能上翻就接受了包皮完全切除术。包皮是男性生殖器最敏感的部分，包皮松解是一个自然过程，可以持续到青春期早期。因此，不可逆的手术操作，如完全切除包皮，应仅限于明确的医学指征。
