Calleja Aguayo E, Hernández Calvarro A E, Marhuenda Irastorza C
Servicio de Cirugía Pediátrica. Unidad de Urología. Hospital Universitario Son Espases. Palma de Mallorca.
Cir Pediatr. 2015 Jul 20;28(3):133-136.
Balanitis xerotica obliterans (BXO) is a chronic inflamatory disease, a genital form of Lichen Sclerosus in males.
This retrospective and descriptive analysis was carried out by rewiew of the medical records of boys who underwent circumcision from April 2013 to April 2014. The study group consisted of boys that were circumcised due it persistant phimosis at 4 years of age, urinary symptoms or painful erection. The histopathological examination was performed only in patients with clinical suspicion of BXO.
339 patients were circumcised. The mean age of surgery was 6.5 years (Median 5, Mode 4). BXO was confirmed in eleven boys (3.9%) out of 16 biopsies (5.7%), with a mean age of 8.2 years (6-12). Of all the biopsies that were analysed for clinical BXO, 9 had scarring phimosis (2 meatal stenosis), 2 had balanitis and 1 had acute urinary retention, 2 presented descamative foreskin or glands, and 1 had recurrent phimosis. The histopathological examination revealed lichen sclerosus in 10 patients. Meatotomy was performed in 3 boys, one of them in during the follow-up period. 10 patients with BXO were treated with topical corticosteroid cream after circumcision.
Our incidence is low in compared to literature (10-40%) as we did not refer the foreskin routinely to histopathological analysis. The clinical suspicion underestimates the incidence of BXO up to 49%. The circumcision is curative in most cases with BXO. The BXO may produce meatoestenosis and urethral abnormalities, and it is associated with a high incidence of penile carcinoma of the penis.
闭塞性干燥性龟头炎（BXO）是一种慢性炎症性疾病，是男性硬化性苔藓的生殖器形式。
通过回顾2013年4月至2014年4月接受包皮环切术的男孩的病历进行这项回顾性和描述性分析。研究组包括因4岁时持续性包茎、泌尿系统症状或阴茎勃起疼痛而接受包皮环切术的男孩。仅对临床怀疑患有BXO的患者进行组织病理学检查。
339例患者接受了包皮环切术。手术的平均年龄为6.5岁（中位数5岁，众数4岁）。在16例活检病例（5.7%）中的11名男孩（3.9%）中确诊为BXO，平均年龄为8.2岁（6 - 12岁）。在所有因临床怀疑BXO而进行分析的活检病例中，9例有瘢痕性包茎（2例尿道外口狭窄），2例有龟头炎，1例有急性尿潴留，2例有脱屑性包皮或龟头，1例有复发性包茎。组织病理学检查显示10例患者有硬化性苔藓。3名男孩进行了尿道外口切开术，其中1例在随访期间进行。10例BXO患者在包皮环切术后接受了外用糖皮质激素乳膏治疗。
与文献报道（10 - 40%）相比，我们的发病率较低，因为我们没有常规将包皮送检进行组织病理学分析。临床怀疑会使BXO的发病率低估高达49%。在大多数BXO病例中，包皮环切术具有治愈作用。BXO可能会导致尿道外口狭窄和尿道异常，并且与阴茎癌的高发病率相关。
