Pedersini Pierluigi, Parolini Filippo, Bulotta Anna Lavinia, Alberti Daniele
Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy.
Department of Paediatric Surgery, "Spedali Civili" Children's Hospital, Brescia, Italy.
J Pediatr Urol. 2017 Jun;13(3):278.e1-278.e4. doi: 10.1016/j.jpurol.2017.01.024. Epub 2017 Mar 15.
To evaluate the functional and cosmetic result of modified-triple incision preputial plasty for surgical management of phimosis in children.
This prospective study involved all consecutive children (age 3-15) with phimosis, managed at our Institution in a one-year period. All patients unable to retract the foreskin and symptomatic with episodes of posthitis or balanoposthitis or ballooning of the foreskin with voiding were initially included. After a two-month trial of topic corticosteroids treatment, for patients refractory to conservative ointment treatment, "trident" preputial plasty was offered. This procedure combines two lateral Z-plasty and one middle Y-V plasty. All the procedures were performed as a day care, in general anaesthesia by two senior surgeons. Outpatient follow-up controls were scheduled at 1 and 2 week, 1, 6 and 12 months after surgery, respectively.
A total of 41 patient were enrolled. Mean operative time was 24 minutes (range 15-43). At 12-month follow-up, all but one patients (97.6%) was able to retract the prepuce. Cosmetic and functional results were satisfactory.
In selected group of children with phimosis, the "trident" preputial plasty provided excellent cosmetic and functional result. Adequate retraction of the prepuce by the patients soon after surgery is mandatory.
评估改良三切口包皮成形术治疗儿童包茎的功能和美容效果。
这项前瞻性研究纳入了在我院一年内连续收治的所有包茎患儿（年龄3 - 15岁）。所有无法翻开包皮且有包皮炎、龟头包皮炎发作症状或排尿时包皮呈气球样膨胀症状的患者最初均被纳入。在进行为期两个月的局部皮质类固醇治疗试验后，对于保守药膏治疗无效的患者，采用“三叉戟”包皮成形术。该手术结合了两个外侧Z成形术和一个中间Y - V成形术。所有手术均在日间病房进行，由两位资深外科医生实施全身麻醉。术后分别在第1周、第2周、1个月、6个月和12个月安排门诊随访检查。
共纳入41例患者。平均手术时间为24分钟（范围15 - 43分钟）。在12个月的随访中，除1例患者外（97.6%），所有患者均能翻开包皮。美容和功能效果均令人满意。
在选定的包茎患儿群体中，“三叉戟”包皮成形术提供了出色的美容和功能效果。术后患者尽快充分翻开包皮是必要的。
