Saeedi Parisa, Ahmadnia Hassan, Akhavan Rezayat Alireza
Assistant professor of Urology, Mashhad University of Medical Science, Mashhad, Iran.
Professor of Urology, Mashhad University of Medical Science, Mashhad, Iran.
Urol J. 2017 May 23;14(3):3071-3074.
Circumcision is one of the oldest surgical procedures that originated for religious purposes. Circumcision in infancy is a common procedure in our country and secondary meatal stenosis due to circumcision is a common complication. The aim of our study is to determine the effect of meatal stenosis on the lower and upperurinary tract of circumcised boys by using ultrasonography.
In this cross-sectional study, we enrolled 87 circumcised boys between 4 to 8 years old with severe meatal stenosis. Clinical findings of our subjects were gathered by a checklist that included: thin stream of urine, upward urine stream deviation, infrequent voiding, urinary tract infections, voiding dysfunction, and urge incontinency. In lab data analysis, complete blood cell count (CBC), urine analysis, urine culture, blood urea nitrogen (BUN), and plasma creatinine level were evaluated. Ultrasonography detected hydronephrosis, hydroureter, bladder wall thickening in a full and empty bladder, bladder volume, and residual urine volume.
Narrowing of urine stream is commonly seen (about 54%) among patients with severe meatal stenosis, and similarly in sonographic evaluations the most common symptoms among patients was thickening of the bladder wall that increased in an empty and a full bladder (about 82%).
The author of this study recommends performing long-term follow up after circumcision and ultrasonographyto detect meatal stenosis before permanent renal damage occurs.
包皮环切术是最古老的外科手术之一，起源于宗教目的。婴儿期包皮环切术在我国是一种常见的手术，包皮环切术后继发尿道口狭窄是一种常见的并发症。我们研究的目的是通过超声检查确定尿道口狭窄对接受包皮环切术男孩的下尿路和上尿路的影响。
在这项横断面研究中，我们纳入了87名4至8岁患有严重尿道口狭窄的接受包皮环切术的男孩。通过一份检查表收集我们研究对象的临床发现，该检查表包括：尿流细、尿流向上偏斜、排尿不频繁、尿路感染、排尿功能障碍和急迫性尿失禁。在实验室数据分析中，评估全血细胞计数（CBC）、尿液分析、尿培养、血尿素氮（BUN）和血浆肌酐水平。超声检查检测肾积水、输尿管积水、膀胱充盈和排空时的膀胱壁增厚、膀胱容量和残余尿量。
严重尿道口狭窄患者中常见尿流变窄（约54%），同样在超声评估中，患者最常见的症状是膀胱壁增厚，在膀胱排空和充盈时均增加（约82%）。
本研究的作者建议在包皮环切术后进行长期随访并进行超声检查，以便在永久性肾损伤发生之前检测到尿道口狭窄。
