Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica. Hospital Universitario Vall d'Hebron. Barcelona.
Cir Pediatr. 2020 Apr 1;33(2):79-83.
Balanitis xerotica obliterans (BXO) is a chronic inflammatory disease with a little known incidence in pediatric population. The objective of this work was to describe our experience in the treatment of BXO.
Retrospective study carried out in 419 patients undergoing circumcision surgery between January 2014 and January 2017. Demographic, clinical, therapeutic, and anatomical and pathological variables, as well as complications during follow-up, were analyzed.
Of the 419 patients, 41 (9.78%) were diagnosed with BXO. 6 patients were excluded owing to lack of follow-up, so 35 patients were analyzed. Mean age at diagnosis was 8.6 years. Suspicion diagnosis was clinical at physical exploration in 17 patients (48.6%), and at surgery in 18 patients (51.4%). Anatomical and pathological confirmation was performed in a total 35 patients (100%). During follow-up, 6 patients (17.14%) had lesions in the glans, 3 (8.57%) in the urethra, and 9 (25.71%) in both. 6 meatotomies (17.14%) and 5 new circumcisions (14.28%) had to be carried out. Mean recurrence time was 32.43 months. In 19 patients (54.28%), topical corticoids - ointment - were applied, and 1 patient (2.85%) received topical immunosuppressants.
A close follow-up of patients with clinical or anatomical and pathological diagnosis of BXO is required given its high morbidity. The complications described in pediatric population include meatal and urethral stenosis, as well as recurrent phimosis, unless a sufficient amount of foreskin is resected.
硬化性苔藓性外阴炎（BXO）是一种慢性炎症性疾病，在儿科人群中发病率较低。本研究旨在描述我们在 BXO 治疗方面的经验。
对 2014 年 1 月至 2017 年 1 月间行包皮环切术的 419 例患者进行回顾性研究。分析了人口统计学、临床、治疗、解剖和病理变量以及随访期间的并发症。
419 例患者中，41 例（9.78%）诊断为 BXO。因随访缺失，排除 6 例，共分析 35 例患者。诊断时的平均年龄为 8.6 岁。17 例（48.6%）患者在体格检查时临床怀疑为 BXO，18 例（51.4%）在手术时怀疑为 BXO。35 例患者均行解剖和病理检查确诊（100%）。随访期间，6 例（17.14%）患者龟头有病变，3 例（8.57%）患者尿道有病变，9 例（25.71%）患者龟头和尿道均有病变。6 例行阴茎皮切开术（17.14%），5 例行新包皮环切术（14.28%）。平均复发时间为 32.43 个月。19 例（54.28%）患者外用皮质激素乳膏，1 例（2.85%）患者外用免疫抑制剂。
鉴于 BXO 的高发病率，需要对临床或解剖病理诊断为 BXO 的患者进行密切随访。在儿科人群中，并发症包括尿道口和尿道狭窄，以及复发性包茎，除非切除足够量的包皮。
