Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
Sullivan Nicolaides Pathology, Brisbane, Queensland, Australia.
Int J Dermatol. 2021 May;60(5):559-563. doi: 10.1111/ijd.15359. Epub 2020 Dec 15.
Circumcision is one of the most frequently performed procedure by clinicians, yet its role and indication in clinical practice lacks consensus and remains unclear. We sought to evaluate a collection of male circumcisions to determine the range of indications, histopathological diagnoses, and type of clinicians associated with circumcision.
We performed a retrospective descriptive cohort study of male patients who received a circumcision reported by one major dermatopathology laboratory between January 2017 and December 2018. Data were extracted from the histological report of the pathologist for each case. Patient age, type of clinician, clinical notes, and histopathological diagnosis were evaluated.
"/> A total of 406 circumcisions were identified. The median age for circumcision was 36 (IQR 16-61). Boys less than 18 years of age made up 24% (98/406). Histological diagnoses included normal (43/406, 11%), nonspecific inflammation (82/406, 20%), inflammatory conditions (264/406, 65%), infections (9/406, 2.2%), benign neoplasms (5/406, 1.0%), and scar tissue (3/406, 0.7%). The most common diagnosis was balanitis xerotica obliterans (226/406, 56%). Rarely, genital infections and neoplastic lesions were identified. Circumcisions were performed by urologists (289/406, 71.2%), general practitioners (76/406, 18.7%), general surgeons (32/406, 8%), pediatric surgeons (5/406, 1%), and dermatologists (4/406, 1%). The main indications for circumcision were phimosis (110/202, 54%), suspected lichen sclerosus (28/202, 14%), and balanitis (15/202, 7%).
Circumcision was performed for a broad range of genital dermatoses across various medical and surgical specialties. Few studies have described these observations. We discuss the common pathological conditions leading to circumcision and its role in diagnosis and treatment.
包皮环切术是临床医生最常进行的手术之一，但在临床实践中，其作用和适应证缺乏共识，仍不清楚。我们旨在评估一组男性包皮环切术，以确定适应证范围、组织病理学诊断和与包皮环切术相关的临床医生类型。
我们对 2017 年 1 月至 2018 年 12 月期间一家主要皮肤科病理实验室报告的接受包皮环切术的男性患者进行了回顾性描述性队列研究。从每个病例的病理医生的组织学报告中提取数据。评估患者年龄、临床医生类型、临床记录和组织病理学诊断。
共确定了 406 例包皮环切术。包皮环切术的中位年龄为 36 岁（IQR 16-61）。年龄小于 18 岁的男孩占 24%（98/406）。组织学诊断包括正常（43/406，11%）、非特异性炎症（82/406，20%）、炎症性疾病（264/406，65%）、感染（9/406，2.2%）、良性肿瘤（5/406，1.0%）和疤痕组织（3/406，0.7%）。最常见的诊断是干燥性龟头炎（226/406，56%）。罕见情况下，也发现了生殖器感染和肿瘤性病变。包皮环切术由泌尿科医生（289/406，71.2%）、全科医生（76/406，18.7%）、普通外科医生（32/406，8%）、小儿外科医生（5/406，1%）和皮肤科医生（4/406，1%）进行。包皮环切术的主要适应证是包茎（110/202，54%）、疑似硬化性苔藓（28/202，14%）和龟头炎（15/202，7%）。
包皮环切术用于治疗各种医学和外科专业的广泛生殖器皮肤病。很少有研究描述过这些观察结果。我们讨论了导致包皮环切术的常见病理情况及其在诊断和治疗中的作用。
