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宗教仪式性男性包皮环切术后龟头-包皮粘连的谱系及处理

Spectrum and the management of glanular-preputial adhesions after ritual male circumcision.

作者信息

Baky Fahmy Mohamed A, Elsayed Mohamed Amr Hussein, Ali AbdAlla Mohamed Fawzy ElSayed, Nour Nour A

机构信息

Pediatric Surgery Dept, Al-Azhar university, Cairo, Egypt.

Urology Dept, National Institute of Urology, Cairo, Egypt.

出版信息

BMC Urol. 2024 Dec 23;24(1):283. doi: 10.1186/s12894-024-01672-9.

DOI:10.1186/s12894-024-01672-9
PMID:39716167
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11667837/
Abstract

BACKGROUND

Complications after male circumcision are numerous and may be presented as an adhesion between the glans penis and the preputial remnants, these adhesions may acquire different forms and troublesome the affected children.

PATIENTS AND METHODS

This is a retrospective study of 95 consecutive children of presumed glanular-preputial adhesions referred for correction of circumcision. They were assessed and classified as having either an early preputial adhesion or a well-formed skin bridge into 2 groups; group (A) who have a simple adhesion that was resolved through a conservative preputial adhesiolysis while those in the group (B) had a well-formed skin bridge, which deserves surgical correction. Histopathology done for 30 cases from group B. All cases were followed up till resolution of the adhesion.

RESULTS

A wide diversity of the Glanular-Preputial Adhesions (GPA) was recognized with a different form ranged from a simple fibrinous adhesion which was diagnosed in 55 cases (group A), these adhesions were resolved with medical treatment, and a well-formed single or multiple skin bridges formed 3-4 months after circumcision; which were detected in 40 patients (group B) with a smegma pearls in 15, all required a surgical adhesiolysis. Mean age of patients was 3 years (6 months to 12 years). Three cases were diagnosed with penile scleroatrophic lichen balanitis.

CONCLUSION

Glanular-Preputial Adhesions is not a rare complication after MC. It could be a simple fibrinous; which resolves with topical corticosteroid or a well-formed skin bridge which needs surgical adhesiolysis.

摘要

背景

男性包皮环切术后并发症众多,可能表现为阴茎头与包皮残余之间的粘连,这些粘连可能呈现不同形式并给患病儿童带来困扰。

患者与方法

这是一项对95例因包皮环切矫正术前来就诊的疑似阴茎头 - 包皮粘连患儿的回顾性研究。他们被评估并分为早期包皮粘连组或形成良好的皮肤桥组,共2组;A组有单纯粘连,通过保守的包皮粘连松解术得以解决,而B组有形成良好的皮肤桥,需要手术矫正。对B组30例进行了组织病理学检查。所有病例均随访至粘连松解。

结果

认识到阴茎头 - 包皮粘连(GPA)具有广泛多样性,其形式各异,从55例被诊断为单纯纤维蛋白性粘连的病例(A组)开始,这些粘连通过药物治疗得以解决,以及在包皮环切术后3 - 4个月形成的形成良好的单处或多处皮肤桥;在40例患者(B组)中检测到,其中15例有包皮垢珍珠,所有这些都需要手术粘连松解。患者的平均年龄为3岁(6个月至12岁)。3例被诊断为阴茎硬化萎缩性苔藓龟头炎。

结论

阴茎头 - 包皮粘连在包皮环切术后并非罕见并发症。它可能是单纯纤维蛋白性的,可通过局部使用皮质类固醇解决,也可能是形成良好的皮肤桥,需要手术粘连松解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/cb00a3765d76/12894_2024_1672_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/d443e9ba91df/12894_2024_1672_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/d0d4315f6732/12894_2024_1672_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/3a135a1e6a19/12894_2024_1672_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/cb00a3765d76/12894_2024_1672_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/d443e9ba91df/12894_2024_1672_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/d0d4315f6732/12894_2024_1672_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/3a135a1e6a19/12894_2024_1672_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0bb5/11667837/cb00a3765d76/12894_2024_1672_Fig4_HTML.jpg

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