Persad R, Sharma S, McTavish J, Imber C, Mouriquand P D
Department of Paediatric Urology, Addenbrooke's Hospital, Cambridge, UK.
Br J Urol. 1995 Jan;75(1):91-3. doi: 10.1111/j.1464-410x.1995.tb07242.x.
To describe the clinical presentation and pathophysiology of meatal stenosis occurring after circumcision.
The clinical presentation and operative findings are reported in 12 children who presented with meatal stenosis over a period of 3 years.
The cardinal symptoms of meatal stenosis were penile pain at the initiation of micturition (12 of 12), narrow, high velocity stream (8 of 12) and the need to sit or stand back from the toilet bowl to urinate (6 of 12). Following surgical correction with meatotomy there was no recurrence of stenosis after a mean follow-up of 13 months. Traumatic meatitis of the unprotected post-circumcision urethral meatus and/or meatal ischaemia following damage to the frenular artery at circumcision are suggested as possible causes of meatal stenosis.
Preservation of the frenular artery at circumcision, or the use of an alternative procedure (preputial plasty), may be advisable when foreskin surgery is required, to avoid meatal stenosis after circumcision.
描述包皮环切术后尿道口狭窄的临床表现及病理生理学。
报告了3年间出现尿道口狭窄的12例儿童的临床表现及手术所见。
尿道口狭窄的主要症状为排尿起始时阴茎疼痛（12例中的12例）、尿流变细且流速快（12例中的8例）以及需要从马桶上坐起或向后站着排尿（12例中的6例）。经尿道外口切开术手术矫正后，平均随访13个月，狭窄未复发。包皮环切术后未受保护的尿道外口创伤性尿道口炎和/或包皮环切时系带动脉受损后的尿道口缺血被认为是尿道口狭窄的可能原因。
在需要进行包皮手术时，为避免包皮环切术后尿道口狭窄，建议在包皮环切时保留系带动脉，或采用替代手术（包皮成形术）。
