Valenzuela-López R, Cuevas-Alpuche JO, Olivera-Vázquez JL, Aguilar-Anzures R, Bornstein-Quevedo L

Language: Spanish
References: 6
Page: 118-121
PDF size: 148.54 Kb.

ABSTRACT

Generals. The prepuce is a composite structure of mucocutaneous tissue which corbes the glans penis or the clitoris. In the most neonates there exist a physiologic phimosis and it normally up to 90% of the prepuces are released at three years of age as a result of growth of the penis and of the accumulation of epithelium between the glans and the prepuce. For this reason medical indication for prepuce retraction exercises or a circumcision are indicated in selected cases. A circumcision is then performed for aesthetic, religious or social reasons.
Objectives. A 13 year old patient is presented, with a history of myelomeningocele, hydrocephalus and severe phimosis.
Clinical case. A 13 year old male patient with a history of myelomeningocele and hydrocephalus operated at 15 days of age. His present illness started four months before characterized by redundant prepuce, globe form (12 cm of diameter) containing 300 cc of fetid and turbid urine, secondary to true phimosis. Circumcision was practiced, the redundant prepuce weighted 85 g.
Discussion. The true phimosis or ballon type is a rare condition, it can cause urine retention; it is associated with balanitis xerotica obliterans and it can be solved with a circumcision.
Conclusions. It is important to practice a physical examination of children in order to identify phimosis and to differentiate physiological state from a pathological one to avoid undesired progressions of the phimosis and the unnecessary circumcision.

REFERENCES

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2. Rickewood AM. Medical indications for circumcision. Br J Urol Inter 1999;83(suppl 1):45-51.

3. Kayaba H, Tamura H, Kitajima S, et al. Analysis of shape and retractability of the prepuce in 603 Japanese boys. J Urol 1996;156(5):1813-5.

4. Dunsmuir WD, Gordon EM. The history of circumcision. Br J Urol 1999;83(suppl 1):1-12.

5. Harbinson M. The arguments for and against circumcision. J Urol 1997;11(32):42-7.

6. Depasquale P, Bracka A. The treatment of balanitis xerotica obliterans. Br J Urol 2000;86:459-65.