China
Africa
Explore chapters and articles related to this topic
Circumcision, meatotomy, meatoplasty, and preputioplasty
Published in Mark Davenport, James D. Geiger, Nigel J. Hall, Steven S. Rothenberg, Operative Pediatric Surgery, 2020
Rachel Harwood, Simon E. Kenny
The main complication with preputioplasty is the recurrence of phimosis which may require circumcision in the future. With BXO, this risk is about 20%. The risk can be reduced by asking that boys retract and replace their foreskin twice a day, starting 2 weeks after preputioplasty. If phimosis is recurring, a topical steroid cream can be beneficial.
Urethra and Penis
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
In a young child with a non-retractile foreskin, no treatment is necessary or appropriate. When the foreskin is mildly scarred, then preputioplasty is possible. For all other cases, circumcision is the appropriate treatment. In cases of BXO, circumcision is often curative, although when the condition affects the glans penis, topical steroid cream may be helpful. In resistant cases, formal meatotomy is necessary. In emergency situations, such as when catheterisation is required, but is impossible, then it is possible to divide the foreskin dorsally under local anaesthetic (a so called dorsal slit).
Circumcision and disorders of penis
Published in Brice Antao, S Irish Michael, Anthony Lander, S Rothenberg MD Steven, Succeeding in Paediatric Surgery Examinations, 2017
Preputioplasty has been used in Europe to produce a retractable yet intact foreskin. There are various techniques to achieve this, the simplest being a dorsal incision at the narrowest part of the prepuce down to the level of Buck’s fascia. Closing this longitudinal incision transversely with absorbable sutures produces widening of the prepuce. These procedures avoid complications encountered following circumcision such as bleeding, meatal stenosis and fewer postoperative follow-up consultations with the patient’s GP. They also cause less discomfort than circumcision. The success of preputioplasty depends on early mobilisation of the foreskin – within 2 weeks following the procedure – which prevents contracture of the suture line and scarring. Following preputioplasty, only 4% of patients went on to have a full circumcision, which was attributed to late mobilisation of the foreskin following the procedure. Seventy per cent of boys who undergo this procedure consider the appearance of the penis to be normal. It seems therefore that a preputioplasty is an attractive alternative to circumcision.
An evaluation of the pharmacotherapeutic options for the treatment of adult phimosis. A systematic review of the evidence
Published in Expert Opinion on Pharmacotherapy, 2022
Anna Lygas, Hrishikesh Bhaskar Joshi
Some indications to proceed with active treatment, in children, are recurrent urinary tract infections (UTIs), balanoposthitis and paraphimosis. Historically, the mainstream treatment of phimosis in children was surgery in a form of either circumcision or preputioplasty. The surgery caries number of risks and complications including local infection, hemorrhage, meatitis, and ulceration. For that reason, conservative treatment options have been explored as alternative to surgery.