ABSTRACT
Introducción. El examen genital en varones es una evaluación clínica simple y rápida para detectar patología urogenital. Los datos sobre prevalencia de patología urogenital en varones adolescentes son limitados. Nuestro objetivo fue describir la prevalencia de patología urogenital en varones adolescentes. Población y métodos. Estudio descriptivo transversal en el Servicio de Adolescencia de un hospital público de la Ciudad de Buenos Aires. Se evaluaron retrospectivamente las historias clínicas (HC) de varones de 9 a 20 años atendidos entre 2008 y 2018; se incluyeron las que tenían examen genital. Se recabaron datos de edad, estadio puberal, orquidometría, patología urogenital antes de la adolescencia y al momento de la consulta. La prevalencia se expresó en porcentaje e intervalo de confianza del 95 % (IC95%). Se estimó necesario incluir 1167 HC como muestra poblacional. Resultados. Se evaluaron 2129 HC; se incluyeron 1429. En 686 casos no se hizo el examen genital. La población tuvo una mediana de edad de 12 años (rango intercuartílico 11-14 años). En 72 varones (5,7 %; IC95% 4,5-7,2), se halló una enfermedad genitourinaria antes de la adolescencia. Se detectó al menos una patología urogenital en 272 adolescentes (14,8 %; IC95% 13,1-16,7); las más frecuentes fueron adherencia balanoprepucial 5,3 % (IC95% 4,2-6,6), varicocele 2,7 % (IC95% 2-3,7) y fimosis 1,8 % (IC95% 1,2-2,6). Conclusiones. El examen genital permitió detectar que el 14,8 % de los varones adolescentes atendidos presentó alguna patología urogenital. Las entidades más frecuentes fueron adherencia balanoprepucial, varicocele y fimosis.
Introduction. The male genital exam is a simple and quick assessment to look for urogenital disease. Data on the prevalence of urogenital disease in male adolescents are limited. Our objective was to describe the prevalence of urogenital disease in male adolescents. Population and methods. Descriptive, cross-sectional study conducted at the Department of Adolescenceof a public hospital in the City of Buenos Aires. The medical records of male patients aged 9 to 20 years seen between 2008 and 2018 were retrospectively reviewed; all those with a genital exam were included. Data on age, pubertal stage, orchidometry, and urogenital disease before adolescence and at the time of consultation were recorded. The prevalence was described as percentage and 95% confidence interval (CI).As per estimations, 1167 medical records had to be included to establish the population sample. Results. A total of 2129 medical records were assessed and 1429 were included. No genital exam had been conducted in 686 cases. The median age of the population was 12 years (interquartile range: 1114 years). Urogenital disease before adolescence was detected in 72 boys (5.7%; 95% CI: 4.57.2). Urogenital disease was found in 272 adolescents (14.8%; 95% CI: 13.116.7); the most common conditions were balanopreputial adhesions in 5.3% (95% CI: 4.26.6), varicocele in 2.7% (95% CI: 23.7), and phimosis in 1.8% (95% CI: 1.22.6). Conclusions. A genital exam allowed to detect that 14.8% of adolescent boys had a urogenital diseaseThe most common conditions were balanopreputial adhesions, varicocele, and phimosis.
Subject(s)
Humans , Male , Child , Adolescent , Adult , Phimosis/diagnosis , Phimosis/epidemiology , Varicocele/diagnosis , Varicocele/epidemiology , Outpatients , Prevalence , Cross-Sectional Studies , Retrospective StudiesABSTRACT
Introduction. The male genital exam is a simple and quick assessment to look for urogenital disease. Data on the prevalence of urogenital disease in male adolescents are limited. Our objective was to describe the prevalence of urogenital disease in male adolescents. Population and methods. Descriptive, cross-sectional study conducted at the Department of Adolescence of a public hospital in the City of Buenos Aires. The medical records of male patients aged 9 to 20 years seen between 2008 and 2018 were retrospectively reviewed; all those with a genital exam were included. Data on age, pubertal stage, orchidometry, and urogenital disease before adolescence and at the time of consultation were recorded. The prevalence was described as percentage and 95% confidence interval (CI). As per estimations, 1167 medical records had to be included to establish the population sample. Results. A total of 2129 medical records were assessed and 1429 were included. No genital exam had been conducted in 686 cases. The median age of the population was 12 years (interquartile range: 11-14 years). Urogenital disease before adolescence was detected in 72 boys (5.7%; 95% CI: 4.5- 7.2). Urogenital disease was found in 272 adolescents (14.8%; 95% CI: 13.1-16.7); the most common conditions were balanopreputial adhesions in 5.3% (95% CI: 4.2-6.6), varicocele in 2.7% (95% CI: 2-3.7), and phimosis in 1.8% (95% CI: 1.2-2.6). Conclusions. A genital exam allowed to detect that 14.8% of adolescent boys had a urogenital disease. The most common conditions were balanopreputial adhesions, varicocele, and phimosis.
Introducción. El examen genital en varones es una evaluación clínica simple y rápida para detectar patología urogenital. Los datos sobre prevalencia de patología urogenital en varones adolescentes son limitados. Nuestro objetivo fue describir la prevalencia de patología urogenital en varones adolescentes. Población y métodos. Estudio descriptivo transversal en el Servicio de Adolescencia de un hospital público de la Ciudad de Buenos Aires. Se evaluaron retrospectivamente las historias clínicas (HC) de varones de 9 a 20 años atendidos entre 2008 y 2018; se incluyeron las que tenían examen genital. Se recabaron datos de edad, estadio puberal, orquidometría, patología urogenital antes de la adolescencia y al momento de la consulta. La prevalencia se expresó en porcentaje e intervalo de confianza del 95 % (IC95%). Se estimó necesario incluir 1167 HC como muestra poblacional. Resultados. Se evaluaron 2129 HC; se incluyeron 1429. En 686 casos no se hizo el examen genital. La población tuvo una mediana de edad de 12 años (rango intercuartílico 11-14 años). En 72 varones (5,7 %; IC95% 4,5-7,2), se halló una enfermedad genitourinaria antes de la adolescencia. Se detectó al menos una patología urogenital en 272 adolescentes (14,8 %; IC95% 13,1-16,7); las más frecuentes fueron adherencia balanoprepucial 5,3 % (IC95% 4,2-6,6), varicocele 2,7 % (IC95% 2-3,7) y fimosis 1,8 % (IC95% 1,2-2,6). Conclusiones. El examen genital permitió detectar que el 14,8 % de los varones adolescentes atendidos presentó alguna patología urogenital. Las entidades más frecuentes fueron adherencia balanoprepucial, varicocele y fimosis.
Subject(s)
Phimosis , Varicocele , Humans , Male , Adolescent , Child , Varicocele/diagnosis , Varicocele/epidemiology , Cross-Sectional Studies , Retrospective Studies , Prevalence , Outpatients , Phimosis/diagnosis , Phimosis/epidemiologyABSTRACT
BACKGROUND: The incidence of preputial lichen sclerosus (PLS) among children presenting with phimosis varies from 10 to 95%, depending on the age, the protocol for the treatment of pediatric phimosis, the method of diagnosis (clinical versus histological), and case mix (congenital versus acquired phimosis). OBJECTIVE: PLS may not be clinically obvious. Our aim is to show that a systematic histological examination of the prepuce may diagnose PLS in clinically unsuspected cases. METHODS: Prospective observational study of the histology of all prepuces resected from boys undergoing circumcision for phimosis but not clinically suspected to have PLS. RESULTS: PLS was diagnosed histologically in 22 boys (32%). Boys with PLS were significantly older (mean 8.4 versus 4.7 years old). Diagnosis of PLS was not related to the degree of phimosis (summary figure). In three patients (grade 4 phimosis) glans discoloration was observed during surgery, and all had PLS. Follow up for boys found to have PLS ranged from 1 to 10 years. One patient developed recurrent phimosis, attributed to inappropriate conservative resection, and required further surgery. There were no cases of meatal stenosis. DISCUSSION: Subtle cases of PLS may be difficult to detect clinically. Children are frequently asymptomatic, except for being unable to retract the prepuce. Physical examination has a low negative predictive value for the diagnosis of PLS. Complete removal of the prepuce with permanent glans exposure is regarded as essential to cure PLS and to avoid recurrent phimosis, but our patients were treated with partial circumcisions for cultural reasons. Only one needed reoperation for recurrent phimosis. CONCLUSION: Histological PLS was present in approximately 1/3 of boys with phimosis, frequently without typical manifestations. Those patients may be cured with partial circumcisions.
Subject(s)
Circumcision, Male , Lichen Sclerosus et Atrophicus , Phimosis , Urethral Stricture , Male , Child , Humans , Child, Preschool , Lichen Sclerosus et Atrophicus/complications , Lichen Sclerosus et Atrophicus/diagnosis , Lichen Sclerosus et Atrophicus/epidemiology , Phimosis/diagnosis , Phimosis/surgery , Circumcision, Male/adverse effects , Urethral Stricture/surgery , Prospective StudiesABSTRACT
Fundamento: la circuncisión como tratamiento de la fimosis no es considerada cuando no hay indicaciónmédica. La tendencia actual es mantener el prepucio como componente integral y multifuncional del pene,dada su importancia. El uso tópico de esteroides es considerado una alternativa de valor en el tratamientode la fimosis. Objetivo: evaluar el efecto de la triamcinolona en aplicación tópica para el tratamiento dela fimosis. Métodos: estudio descriptivo longitudinal realizado en el Hospital Pediátrico Universitario PaquitoGonzález Cueto de Cienfuegos durante el periodo comprendido desde marzo del 2000 hasta marzo del 2009, que incluyó 994 pacientes que acudieron a laconsulta externa del Servicio de Urología por imposibilidad de retracción del prepucio y fimosis. Se excluyeron aquellos pacientes que presentaban fimosis adquirida por dilataciones forzadas, liquen esclero atrófico o balanitis serosa obliterante. Se utilizó esteroide tópico (crema de acetónido de triamcinolona 0,1 por ciento), aplicada en el anillo prepucial constrictivo, durante 6 semanas. Resultados: el mayor número de pacientes correspondió a los menores de 5 años, de los cuales 660 pacientes (96,2 por ciento) tenían el prepucio normal no retractable y 245 pacientes (79,5 por ciento) presentaban fimosis; el tratamiento fue considerado satisfactorio en el 96,8 por ciento de los casos; en el 1,7 por ciento fue bueno, mientras que solo 15 pacientes no resolvieron y se les indicó tratamiento quirúrgico. Conclusiones: la triamcinolona en utilización tópica constituye una alternativa adecuadapara el tratamiento de la fimosis(AU)
Background: circumcision as a treatment for phimosis is not considered unless there is medical indication.Current trend is to preserve the foreskin as an integral and multifunctional penis component, given its importance. Topical steroids are considered a valuable alternative in the treatment of phimosis. Objective: To assess the effects of triamcinolone for topical application in the treatment of phimosis. Methods: A longitudinal descriptive study was conducted in the PediatricUniversity Hospital Paquito González Cueto in Cienfuegos from March 2000 to March 2009. The sample included 994 patients attending the outpatient UrologyDepartment because of the impossibility of prepuce retraction and phimosis. Patients with forceful dilationacquired phimosis, lichen sclerosis atrophy or balanitis xerótica obliterante were excluded. Topical steroid(triamcinolone acetonide cream 0.1 percent) was applied in the constricting preputial ring for 6 weeks. Results: Thelargest group of patients was that of children under 5 years old. In that group, 660 patients (96.2 percent) hadnormal non-retractable foreskin and 245 patients (79.5 percent) had phimosis. Treatment was considered to be satisfactory in 96.8 percent of cases, good in 1.7 percent and only15 patients had to be surgically treated. Conclusions: The use of topical triamcinolone for the treatment ofphimosis proves to be an appropriate alternative(AU)
Subject(s)
Humans , Male , Phimosis/diagnosis , Phimosis/drug therapy , Triamcinolone/therapeutic use , Epidemiology, Descriptive , Longitudinal StudiesABSTRACT
The term phimosis is used when the prepuce cannot be reytracted behind the glans. This condition is present in almost all newborns, fulfilling mostly a protective function. In childhood, a gradual separation occurs, which is completed in adolescence. Through this process, complications may happen such as urinary tract infections, balanitis, or paraphimosis. Circumcision has been considered the treatment of choice, although some factors must be weighed: degree of narrowing, complications, opinión and religious beliefs of the parents. In the past 15 years, publications have suggested topical steroids as an alternative treatment, with variable success. Treatment of phimosis will continue to be controversial.
El término fimosis se utiliza cuando el prepucio no puede ser retraído por detrás del glande. Esta condición está presente en casi todos los recién nacidos cumpliendo una función principalmente protectora. Durante la infancia se produce una separación gradual del prepucio, que se completa, en la mayoría de los casos, al llegar la adolescencia. Mientras ocurre el proceso de desprendimiento pueden presentarse complicaciones como; infección del tracto urinario, balanitis o parafimosis. La circuncisión ha sido tradicionalmente el tratamiento de elección, sin embargo, se debe tener en cuenta diversos factores antes de tomar una decisión quirúrgica. Debe ser considerado: el grado de estrechez, las complicaciones, la opinión y las creencias religiosas de los padres. En los últimos 15 años se han publicado numerosos trabajos sobre el uso de esteroides tópicos como alternativa terapéutica, con resultados de éxito variable. El tratamiento de la fimosis seguirá siendo un tema controvertido.
Subject(s)
Humans , Child , Circumcision, Male , Phimosis/surgery , Phimosis/complications , Phimosis/diagnosis , Diagnosis, Differential , Phimosis/therapy , Patient SelectionABSTRACT
Fimose é condição comum nos consultórios pediátricos. Por tratar-se, possivelmente, de evento fisiológico na vida da criança e, muitas vezes, não precisar de tratamento é fundamental diferenciar as situações patológicas e fisiológicas. Este artigo trata de questões como conceitos, classificação e indicações para o tratamento clínico ou cirúrgico. Explorando opções desses tratamentos, discutimos o sucesso e as principais complicações dos mesmos. Além disso, faz-se breve análise da relação custo-benefício entre os tratamentos.
Subject(s)
Humans , Male , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Phimosis/complications , Phimosis/diagnosis , Phimosis/epidemiology , Phimosis/physiopathology , Phimosis/therapy , Foreskin/anatomy & histology , Circumcision, Male/methodsSubject(s)
Infant , Child, Preschool , Child , Adolescent , Phimosis/diagnosis , Phimosis/therapy , Infections , PediatricsSubject(s)
Infant , Child, Preschool , Child , Adolescent , Infections , Phimosis/diagnosis , Phimosis/therapy , PediatricsABSTRACT
La circuncisión es la intervención quirúrgica más antigua conocida por el hombre; su técnica libera tejido prepucial cicatrizal fibroso que disminuye la abertura prepucial y exposición normal del glande, patología conocida como fimosis. Tanto el prepucio como el glande conservan un epitelio común que se separa y queratiniza gradualmente, fénomeno que concluye normalmente al final de la gestación y en la adolescencia, hecho que logra completarse en el 4 por ciento de recién nacidos. El 90 por ciento de niños presentan adherencias del prepucio que generalmente desaparecen antes de los 17 años y tan sólo el 2-5 por ciento de los niños presentan una fimosis verdadera y requieren de circuncisión...
Subject(s)
Circumcision, Male , Phimosis/diagnosis , Phimosis/prevention & control , Phimosis/therapyABSTRACT
A 4-month-old infant presenting with bilateral popliteal pterygion syndrome, a seldom pathology, is reported. Bilateral cheiloplasty was performed in one stage and palatoplasty with pharyngoplasty through transposition of rear pillars. Thrice operated the pterygium area in order to stretch out the legs, but remaining 30% limitation. In regard to etiology the teratogenic effect of free radicals, issued from malnutrition, tobacconism and weed-killers, is contemplate all those factors breaking partly the H linkages joining together the two chains of genetic messenger, the DNA. So are originated the mistake on the blastogenesis with the issuing malformations.