Lichen sclerosus et atrophicus in children with phimosis and hypospadias

Mattioli, Girolamo; Repetto, P.; Carlini, Claudio; Granata, Claudio; Gambini, Claudio; Jasonni, Vincenzo

doi:10.1007/s003830100699

Cited by 53 publications

(45 citation statements)

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“…96 BXO is thought to account for 4-15% of the strictures that occur after hypospadias repairs in which the urethroplasty is performed using a prepucial flap or graft. 97,98 Substitution urethroplasty with oral mucosa is mandatory in the presence of BXO. 98,99 Urethral diverticula Dilation of the neourethra (Figure 4), also known as megalourethra, has been described after the correction of proximal hypospadias, 100,101 although only for flap tube repairs.…”

Section: Urethral Stricturementioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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| Failed hypospadias refers to any hypospadias repair that leads to complications or causes patient dissatisfaction. The complication rate after hypospadias repairs ranges from 5-70%, but the actual incidence of failed hypospadias is unknown as complications can become apparent many years after surgery and series with lifelong follow-up data do not exist. Moreover, little is known about uncomplicated repairs that fail in terms of patient satisfaction. Risk factors for complications include factors related to the hypospadias (severity of the condition and characteristics of the urethral plate), the patient (age at surgery, endocrine environment, and wound healing impairment), the surgeon (technique selection and surgeon expertise), and the procedure (technical details and postoperative management). The most important factors for preventing complications are surgeon expertise (number of cases treated per year), interposition of a barrier layer between the urethroplasty and the skin, and postoperative urinary drainage. Major complications associated with failed hypospadias include residual curvature, healing complications (preputial dehiscence, glans dehiscence, fistula formation, and urethral breakdown), urethral obstruction (meatal stenosis, urethral stricture, and functional obstruction), urethral diverticula, hairy urethra, and penile skin deficiency.

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Section: Urethral Stricturementioning

confidence: 99%

Failed hypospadias in paediatric patients

et al. 2013

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“…[95] A further study found LS in 60% of boys with acquired phimosis and in 30% of those with congenital phimosis. [96] Foreskin inflammation was seen in 88% and 82%, respectively. The study also examined boys with congenital hypospadias, with 61% showing symptoms of inflammation and 15% having features consistent with LS.…”

Section: Resultsmentioning

confidence: 99%

Penile inflammatory skin disorders and the preventive role of circumcision

Morris

Krieger

2017

Int J Prev Med

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Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We conducted a systematic review of the medical literature on PubMed, EMBASE, and Cohrane databases using keywords “balanitis,” “posthitis,” “balanoposthitis,” “lichen sclerosus,” “penile inflammation,” and “inflammation penis,” along with “circumcision,” “circumcised,” and “uncircumcised.” Balanitis is the most common inflammatory disease of the penis. The accumulation of yeasts and other microorganisms under the foreskin contributes to inflammation of the surrounding penile tissue. The clinical presentation of inflammatory penile conditions includes itching, tenderness, and pain. Penile inflammation is responsible for significant morbidity, including acquired phimosis, balanoposthitis, and lichen sclerosus. Medical treatment can be challenging and a cost burden to the health system. Reducing prevalence is therefore important. While topical antifungal creams can be used, usually accompanied by advice on hygiene, the definitive treatment is circumcision. Data from meta-analyses showed that circumcised males have a 68% lower prevalence of balanitis than uncircumcised males and that balanitis is accompanied by a 3.8-fold increase in risk of penile cancer. Because of the high prevalence and morbidity of penile inflammation, especially in immunocompromised and diabetic patients, circumcision should be more widely adopted globally and is best performed early in infancy.

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“…Meatal or urethral involvement is more likely with a history of previous surgery and was seen in 27% in the series by Gargollo et al [168]. The incidence of this condition is underestimated and recent evidence suggests that in boys referred with a diagnosis of phimosis the incidence ranges between 10-40 % [169][170][171][172]. In a series of 100 boys referred for phimosis, the incidence of LS was 1.8% under 6 years of age and up to 21% in those older [171].…”

Section: Genital Lichen Sclerosismentioning

confidence: 97%