Circoncisione, bambini, stenosi del meato

J Pediatr Urol. 2011 Oct; 7 (5): 526-8. doi: 10.1016 / j.jpurol.2010.08.005. Epub 2010 Sep 18 anni.

Incidenza di stenosi del meato nei bambini dopo la circoncisione neonatale.

Joudi M 1 , Fathi M , Hiradfar M .

OBIETTIVO:
Determinare l'incidenza di stenosi del meato dopo la circoncisione neonatale.
PATIENTS AND METHODS:
Male children (5-10 years old) who had been circumcised during the neonatal period and presented at our pediatric clinic for reasons other than urinary complaints were examined and interviewed regarding urination problems.

RISULTATI:Dei 132 casi, 27 (20,4%) hanno avuto una grave stenosi del meato (diametro <5 F). Ispessimento della vescica e idronefrosi bilaterale (pyelocaliceal) sono stati trovati in tre casi (11,1%), and a voiding cystourethrogram was performed to reveal vesicoureteral reflux (VUR). Un paziente ha avuto II grado RVU nel suo rene destro e un altro di grado III nel suo rene sinistro; un altro paziente aveva II grado RVU in entrambi i reni.

CONCLUSIONI:
E’ importante seguire, controllare ed esaminare i genitali di ogni bambino sottoposto a circoncisione durante il periodo neonatale, per valutare se presenta o meno un’infezione del meato (o una stenosi).
Journal of Pediatric Urology Company.


Clin Pediatr (Phila). 2006 Jan-Feb;45(1):49-54.
Incidence of meatal stenosis following neonatal circumcision in a primary care setting.
Van Howe RS.
Department of Pediatrics, Michigan State University College of Human Medicine, Marquette, Michigan, USA.
Abstract

The objective of this study was to prospectively document the incidence of meatal stenosis in boys. The study included a consecutive sample of boys whose visit with the physician included a genital examination in a private primary care pediatric practice in rural northern Wisconsin. Meatal stenosis was diagnosed in boys from 1.94 to 12.34 years of age. The diagnosis was made in 24 of 329 circumcised boys who were Tanner I development and older than 3 years of age (7.29%, 95%CI=4.48-10.10%). Nearly all required meatotomy to resolve their symptoms. All of the boys with meatal stenosis were circumcised neonatally (exact OR=3.54, 95%CI=0.62-infinity). The ratio of circumcised boys to noncircumcised boys in this study provided 80% power to demonstrate a 21.4% difference in the incidence of meatal stenosis between circumcised and noncircumcised Tanner I boys 3 years and older. Meatal stenosis may be the most common complication following neonatal circumcision. Stenosi del meato è la complicazione più comune dopo la circoncisione neonatale. The frequency of this complication and the need for surgical correction need to be disclosed as part of the informed consent for neonatal circumcision. A careful meatal examination is indicted in any circumcised boy with abdominal or urinary complaints.



NZ Med J. 111 (1060): 57-8.

Circoncisione e stenosi del meato: 12 anni di esperienza

Upadhyay V 1 , Hammodat HM , Pease PW .

OBIETTIVI: Studiare e valutare l’incidenza di stenosi del meato nei bambini e neonati sottoposti a circoncisione.

METHODS:
A total of 50 patients were studied. These patients had meatotomy performed to treat meatal stenosis. All the patients had circumcision during the neonatal period or in the nappy age. Meatal stenosis was defined as change in the appearance of the delicate lips of the urinary meatus, with loss of elliptical shape to a circular shape because of fibrosis or scarring, with visually apparent narrowing. Patients with this appearance and no symptoms, but who had presented with a hernia, undescended testes or some other unassociated condition and had meatotomy were for the purpose of this study classed as the incidental group. Patients who were symptomatic and had the meatal stenosis as defined above were classed as the symptomatic group.

RESULTS:
Sixteen patients (total n = 50) had the diagnosis of meatal stenosis made incidentally. Thirty four patients, (68% of the total treated by meatotomy) presented to the clinic, being symptomatic due to meatal stenosis. The median age at presentation of the symptomatic group was 48 months (range 3 months-13 years) following circumcision. In all the symptomatic patients meatotomy alleviated the symptoms. All the operated patients were seen between one to three months following the operation and discharged.

CONCLUSIONE:
Stenosi del meato è riconosciuta come la complicazione più comune della circoncisione neonatale.