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Objective:To investigate the clinical characteristics of pathological phimosis and analyze the correlation between pathological phimosis and balanitis xerotica obliterans(BXO) in children.Methods:The clinical data of 45 children who underwent circumcision and histopathologic evaluation in our hospital from July 2018 to August 2022 were retrospectively analyzed. According to the results of the pathological examination, lichen sclerosis et atrophicus cases were classified as the BXO group, and other cases were classified as the non-BXO group. The two groups' age, history, and symptoms were recorded and compared. The management of meatal stenosis and the effect of topical steroids were described.Results:There were 33 patients in the BXO group, aged (7.42±2.46)years old, of which 91% (30/33) were 5-11 years old. There were 12 patients in the non-BXO group, aged (10.42±2.88) years old. The difference of age between the two groups was statistically significant ( P< 0.05). But there was no significant difference between the BXO group and non-BXO group in the history of balanoposthitis(28 cases vs. 7 cases), history of foreskin dilated(15 cases vs. 3 cases), frequent urination (18 cases vs. 10 cases), urgent urination(12 cases vs. 4 cases), urination pain(17 cases vs. 3 cases), dysuria(21 cases vs. 5 cases), pruritus(25 cases vs. 7 cases), penile pain(7 cases vs. 1 case), ballooning(7 cases vs. 6 cases), and spraying (14 cases vs. 2 cases)( P > 0.05). All 8 cases of meatal stenosis were in the BXO group. Three cases underwent meatal dilatation and indwelling catheter was left for 5-10 days, and topical steroid was used on the third day after surgery. The remaining cases were treated with topical steroids after a pathological diagnosis of BXO. Among the 4 cases with partial urethral meatus involvement, 3 had good results after treatment, and 1 had no significant improvement and underwent meatal dilatation twice later. In 1 case, meatal stenosis was found two weeks after surgery, but no meatal abnormality was found during operation. All patients recovered smoothly during a median follow-up of 12.2 (5.4, 21.8) months. Conclusions:BXO is the main cause of pathologic phimosis in boys, and the diagnosis is based on histopathology. The main complication of BXO is meatal stenosis, which should be detected as early as possible and treated in time.
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Objective To explore the diagnosis and treatment of children anterior urethral valve combined with urethral diverticulum, and study the causes of lower urethral obstruction caused by the anterior urethral valve combined with urethral diverticulum. Methods The clinical data of 5 cases of anterior urethral valves combined with urethral diverticulum were retrospectively analyzed. Excretory bladder urography showed the formation of anterior urethral valve and diverticulum. All children underwent cystostomy, urethral valves, diverticulectomy and urethroplasty. Results All the 5 children were cured by surgery, and urination was smooth, with no urinary fistula and urethral stricture; the postoperative urodynamics, renal function and urinalysis were normal. Conclusions Anterior urethral valve combined urethral diverticulum is rare in clinic, and excretory bladder urethroplasty is the main diagnosis method of lower urethral obstruction. The effect of early diagnosis and treatment is good. Transurethral resection of valve and diverticulum is the first choice.
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Objective To investigate the feasibility and efficacy of tunica vaginalis flap cover in treatment of recurrent urethrocutaneous fistula (UCF).Methods We reviewed the clinical datas of 25 cases of UCF after urethroplasty of hypospadias from January 2011 to January 2015.The mean age of the patients was 6.2 years(range 1.6-14.0 years).All patients had undergone previous hypospadias repair and at least one previous failed attempt to close the urethrocutaneous fistulae.There were 5 cases of fistula in the coronary sulcus,6 cases of fistula in the penile body and 14 cases of fistula at the junction of penis and scrotum.The diameter of urethrocutaneous fistulae were 3-10 mm.Single fistula was present in all patients.16 cases had undergone UCF repair for two times, 9 cases had undergone UCF repair for more than two times.After closing the fistula with inverting running stitch, a tunica vaginalis flap was mobilized to cover the repair site through a subcutaneous tunnel and the skin closed.Results The mean follow-up time was 2.1 years(range 0.5-4 years).The overall success rate was 96％ (24/25).Penile cosmesis was excellent.There was no evidence of recurrent fistulas or urethral strictures.All parents reported a straight penis when erected, and one patient in whom there was leak from the fistula site because of local wound infection.No postoperative complication was encountered in the testis.The testis was of normal size and position, and the ultrasound findings were normal.Conclusions Repairment of recurrent urethrocutaneous fistulas with a tunica vaginalis flap could be effective regardless of fistula location.The technique is simple to improve the success rate of the repair of UCF effectively and reduce the occurrence of postoperative complications.
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OBJECTIVE: To observe the changes of peristalsis of small intestine in guinea pigs after administration of traditional Chinese medicines activating blood to resolve stasis (Compound Danshen Decoction, CDSD) or/and medicines dredging intestines (Dachengqi Decoction, DCQD), and to explore the synergetic or intensive effect of CDSD on DCQD. METHODS: By means of BL-420 Biological Experimental System, peristalsis of small intestine was recorded and analyzed following administration of DCQD, CDSD or Huoxue Chengqi Decoction (HXCQD, compound of CDSD and DCQD) respectively in different experimental periods. RESULTS: The amplitude and frequency of intestinal peristaltic wave obviously increased following administration of the three decoctions, but HXCQD appeared to be most dominantly. CONCLUSION: The effect of DCQD can be further enhanced by combining use of CDSD, suggesting that the traditional Chinese medicines activating blood to resolve stasis have an intensive effect on medicines dredging intestines.