Meatal ulceration in neonates

ABSTRACT

Meatal ulceration [MU] is a benign problem, commonly fellow neonatal circumcision. It can lead to meatal stenosis and other complications, which can be prevented by proper post circumcision care. This study aims to disclose the different causes of MU in male neonates. Four hundred male neonates attended to Al- Mustansyria primary health care centre PHC/Baghdad for BCG vaccination, were studied cross-sectionally over 5 months period from the 1[st] of March to 10[th] of July, 2007. The parents of neonates were interviewed once by questionnaire and neonates were examined for meatal ulceration as they came for BCG vaccination which was done once weekly in this PHC. Meatal ulcerations were found in 24 out of 400 neonates [6%]. Thirty six neonates were circumcised [9%], 15 of them develop meatal ulceration [41.66%]. Twenty-five neonates were circumcised by doctors [69.45%], nine of them with meatal ulceration [36%], while 11/36 neonates were circumcised by dresser [30.55%], six of them develop meatal ulceration [54.54%]. The incidence of meatal ulceration increase from [2.47%] in non circumcised neonates to [41.66%] in circumcised neonates, [Chi[2] = 115.436, p<0/01]. It was found that 296/400 neonates [74%] used nylon diaper, 20 [6.75%] of them had MU compared to 104/400 used a piece of cloth or cloth diaper, 4 of them develop MU [3.84%]. Circumcision was found to be the most important cause of MU in male neonates, especially when the circumcision was one by not well trained person. Using nylon diaper or a piece of nylon, and not applying cream or cover are accelerating factors for the development of MU. So I recommend that circumcision of neonates to be done by well trained doctor and followed by proper post circumcision care. Also recommend to do further studies of larger sample size and to follow them for long-term bad consequences to give firmer recommendation regarding neonatal circumcision