FREQUENCY OF BALANITIS XEROTICA OBLITERANS AMONG BOYS WITH PHIMOSIS
Sažetak
Introduction: Balanitis xerotica obliterans (BXO) is an inflammatory disease of unknown etiology and pathogenesis, that represents genital form of lichen sclerosus. Disease is located on foreskin, glans of penis and on urethra. It was discovered that BXO is common cause of phimosis. There is evidence of connections between balanitis xerotica obliterans and appearance of squamous cell carcinoma. The diagnosis of the disease can be clinical and pathohistological. Therapy can be conservative and surgical.
The Aim: Determining the frequency of BXO among the boys with phimosis in the light of increasing number of evidence about importance of this clinical entity in development of many complications of urogenital system.
Material and methods: Our research contained 470 male patients aged from 1 to 18 years. All the patients who were included in the study were surgically treated in period from 1. January 2014. till 1. January 2017. in University Children’s Hospital and all of them had diagnosed phimosis. All the patients underwent circumcision. Foreskins that were suspicious of BXO diagnosis, but could not be diagnosed clinically, were sent to pathohistological analysis. Statistical methods used for measuring central tendency and for determining frequency of BXO were methods of descriptive statistics, or frequency analysis in IBM SPSS Statistics 22 program.
Results: Patients with phimosis were in average age of 9.12 ± 4.46 (1-18) years. After data analysis, it was established that in the group of 470 patients there are 48 with BXO diagnosis (10.21%). Patients with BXO were in average age of 10.33 ± 3.14 (6-18) years.
Conclusion: Our research has shown that the frequency of BXO among boys with phimosis population is coherent with results of other studies. We concluded that pathohistological analisys of the foreskin is necessary to avoid false negative results after clinical examination.
Keywords: balanitis xerotica obliterans, lichen sclerosus, phimosis
Reference
Depasquale I, Park AJ, Bracka A. The treatment of balanitis xerotica obliterans. BJU Int. 2000 Sep; 86(4):459-465.
Holbrook C, Tsang T. Management of boys with abnormal appearance of meatus at circumcision for balanitis xerotica obliterans. Ann R Coll Surg Engl. 2011 Sep; 93(6):482-484.
Fallick, ML, Faller G, Klauber GT. Balanitis xerotica obliterans in monozygotic twins. Br J Urol. 1997 May; 79(5):810.
Jasaitiene D, Valiukeviciene S, Vaitkiene D, Jievaltas M, Barauskas V, Gudinaviciene I, et al. Lichen sclerosus et atrophicus in pediatric and adult male patients with congenital and acquired phimosis. Medicina (Kaunas). 2008; 44(6):460-466.
Hartley A, Ramanathan C, Siddiqui H. The surgical treatment of Balanitis Xerotica Obliterans. Indian J Plast Surg. 2011 Jan-Apr; 44(1): 91–97.
Philippou P, Shabbir M, Ralph DJ, Malone P, Nigam R, Freeman A, et al. Genital lichen sclerosus/balanitis xerotica obliterans in men with penile carcinoma: a critical analysis. BJU Int. 2013; 111:970–976.
Fistarol SK, Itin PH. Diagnosis and Treatment of Lichen Sclerosus An Update. Am J Clin Dermatol. 2013 Feb; 14(1): 27–47.
Garzon MC, Paller AS. Ultrapotent Topical Corticosteroid Treatment of Childhood Genital Lichen Sclerosus. Arch Dermatol. 1999 May; 135(5):525-528.
Celis S, Reed F, Murphy F, Adams S, Gillick J, Abdelhafeez AH, et al. Balanitis xerotica obliterans in children and adolescents: a literature review and clinical series. J Pediatr Urol. 2014 Feb; 10(1):34-39.
Irkilata L, Bakirtas M, Aydin HR, Aydin M, Demirel HU, Adanur S, et al. Pathological Investigation of Childhood Foreskin: Are Lichen Sclerosus and Phimosis Common? J Coll Physicians Surg Pak. 2016 Feb; 26(2):134-137.
Kiss, Király L, Kutasy B, Merksz M. High incidence of balanitis xerotica obliterans in boys with phimosis: prospective 10-year study. Pediatr Dermatol. 2005 Jul-Aug; 22(4):305-308.
Jayakumar S, Antao B, Bevington O, Furness P, Ninan GK. Balanitis xerotica obliterans in children and its incidence under the age of 5 years. J Pediatr Urol. 2012 Jun; 8(3):272-275.
Bochove-Overgaauw DM, Gelders W, De Vylder AM. Routine biopsies in pediatric circumcision: (non) sense? J Pediatr Urol. 2009 Jun; 5(3):178-180.
Naji H, Jawad E, Ahmed HA, Mustafa R. Histopathological examination of the prepuce after circumcision: Is it a waste of resources? Afr J Paediatr Surg. 2013 Apr-Jun; 10(2):164-166.