MotherNurture
25-09-2006, 11:49
Just a quick FYI/PSA:
MEATAL STENOSIS: Circumcised boys have a 10% risk of developing meatal stenosis.
Background: Genital disorders are commonly encountered in the office of the primary care physician. Meatal stenosis is a relatively common acquired condition occurring in 9-10% of males who are circumcised. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream and, occasionally, dysuria and urgent, frequent, and prolonged urination. Surgical meatotomy is curative.
Pathophysiology: After circumcision, a child who is not toilet trained persistently exposes the meatus to urine, resulting in inflammation (ammoniacal dermatitis) and mechanical trauma as the meatus rubs against a wet diaper. This causes the loss of the delicate epithelial lining of the distal urethra. This loss may result in adherence of the epithelial lining at the ventral side, leaving a pinpoint orifice at the tip of the glans. Because this condition is exceedingly rare in children who are not circumcised, circumcision is believed to be the most important causative factor of meatal stenosis.
Another hypothetical cause of this condition is ischemia due to damage to the frenular artery during circumcision, resulting in poor blood supply to the meatus and subsequent stenosis. In a prospective study of circumcised boys, Van Howe (2006) found meatal stenosis in 24 of 239 (7.29%) children older than 3 years, making meatal stenosis the most common complication of circumcision.
Frequency:
Internationally: Incidence is 9-10% of males who are circumcised.
http://www.emedicine.com/ped/topic2356.htm
PENILE ADHESIONS: Circumcised boys have a 71% risk of developing penile adhesions during the first year of life.
RESULTS: We enrolled in our study 254 boys 1 month to 19 years 8 months old. Only 7 patients had a history of treatment of adhesion, of whom 3 had recurrent adhesions at evaluation. Patients were divided into groups based on age, including younger than 12 months (61), 13 to 60 (78), 61 to 108 (51) and 109 months old or older (64). In these groups we noted an adhesion rate of 71%, 28%, 8% and 2%, respectively. The rate of adhesions more severe than grade 1 was 30%, 10% and 0% in boys 12 months old or younger, 13 to 60 and 61 months old or older, respectively. The oldest patient with grade 3 adhesions was 31 months old. Skin bridges in 6 cases involved the circumcision line in 4. CONCLUSIONS: Penile adhesions develop after circumcision and the incidence decreases with patient age. Although there is debate on whether to lyse these adhesions manually, our findings suggest that adhesions resolve without treatment. Based on our results we do not recommend lysing penile adhesions, except perhaps those involving the circumcision line.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10893633&dopt=Abstract
My stepson developed meatal stenosis as a toddler. His urine actually came out in a double-stream. At the time, neither my husband nor his ex-wife realized the condition was actually caused by his newborn circumcision. He went under general anesthesia to have it corrected. Also, I have a Jewish friend who's son was circed by a mohel during a bris ceremony. He's almost two years old and has adhesions almost all the way around the glans. I think it's important to know about these common complications in order to make an informed choice and to know what to watch for/how they're treated should your son experience them.
Jen
MEATAL STENOSIS: Circumcised boys have a 10% risk of developing meatal stenosis.
Background: Genital disorders are commonly encountered in the office of the primary care physician. Meatal stenosis is a relatively common acquired condition occurring in 9-10% of males who are circumcised. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream and, occasionally, dysuria and urgent, frequent, and prolonged urination. Surgical meatotomy is curative.
Pathophysiology: After circumcision, a child who is not toilet trained persistently exposes the meatus to urine, resulting in inflammation (ammoniacal dermatitis) and mechanical trauma as the meatus rubs against a wet diaper. This causes the loss of the delicate epithelial lining of the distal urethra. This loss may result in adherence of the epithelial lining at the ventral side, leaving a pinpoint orifice at the tip of the glans. Because this condition is exceedingly rare in children who are not circumcised, circumcision is believed to be the most important causative factor of meatal stenosis.
Another hypothetical cause of this condition is ischemia due to damage to the frenular artery during circumcision, resulting in poor blood supply to the meatus and subsequent stenosis. In a prospective study of circumcised boys, Van Howe (2006) found meatal stenosis in 24 of 239 (7.29%) children older than 3 years, making meatal stenosis the most common complication of circumcision.
Frequency:
Internationally: Incidence is 9-10% of males who are circumcised.
http://www.emedicine.com/ped/topic2356.htm
PENILE ADHESIONS: Circumcised boys have a 71% risk of developing penile adhesions during the first year of life.
RESULTS: We enrolled in our study 254 boys 1 month to 19 years 8 months old. Only 7 patients had a history of treatment of adhesion, of whom 3 had recurrent adhesions at evaluation. Patients were divided into groups based on age, including younger than 12 months (61), 13 to 60 (78), 61 to 108 (51) and 109 months old or older (64). In these groups we noted an adhesion rate of 71%, 28%, 8% and 2%, respectively. The rate of adhesions more severe than grade 1 was 30%, 10% and 0% in boys 12 months old or younger, 13 to 60 and 61 months old or older, respectively. The oldest patient with grade 3 adhesions was 31 months old. Skin bridges in 6 cases involved the circumcision line in 4. CONCLUSIONS: Penile adhesions develop after circumcision and the incidence decreases with patient age. Although there is debate on whether to lyse these adhesions manually, our findings suggest that adhesions resolve without treatment. Based on our results we do not recommend lysing penile adhesions, except perhaps those involving the circumcision line.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10893633&dopt=Abstract
My stepson developed meatal stenosis as a toddler. His urine actually came out in a double-stream. At the time, neither my husband nor his ex-wife realized the condition was actually caused by his newborn circumcision. He went under general anesthesia to have it corrected. Also, I have a Jewish friend who's son was circed by a mohel during a bris ceremony. He's almost two years old and has adhesions almost all the way around the glans. I think it's important to know about these common complications in order to make an informed choice and to know what to watch for/how they're treated should your son experience them.
Jen