RESUMO
OBJECTIVE: To evaluate prepuce development and retractibility in a group of boys. To point out the value of circumcision and prepucial forced dilation during childhood. METHODS: Prepuce development and retractibility were evaluated in 400 boys ages between 0-16 year old. RESULTS: In boys under 1 year prepuce retractibility (assessed only in children who did not undergo forced dilation previously) was type I (non retractile) in 71.5% whereas type V (completely retractile) was only 5.5%. In adolescent boys type I prepuce was observed in 1 boy only, 1.6%, whereas type V was observed in 82.3%. Furthermore, it was observed that at the time of examination for the study 106 boys who had undergone forced dilation at an earlier age had balano-prepucial adhesions again, which demonstrates that prepuce adheres again to glans penis in many boys after a forced dilation is performed. Only 11 boys were considered in need for circumcision, three of them for prepucial orifice stenosis, which prevented normal micturition, causing a prepucial sac, one case due to a constrictive ring below the prepucial edge that would have prevented ulterior retractability, two cases with repetitive balanopostitis, and five cases secondary to xerosol balanitis, accounting for 2.7% of all examined boys. CONCLUSIONS: Incomplete separation between prepuce and glans penis is normal and common among new-borns, progressing until adolescence to spontaneous separation, at which time it is complete in the majority of boys. Accordingly to the criteria we have sustained for years and present study's findings, circumcision has few indications during childhood, as well as forced prepucial dilation.
Assuntos
Circuncisão Masculina , Fimose/cirurgia , Procedimentos Desnecessários , Adolescente , Fatores Etários , Pré-Escolar , Circuncisão Masculina/efeitos adversos , Circuncisão Masculina/psicologia , Dilatação/efeitos adversos , Humanos , Lactente , Masculino , Doenças do Pênis/epidemiologia , Pênis/crescimento & desenvolvimento , Fimose/epidemiologia , Aderências Teciduais/epidemiologiaRESUMO
Con el objetivo de evaluar el desarrollo del prepucio y su retractilidad se estudiaron 500 niños con edades entre 0 y 16 años en 3 hospitales pediátricos de La Habana, desde agosto del 2000 hasta julio del 2001. Se evaluó en todos los pacientes el grado de retractilidad del prepucio sobre la base de la clasificación de Kayaba. Se observó en 59,6 por ciento de los lactantes el prepucio tipo I (no retráctil) mientras que el tipo V (completamente retráctil) en 3,8 por ciento. En los adolescentes el prepucio tipo I no se apreció, mientras que el tipo V se encontró en 81,1 por ciento. Se halló que 132 niños que habían sido dilatados forzadamente éstos tenían adherencias balanoprepuciales al momento del examen. La circuncisión fue necesaria en 11 niños (2,2 por ciento). La separación incompleta del prepucio y el glande es normal y común en recién nacidos, con progresos de la separación espontánea hasta la adolescencia, la que es total en la mayoría de los niños, por lo que se concluye que la circuncisión tiene muy poca indicación en la infancia, al igual que la dilatación forzada del prepucio