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Are mechanical and chemical trauma the reason of meatal stenosis after newborn circumcision?

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Abstract

Mechanical and chemical trauma are a widely accepted theories to explain the pathogenesis of meatalstenosis after newborn circumcision. The aim of the present study was to explore the theory that an exposed glans is prone to meatal stenosis. This was done by a novel investigation of boys who were born with “hooded prepuce”, a condition in which the glans is completely exposed. Physical examination, lower urinary tract symptoms, urethral meatus configuration, and surgical procedures of 18 children admitted for routine circumcision, who had congenital hooded prepuce with normally located urethral meatus, were analyzed. The study period was 2013 and 2018. All the cases have been seen because of neonatal circumcision request, but was postponed due to hooded prepuce. The only presenting complaint in children was a cosmetically unattractive appearance. There were no symptoms associated with meatal stenosis, they circumcised in an average of 6 years and non of them required any additional procedure.

Conclusion: Meatal stenosis did not occur in cases whose glans penis are naked with hooded prepuce. These findings do not support the default chemical and mechanical trauma theories. Hooded prepuce without any penile anomalies is only a cosmetically unattractive appearance and circumcision can correct this.

What is known:

• The common theory of meatal stenosis etiology is that the meatus undergoes irritation with chemical/mechanical trauma in the absence of a prepuce after newborn circumcision.

• Circumcision is usually postponed in newborns with hooded prepuce.

What is new:

• We did not notice meatal stenosis in cases whose urethral meatus were not covered with a prepuce congenitally. Ammoniacal dermatitis or mechanical trauma theories may not explain the cause of meatal stenosis.

• Hooded prepuce is not a handicap to newborn circumcision. It is just a cosmetic problem and circumcision can solve it.

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Abbreviations

MS:

Meatal stenosis

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Authors and Affiliations

  1. Department of Pediatric Surgery, School of Medicine, Koç University Hospital, Topkapı, Maltepe, 34010, Istanbul, Turkey

    Mehmet Ali Özen, Gökhan Gündoğdu & Egemen Eroğlu

  2. Department of Pediatric Nephrology, Koç University Hospital, Topkapı, Maltepe, 34010, Istanbul, Turkey

    Mehmet Taşdemir

Authors
  1. Mehmet Ali Özen
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  2. Gökhan Gündoğdu
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  3. Mehmet Taşdemir
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  4. Egemen Eroğlu
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Contributions

Özen MA and Eroğlu E had primary responsibility for subjects screening, enrollment, follow-up, and manuscript preparation. Gündoğdu G and Taşdemir M were involved in the literature search and revised the manuscript. All authors read and approved the final version of the manuscript. Egemen E is the guarantor.

Corresponding author

Correspondence to Egemen Eroğlu.

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Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

Written informed consent was obtained from all individual participants included in the study and their parents (or legal guardians). All procedures performed involving human participants were in accordance with the ethical standards of the local ethics committee and with the 1964 Helsinki declaration and its later amendments.

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Communicated by Mario Bianchetti

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Özen, M.A., Gündoğdu, G., Taşdemir, M. et al. Are mechanical and chemical trauma the reason of meatal stenosis after newborn circumcision?. Eur J Pediatr 178, 77–80 (2019). https://doi.org/10.1007/s00431-018-3261-4

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  • DOI: https://doi.org/10.1007/s00431-018-3261-4

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