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Phimosis, Meatal Stenosis, and BXO

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Pediatric Urology

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Abstract

The primary aim in diagnosis and treatment of phimosis and meatal stenosis is relief of symptoms.

The primary aim in diagnosis and treatment of BXO is to avoid urethral stricture from progressive disease.

A secondary aim for circumcision is to reduce likelihood for sexually transmitted disease in adults.

Evidence for these aims:

  • Our review found no study reporting the incidence of symptomatic phimosis.

  • The normal foreskin does not fully retract at birth, but persistent failure to retract occurs in <10 % of teens.

  • RCTs demonstrate betamethasone ointment is more effective than placebo to achieve partial or complete retraction, but placebo is also effective in up to 45 % of cases.

  • Our review found no definition for meatal stenosis.

  • One study of boys with deflected urinary stream undergoing meatotomy reported that symptoms improved and mean Qmax increased.

  • There is poor evidence that meatotomy is indicated for a small-appearing meatus, dysuria, or incontinence.

  • BXO involvement of glans and meatus clinically resolves in most patients within 2 years of circumcision.

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Authors and Affiliations

  1. Department of Pediatric Urology, University of Texas Southwestern Medical Center and Children’s Medical Center Dallas, 1935 Medical District Drive, MS F4.04, Dallas, TX, 75235, USA

    Patricio C. Gargollo M.D.

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  1. Patricio C. Gargollo M.D.
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Correspondence to Patricio C. Gargollo M.D. .

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Editors and Affiliations

  1. Children’s Medical Center Dallas, Department of Pediatric Urology, University of Texas Southwestern Medical, N/A, Dallas, 75235, Texas, USA

    Warren T. Snodgrass

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Gargollo, P.C. (2013). Phimosis, Meatal Stenosis, and BXO. In: Snodgrass, W. (eds) Pediatric Urology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6910-0_10

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  • DOI: https://doi.org/10.1007/978-1-4614-6910-0_10

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