Objectives


In the last years, many surgical techniques of preputioplasty
have aimed to preserve the foreskin in case of phimosis. These
techniques are not reliable for patients affected by phimosis linked to
balanitis xerotica obliterans (BXO) and scarred foreskin. We tried
an original technique of resection of the pathological foreskin,
removing the mucosal internal layer followed by reconstruction of the
foreskin. The aim was to evaluate the outcome of paediatric patients who
underwent modified partial circumcision for pathological phimosis.


Patients
and methods


In all, 360 patients with phimosis underwent modified partial
circumcision at our institution. The mean age of the boys was 8.9 years,
range 5–15 years. In 145 (40.3%) cases, indication for surgery was
clinical suspicion of BXO, in 215 (59.7%) cases it was chronic
inflammation of the foreskin.


Results


In all cases, the postoperative period was uneventful. Cosmesis
was considered by parents as excellent in 95.2% of patients. In these
patients, the glans was almost completely covered by soft foreskin.
Histopathological examination of
the removed foreskin documented BXO in 162 (45%). Twelve (3.3%) patients
complained of recurrences and five (1.4%) patients of smegmatic cysts.


Conclusion


The described surgical technique of modified partial circumcision for the correction of pathological phimosis appears
cosmetically well accepted, safe, and simple with low rate of late postoperative complications.