Abstract:
BACKGROUND: Congenital prepubic sinus is a rare anomaly found in the midline of the lower abdomen. Congenital prepubic sinus is usually asymptomatic in neonates, and a diagnosis is often achieved later in life after spontaneous extrusion of purulent material from the pre-existing hole in the pubic region. We present a case of congenital prepubic sinus presenting with purulent discharge after circumcision. A 4-year-old Caucasian boy presented to our urology out-patient clinic with purulent discharge from the distal part of the dorsum of his penis. He had a history of circumcision performed at a different center, 6 months ago. His parents stated that although various antibiotics were used, the purulent discharge continued for 6 months and the child had no complaints before circumcision. His condition was reported as superficial dorsal venous thrombosis, known as penile Mondor disease, in magnetic resonance imaging that was performed in the previous hospital. A physical examination revealed a small pinhole lesion at the distal part of his penis and a rigid cylindrical tube extending to the proximal side of his penis. We performed fistulography by injecting contrast material through a small angiocatheter and confirmed the diagnosis of prepubic sinus. Surgical exploration was performed and a long sinus, apparently ending as a fibrous tract at the anterior surface of his pubic symphysis, was found and resected.
CONCLUSIONS: Before congenital prepubic sinus surgery, it is critically important to rule out penile Mondor disease and the possibility of a circumcision complication (especially infective complications) mimicking congenital prepubic sinus.
摘要:
背景:先天性耻骨前窦是在下腹部中线发现的罕见异常。新生儿先天性耻骨前窦通常无症状,并且诊断通常是在从耻骨区域的先前存在的孔中自发挤出脓性物质之后的以后生活中实现的。我们介绍了一例先天性耻骨前窦包皮环切术后出现脓性分泌物的病例。一个4岁的高加索男孩出现在我们的泌尿科门诊诊所,他的阴茎背侧远端有脓性分泌物。他有在另一个中心进行包皮环切术的历史,6个月前.他的父母说,尽管使用了各种抗生素,脓性分泌物持续了6个月,孩子在包皮环切术前没有任何抱怨。据报道他的情况是浅背静脉血栓形成,被称为阴茎蒙多病,在以前的医院进行的磁共振成像。体格检查显示,他的阴茎远端有一个小的针孔病变,一个刚性的圆柱形管延伸到阴茎的近侧。我们通过小型血管导管注射对比剂进行了血管造影,并确认了耻骨前窦的诊断。进行了手术探查和长鼻窦,显然在他的耻骨联合前表面以纤维束结束,被发现并切除。
结论:先天性耻骨前窦手术前,排除阴茎Mondor病和包皮环切术并发症(尤其是感染性并发症)的可能性是非常重要的,这类似于先天性耻骨前窦.