Abstract：
OBJECTIVE: We describe meatal outcomes for boys undergoing circumcision to treat Lichen Sclerosus (LS/BXO) with a focus on those who underwent meatotomy/meatoplasty at circumcision and factors associated with post-circumcision meatal intervention.
METHODS: Retrospective review of patients undergoing circumcision for histologically confirmed LS between 2011 and 2020. Statistical testing was by Chi2 and multivariate analysis.
RESULTS: 382 patients underwent circumcision at a mean of 9.1 years (SD 2.9). At circumcision, LS on the glans was documented in 213/365 (58%). Meatal involvement was documented in 74/382 (19%); 25/382 (6.5%) had a meatotomy, 94/382 (25%) had meatal calibration/dilatation and 234/367 (64%) were prescribed post-operative topical steroids. Patients with LS glans or meatal involvement were more likely to have a meatotomy (p = 0.0013) and to receive post-operative steroids (OR 5, p = 0.0001). Post circumcision, 40/382 (10%) required a median of 1 subsequent procedure (range 1-5), 10 (2.6%) underwent dilatation, 30 (7.4%) had a meatotomy. Patients undergoing meatotomy at circumcision had an odds ratio (OR) of 1.2 for subsequent meatotomy (p = 0.027). Analysis based on requirement for any subsequent procedure identified an OR of 3.1 for having had a meatotomy at circumcision (p = 0.022) and an OR of 6.0 of receiving post-operative steroids (p=<0.001).
CONCLUSIONS: Meatal stenosis following circumcision for LS requiring meatal intervention affected 10% of boys. Meatotomy at circumcision increased the likelihood of subsequent meatal intervention and is therefore not recommended.
METHODS: Level III.
METHODS: Retrospective review of patients undergoing circumcision for histologically confirmed LS between 2011 and 2020. Statistical testing was by Chi2 and multivariate analysis.
RESULTS: 382 patients underwent circumcision at a mean of 9.1 years (SD 2.9). At circumcision, LS on the glans was documented in 213/365 (58%). Meatal involvement was documented in 74/382 (19%); 25/382 (6.5%) had a meatotomy, 94/382 (25%) had meatal calibration/dilatation and 234/367 (64%) were prescribed post-operative topical steroids. Patients with LS glans or meatal involvement were more likely to have a meatotomy (p = 0.0013) and to receive post-operative steroids (OR 5, p = 0.0001). Post circumcision, 40/382 (10%) required a median of 1 subsequent procedure (range 1-5), 10 (2.6%) underwent dilatation, 30 (7.4%) had a meatotomy. Patients undergoing meatotomy at circumcision had an odds ratio (OR) of 1.2 for subsequent meatotomy (p = 0.027). Analysis based on requirement for any subsequent procedure identified an OR of 3.1 for having had a meatotomy at circumcision (p = 0.022) and an OR of 6.0 of receiving post-operative steroids (p=<0.001).
CONCLUSIONS: Meatal stenosis following circumcision for LS requiring meatal intervention affected 10% of boys. Meatotomy at circumcision increased the likelihood of subsequent meatal intervention and is therefore not recommended.
METHODS: Level III.
摘要：
目的：我们描述了接受包皮环切术治疗硬化性苔藓（LS/BXO）的男孩的饮食结局，重点是那些在包皮环切术时接受了切肉手术/子宫移植术的男孩以及与包皮环切术后干预相关的因素。
方法：回顾性回顾了2011年至2020年间接受包皮环切术的患者的组织学证实的LS。通过Chi2和多变量分析进行统计检验。
结果：382例患者接受包皮环切术平均9.1年（SD2.9）。在包皮环切术时,在213/365（58％）中记录了龟头上的LS。在74/382（19％）中记录了大量受累；25/382（6.5％）进行了切肉手术，94/382（25％）的饮食校准/扩张和234/367（64％）的手术后局部类固醇处方。LS龟头或受累的患者更有可能进行切肉手术（p=0.0013）并接受术后类固醇（OR5，p=0.0001）。包皮环切术后,40/382（10％）需要1次后续手术的中位数（范围1-5），10人(2.6%)接受扩张，30（7.4％）进行了切肉手术。在包皮环切术中进行切肉手术的患者在随后的切肉手术中的比值比（OR）为1.2（p=0.027）。根据任何后续手术的要求进行的分析确定，在包皮环切术中进行切肉手术的OR为3.1（p=0.022），接受术后类固醇的OR为6.0（p=<0.001）。
结论：对于需要肠道干预的LS，包皮环切术后的肠道狭窄影响了10%的男孩。包皮环切术时的切肉术增加了随后进行饮食干预的可能性，因此不建议使用。
方法：三级。
方法：回顾性回顾了2011年至2020年间接受包皮环切术的患者的组织学证实的LS。通过Chi2和多变量分析进行统计检验。
结果：382例患者接受包皮环切术平均9.1年（SD2.9）。在包皮环切术时,在213/365（58％）中记录了龟头上的LS。在74/382（19％）中记录了大量受累；25/382（6.5％）进行了切肉手术，94/382（25％）的饮食校准/扩张和234/367（64％）的手术后局部类固醇处方。LS龟头或受累的患者更有可能进行切肉手术（p=0.0013）并接受术后类固醇（OR5，p=0.0001）。包皮环切术后,40/382（10％）需要1次后续手术的中位数（范围1-5），10人(2.6%)接受扩张，30（7.4％）进行了切肉手术。在包皮环切术中进行切肉手术的患者在随后的切肉手术中的比值比（OR）为1.2（p=0.027）。根据任何后续手术的要求进行的分析确定，在包皮环切术中进行切肉手术的OR为3.1（p=0.022），接受术后类固醇的OR为6.0（p=<0.001）。
结论：对于需要肠道干预的LS，包皮环切术后的肠道狭窄影响了10%的男孩。包皮环切术时的切肉术增加了随后进行饮食干预的可能性，因此不建议使用。
方法：三级。
