Preoperative oral granisetron for the prevention of vomiting following paediatric surgery

BACKGROUND: We evaluated the efficacy of granisetron, 5-hydroxytryptamine type 3 receptor antagonist, given orally, preoperatively, for the prevention of postoperative vomiting in children undergoing general anaesthesia for surgery (inguinal hernia, phimosis-circumcision). METHODS: In a randomized, double-blinded manner, 100 children, ASA physical status I, aged 4-11 years, received orally placebo or granisetron at three different doses (20 microg x kg(-1), 40 microg x kg(-1), 80 microg x kg(-1)) 60 min before surgery (n=25 of each). The same standard general anaesthetic technique was used. RESULTS: The percentage of patients being emesis-free during 0-6 h after anaesthesia was 56% with placebo, 64% with graniseron 20 microg x kg(-1) (P=0.773), 88% with granisetron 40 microg x kg(-1) (P=0.027) and 92% with granisetron 80 microg x kg(-1) (P=0.01); the corresponding rate during 6-24 h after anaesthesia was 60%, 68% (P=0.768), 92% (P=0.02) and 92% (P=0.02) (P-values versus placebo). No clinically serious adverse events were observed in any of the groups. CONCLUSIONS: In summary, preoperative oral granisetron 40 microg x kg(-1) is effective for the prevention of vomiting following paediatric surgery (inguinal hernia, phimosis-circumcision). Increasing the doses to 80 microg x kg(-1) provides no demonstrable additional benefit.     

Penis cancer: a review by the Joint Radiotherapy Committee of the European Organisation for Research and Treatment of Cancer (EORTC) Genitourinary and Radiotherapy Groups

A review of the literature on penis cancer has been undertaken. The disease is rare and most of the cumulative experience is reported in retrospective series. Multi-institutional international collaboration will be needed to study prospectively facets of this disease where controversy presently exists. Suggested areas of research are in the treatment of early invasive tumours, the diagnosis and treatment of inguinal metastases, the improvement of radiotherapy techniques, and the development of effective chemotherapy and effective combinations of therapies. This will potentially lead to a greater degree of organ sparing. Studies of palliation, and aspects of quality of life, are also needed. Public education about the condition and genital hygiene, including the necessity for the early treatment of phimosis, may further reduce the incidence of penis cancer.     

Triple incision to treat phimosis in children: an alternative to circumcision?

OBJECTIVE: To evaluate the functional and cosmetic results and patient satisfaction after triple incision plasty for phimosis in children. PATIENTS AND METHODS: The study included 197 boys who had a triple incision for phimosis (mean age 5.8 years, range 0.25-18). The indications for preputial surgery were recurrent balanoposthitis, ballooning during micturition and severe phimotic stenosis. The results after surgery were assessed using a questionnaire about the child's/parent's satisfaction, and an outpatient follow-up examination for functional and cosmetic preputial appearance. RESULTS: Of 128 parents/children responding, 108 (84%) were satisfied with the function and 102 (80%) reported a good cosmetic outcome. Triple incision as preputioplasty would be recommended to other parents by 119 (93%) respondents. Ninety-one (71%) of the parents feared disadvantages in their son's later life if the child had been circumcised. The outpatient examination showed an excellent functional and cosmetic outcome in 71 (77%) of the children. CONCLUSION: Triple incision is a simple, fast and safe technique for preputial relief, with good functional and cosmetic results, and was well accepted by the patients.     

THE TREATMENT OF CHILDHOOD PHIMOSIS WITH TOPICAL STEROID

A prospective study of the efficacy of topical steroid in the treatment of childhood phimosis is reported. Boys referred to a paediatric surgical practice with pathological non-retractable foreskins were treated for at least 1 month with topical beta methasone cream. One hundred and thirty-nine patients were treated and 111 completed the study. A satisfactory result, defined as foreskin retractability appropriate for the boys' age, was achieved in 80% of patients. In 10% the response was inadequate at the end of the study period, but these boys were still under treatment or surveillance because their parents declined circumcision. In 10%, circumcision was performed because of failure of treatment. In six patients this was due to balanitis xerotica obliterans (lichen sclerosis et atrophicus) which does not respond to conservative treatment. Successful treatment depends upon the presence of a normal, supple foreskin at the outset, and on parental compliance.     

袖套式包皮环切术治疗包皮过长及包茎

目的:探讨袖套式包皮环切术治疗包皮过长及包茎的临床效果.方法:采用袖套式包皮环切术治疗包皮过长及包茎 32例.术中先标记好包皮内外板二个相互平行的环行切口,保留包皮内板约 0.5 cm,小圆刀切开至真皮层,其中腹 侧外板作倒" V"字形切口,防止术后包皮系带过短.小圆刀锐性剥离包皮条,保留完整的肉膜及浅层血管. 3- 0丝线 缝合切口.结果: 32例切口术中出血少,切口整齐,术后无继发出血及感染,切口无水肿,外形美观.结论:袖套式包 皮环切术对包皮过长及包茎的治疗较传统包皮环切术效果满意.     

袖状法包皮环切并改进缝合方法的手术经验

目的　探讨包皮环切的理想术式。方法　对 51例包茎、包皮过长患者采用袖状法包皮环切并间断缝合少许皮缘的方法手术。结果　51例患者,术中出血 1~5ml。术后反应性水肿 6例,占 11. 8%,无切口出血或形成血肿,无包皮切除过多或过少病例,术后 2周 48例患者缝线自动脱落, 3例患者需拆线 2~3针,切口全部甲级愈合。结论　该术式具有出血少、术后并发症少、缝线可自动脱落等优点。     

1227名男性大学生外生殖器健康调查与分析

目的 了解男性大学生外生殖器健康状况,为高校预防保健工作提供科学依据.方法 对1 227名男性大学生进行了问询调查和外生殖器的一般检查,并对结果进行分析.结果 受检学生中有包皮过长、包茎等疾病者占73.19%;有83.13%的学生不知道什么是包茎、包皮过长.结论 大学生外生殖器疾病较为常见,但普遍对外生殖器的健康状况缺乏足够了解.学校应积极关注和加强健康教育,不可忽视男学生的生理卫生教育.     

Foreskin and penile problems in childhood

This article outlines the embryology, natural history and management of different conditions of the foreskin and penis in children. Although the classification of hypospadias is included, the management of this condition is not. Epispadias is not covered at all.     

Disturbed voiding associated with von Recklinghausen''s neurofibroma

Abstract The incidence of von Recklinghausen's disease is most frequent among neurocutaneous syndrome. It is an intractable neurological disease. About half of the disease is caused by an autosomal dominant inheritance and another half by mutation. It is characterized by neurofibroma which arises on various parts of the body and gradually increases with age. We recently encountered a case where a growth of neurofibroma within the foreskin had disturbed voiding.     

包皮环套术治疗小儿及青少年包茎或包皮过长的Meta分析

目的评价包皮环套术治疗小儿及青少年包茎或包皮过长的疗效。方法计算机检索VIP、CNKI、万方、CBM、PubMed、CochraneLibrary、SCI及EMBASE数据库,并辅以手工及其它检索,纳入所有比较包皮环套术与包皮环切术治疗小儿及青少年包茎或包皮过长的随机对照试验,两人独立进行筛选及资料提取,根据Cochrane系统评价手册4.2.6质量评价标准进行评价,用RevMan4.2.10软件进行Meta分析。结果纳入5个研究。Meta分析结果显示：与环切术相比,环套术的手术时间短[加权均数差=-19.74,95%可信区间（-23.00,-16.48）]、术中出血少[加权均数差=-7.50,95%可信区间（-8.48,-6.52）]、感染少[比值比=0.30,95%可信区间（0.12,0.75）]、术后外观好[比值比=0.09,95%可信区间（0.04,0.22）]。结论当前证据表明,包皮环套术是一种疗效可靠、并发症少的治疗小儿及青少年包茎包皮过长的微创术式。但鉴于纳入研究的证据强度有限,有必要进一步开展高质量、大样本的随机临床对照试验评价予以证实。