A COMPARATIVE STUDY OF CIRCUMCISION AND PREPUTIOPLASTY IN PEDIATRIC CASES OF PHIMOSIS: A PROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL, BHAVNAGAR, GUJARAT

Abstract

Introduction: Preputioplasty have gained a new interest now days because the retained preputial skin with mucosa after preputioplasty gives good cosmetic appearance and it can be utilized in future for urethral stricture surgery. The aim of this study was to compare the post-operative complications and post-operative hospital stay in patients operated by circumcision and preputioplasty.

Methodology: This prospective study included 50 patients (age less than 4 years) having phimosis, treated during July 2010 to July 2012. These patients were treated by two methods viz. circumcision and preputioplasty (25 cases by each method).The patients were assessed post-operatively at day 1, day 15, at 2 months and at 3 months.

Results: The study revealed that the immediate post-operative complications like pain, bleeding, oedema, difficulty in micturition and fever were present after both the procedures. But post-operative pain (84%), bleeding (24%) and difficulty in micturition (16%) were higher after circumcision than after preputioplasty (40%, 4% and 4% cases respectively). Post-operative oedema was more prominent in preputioplasty-operated patients (84%). Post-operative hospital stay was longer in cases treated with circumcision. After three months, recurrent adhesions were more common after preputioplasty (32%). Cosmetic appearance was acceptable in patients operated with both the procedures.

Conclusion: Preputioplastyis a faster, easier, relatively painless technique with excellent cosmetic results and lesser complications than circumcision, except post-operative edema and adhesions.