Acta Medica Medianae
ADHERENT PREPUTIUM IN cHILDREN
Danijela Đerić, Ružica Milićević, Marijana Krstić, Zoran Marjanović, Milan Bojanović i Ivana Budić
Klinika za dečju hirurgiju i ortopediju Kliničkog centra u Nišu
Preputium in children is physiologically adherent to the glans up to the age of three or four. Therefore, the recommendation to the parents is not to attempt to perform retraction of preputium until that age, as it could lead to fibrotic reaction of preputium. With growth and spreading of the orificial opening, balanopreputial adhesions disappear. However, recurrent balanoposthitis, chronic ammoniacal inflammation and wrong attempts of retraction performed by parents lead to chronic fibrosis and formation of rigid, stenotic preputium and the appearance of balanitis xerotica obliterans. If preputium does not retract over the glans until the age of four, or if preputium leaves are sticked, the local application of preparations on the basis of corticosteroids is recommended (Ung. Didermal), when successful retraction of preputium is achieved in 70–95% of cases. Surgical interventions in the aforementioned indications have been rare worldwide in the recent years. Circumcision is mainly performed in the case of scleroatrophic lihen or xerotic banalities. Yet, the greatest number of circumcisions in the world are performed because of cultural and religious believes, which bring a series of complications, primarily stenosis of the meatus. Acta Medica Medaiane 2005:44(4): 75 – 79.