Phimosis Postoperative Diagnosis Explained for Students (Easy Guide)

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Original Question

Phimosis. POSTOPERATIVE DIAGNOSIS: Same. PROCEDURE PERFORMED: Lysis of prepuce adhesions, meatotomy, and cystoscopy. CLINICAL NOTE: This 4-year-old has voiding dysfunction and his urine sprays and goes up rather than down. He had had prior circumcision. There is a minimal amount of redundant foreskin. SURGEON: Lucama Hitachi, MD PROCEDURE: The patient was given a general mask anesthetic, prepped, and draped in the supine position. There were some adhesions between the glans and the prepuce. These were broken down easily. Meatus was quite stenotic, and I believe this is a result of a congenital atresia of the urethra. Meatotomy was performed at the 6-o’clock position. A clamp was placed, skin divided, and then reapproximating sutures using 5-0 chromic were placed. The patient was then cystoscoped using a 9.2 rigid instrument. There was no evidence of urethral stricture posterior to the urethral valves. Bladder mucosa and ureteric orifices were all normal. Cystoscope was withdrawn. Bacitracin ointment was applied. The patient tolerated the procedure well and was transferred to the recovery room in good condition. Procedure Key Terms: cystourethroscopy, meatomy, adhesions foreskin phimosis, congenital ureter

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