包茎与包皮过长患儿复发性泌尿系感染的相关因素分析

Analysis of related factors of recurrent urinary tract infection in children with phimosis and redundant prepuce

目的探讨包茎与包皮过长患儿发生复发性泌尿系感染(repeated urinary tract infections,RUTI)的相关因素。方法选取2019年6月至2021年11月在新乡医学院第一附属医院泌尿外科就诊的8~17岁包皮过长或包茎患儿共2000例,排除存在泌尿系统器质性疾病或神经系统疾病者,根据有无RUTI分为RUTI组、无RUTI组,采用病例对照研究方法,分析年龄、身体质量指数(body mass index,BMI)、包皮垢、包皮粘连、习惯性憋尿、包皮环切等与RUTI的相关性,了解包皮过长与包茎儿童出现RUTI的影响因素。结果RUTI组213例(213/2000,10.7%),无RUTI组1787例(1787/2000,89.4%);BMI值是否超过18.54(OR=0.76,95%CI:0.53,1.09)与RUTI的发生无相关性;存在包皮粘连(OR=3.63,95%CI:2.25,5.87)、包皮垢(OR=2.16,95%CI:1.34,3.48)、年龄≤13岁(OR=0.74,95%CI:0.50,0.99)、未行包皮环切术(OR=0.31,95%CI:0.22,0.45)和习惯性憋尿(OR=5.26,95%CI:3.82,7.26)是包皮过长与包茎儿童出现RUTI的危险因素(P<0.05)。结论包茎与包皮过长儿童发生复发性泌尿系感染可能与未行包皮环切术、习惯性憋尿、存在包皮粘连、包皮垢等危险因素相关,行包皮环切术、经常清洗包皮、无憋尿习惯等可降低包皮过长与包茎儿童的泌尿系感染风险。

Objective To explore the relevant influencing factors of recurrent urinary tract infection(RUTI)in children with phimosis and redundant prepuce.Methods From June 2019 to November 2021,2000 children aged 8-17 years with redundant prepuce or phimosis treated at First Affiliated Hospital,Xinxiang Medical College were selected.Excluding those with a history of urinary organic diseases or nervous system diseases,they were divided into two groups of RUTI(n=213)and non-RUTI(n=1801)according to the presence or absence of RUTI.A case-control study was performed for examining the correlations between age,body mass index(BMI),smegma,prepuce adhesion,urination habit,circumcision and RUTI.Results BMI(OR=0.76,95%CI:0.53,1.09)had little effect on RUTI;younger age(OR=0.74,95%CI:0.50,0.99),non-circumcision(OR=0.31,95%CI:0.22,0.45)and frequent holding urine(OR=5.26,95%CI:3.82,7.26)were risk factors for overlength of prepuce and RUTI in phimosis children(all P<0.05).Conclusion Recurrent urinary tract infection in children with phimosis and redundant prepuce may be related to risk factors such as uncircumcised prepuce,frequent urination,adhesion of prepuce,prepuce scale and so on.Circumcision,frequent cleaning of prepuce and infrequent urine lower the risk of urinary tract infection in children with phimosis and redundant prepuce.