Meatal stenosis, BXO, adult circumcision revision
My circumcison needs to be re-done due to scarring and lop-sidedness done by the previous urologist 1 yr ago. However that operation has produced lichen sclerosis of the glans which still exists today and has closed my urethra by 50%. Which of these issues can you help with? and do you know of someone who uses laser to treat/cure LS? thanks. Geoffrey
Good afternoon Geoffrey,
Invasive lichen sclerosis is known but rare. I doubt if it is deep inside the urethra, laser will cure it, as only more scar may be laid down. Please review this reference http://emedicine.medscape.com/article/1074054-overview If your urethra is involved, you may need a buccal graft to replace the involved urethra. That we can do and may require 2 stages.
This entity is often referred to as balanitis xerotica obliterans.
With every best wish for a restful weekend,
Harold M. Reed, M.D.
305-865-2000Thank you for your quick reply Dr. Reed,
I appreciate it. I should have been more clear and said that my BXO has caused meatal stenosis and it’s my urethral opening that has closed by 50% not the urethra itself. I don’t know if you can reverse the stenosis at the same time you perform the reconstuctive circumcision, and at what additional cost? And would you prefer for me to get the BXO lasered off before I see you or after?
Many thanks for your time.
Geoffrey from Ontario Canada
May 26, 2009
Hi George,
Ideally if you know of a physician who reports very successful treatment of meatal stenosis with laser, than have that done first and be sure a suitable period of time has passed without recurrence.
Otherwise we would be delighted to perform a conventional meatotomy with of course removal of any scarified tissue. If you have a process in evolution, there is no guarantee that it will be reform. Otherwise plan on your being left after surgery with a sufficient aperture.
All the best,
Harold M. Reed, M.D.
305-865-2000