delete text and place photo here. pequenos procedimentos ... congresso - apresentações - 19... ·...

PEQUENOS PROCEDIMENTOS NOPREPÚCIO

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João PascoalHospital Dona EstefâniaCentro Hospitalar de Lisboa Central

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Nas pinturas de vasos da GréciaAntiga o prepúciopode ter até ¾ do comprimento total do pénis.Um prepúcio longoClick here to add text. Click here to add text.

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Um prepúcio longoe afunilado reflecteum ethos de identidade cultural, moralidade, virtude, beleza e saúde

KYNODESME

• O prepúcio e a glande têm o mesmo epitélio comum, que gradualmente se separa e queratiniza.

• Este processo pode estar completo em qualquer altura, desde o fim da gestação até à adolescência.

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• As aderências balano-prepuciais não implicam patologia, estão presentes em cerca de 60% das crianças entre os 6 e 9 anos de idade.

• Usualmente desaparecem por volta dos 17 anos de idade, em que só 1,5% dos rapazes têm fimose.

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Combinação de restos celulares epiteliais, transudados e humidade.

Pode formar “quistos de retenção”.

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“Tratamento” das aderências balano-prepuciais é a mani pulação .Código 99.95 – Stretching of foreskin

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Quando é “necessária” cirurgiao procedimento é uma incisão de descarga dorsal do pénis.

Código 64.91 – Dorsal or lateral slit of prepuce

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Tratamento inicialmanipulação

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Quando necessária cirurgia faz-se incisão de descarga dor sal

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Incisão de descarga dorsaltambém conhecida por Plastia de Duhamel

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Complicação de circuncisão, aderências de pele à glande .

Código 64.93 – Division of penile adhesions

• Código de procedimento 64.93 não é adequado para asituação “clínica” aderências balano prepuciais - GDH 341(Procedimentos no pénis); peso relativo 0,7014.

• Código de procedimento 64.91 - GDH 350 (Inflamações doaparelho reprodutor masculino); peso relativo 0,1355 (emambulatório)

• Comparando com a circuncisão GDH 343; peso relativo0,1759.

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