Surveillance of Male Genital Anomalies in Newborns: Experience in a Medical Center in Central Taiwan

新生男嬰生殖器異常之檢測：一個中台灣醫學中心的經驗

陳國樑(Kuo-Liang Chen) ； 蘇百弘(Bai-Horng Su) ； 張兆祥(Chao-Hsiang Chang) ； 吳錫金(Hsi-Chin Wu) ； 張士三(Shih-San Chang)

《Mid-Taiwan Journal of Medicine》 13卷2期 (2008/06) Pp. 95-99

https://doi.org/10.6558/MTJM.2008.13(2).5

摘要

背景／目的　爲了瞭解男性新生兒生殖器異常的確實發生率，我們在中臺灣一個醫學中心進行這個研究，來篩選男性新生兒外生殖器的異常。
方法在2002年7月1日至2003年1月14日間，每週二及週五在嬰兒室的所有男性新生兒（共269位，占同時期出生男嬰的39%）被選定來檢查他們的外生殖器，以記錄其外生殖器異常的發生率，包括包莖、隱睪症、陰囊水腫、腹股溝疝氣、尿道下裂和尿道上裂等。包莖的形態是用Kikiros包莖分類法來記錄。
結果　在這些足月生產的男嬰中，發現有二位(0.7%)尿道下裂，其他99.3%全部爲生理性包莖，沒有一位可以露出整個龜頭。有五位(1.9%)隱睪症被查出，其中四位是腹股溝型、一位是恥骨前型。而且有二位(0.7%)伸縮性睪丸。十七位(6.3%)陰囊水腫被篩檢出來，其中二位在左邊，六位在右邊，九位是兩邊。只有一位男嬰(0.4%)有左側腹股溝疝氣。
結論　在本醫學中心出生的臺灣新生兒隱睪症以腹股溝型占絕大部分，陰囊水腫以右側居多。且與西方國家比較，我們有較高的生理性包莖和尿道下裂的發生率及較低的隱睪症、陰囊水腫和腹股溝疝氣的發生率。這些差異須要進一步研究來回答是肇因於醫院型研究的限制或是種族的差異。

關鍵字

男性生殖器疾病 ； 新生兒篩檢 ； 檢測

並列摘要

Background/Purpose. To determine the incidence of genital anomalies in male newborns.
Methods. During the period from July 1, 2002 to January 14, 2003, we examined the external genitalia of full-term male newborns who were present in the hospital nursery on Tuesdays and Fridays. A total of 269 male newborns were examined and enrolled in this study. The incidence rates of the following male genital anomalies in newborns were calculated: phimosis, undescended testis, scrotal hydrocele, inguinal hernia, hypospadias, and epispadias. The morphological types of phimosis were recorded using Kikiros' phimosis classification system.
Results. The incidence of phimosis was 99.3%. Hypospadias with incomplete prepuce was found in 0.7% of newborns. The incidence of undescended testis was 1.9% and that of retractile testis was 0.7%. Scrotal hydrocele was diagnosed in 6.3% and inguinal hernia was diagnosed in 0.4% of the newborns. There were no cases of epispadias. The types of undescended testes were inguinal in 4 and prepubic in 1 newborn. Scrotal hydroceles were left-sided in 2, right-sided in 6, and bilateral in 9 neonates.
Conclusion. The incidences of penile anomalies (phimosis and hypospadias) were higher and the incidences of testis-related anomalies (undescended testis, scrotal hydrocele, and inguinal hernia) were lower than those reported in Europe and North America. Further study is necessary to investigate whether the differences are caused by the limitation of the hospital-based study or by differences in ethnicity.

並列關鍵字

male genital anomalies ； neonatal screening ； surveillance