RESUMEN
We aimed to investigate patient satisfaction with male circumcision in Taiwan. An online, questionnaire-based, cross-sectional study involving 376 circumcised men 20 to 40 years of age in Taiwan was conducted. Circumcision-related satisfaction was defined as a visual analogue scale score ≥ 6 (range, 1-10). Pearson's chi-square test was performed to compare differences between satisfied and unsatisfied participants. Factors predictive of participant satisfaction were analysed using multivariate logistic regression. Statistical significance was set at P < 0.05. Among 376 circumcised men, 249 (66.2%) reported satisfaction with circumcision. Satisfied participants had higher levels of education, underwent circumcision for phimosis or balanitis, underwent circumcision during adulthood, reported a larger penile size, and had fewer long-term complaints. Furthermore, 89.4% had various long-term complaints, including skin colour mismatch, changes in masturbation methods, hypertrophic scarring, excessive shortening of the prepuce, and redundant prepuce. Multivariate analysis revealed that adult circumcision and the absence of long-term conditions were predictive of satisfaction. Two-thirds of participants were satisfied with their circumcision outcome, especially those who underwent circumcision for phimosis or balanitis during adulthood. Proper preoperative patient selection and postoperative symptom prevention would improve patient satisfaction.
Asunto(s)
Balanitis , Circuncisión Masculina , Fimosis , Adulto , Humanos , Masculino , Taiwán , Estudios Transversales , Balanitis/cirugía , Satisfacción PersonalRESUMEN
PURPOSE: Although circumcision is the most commonly performed surgery in males, less is known about the incidence and indications of adult circumcision. In this study, we aim to present the incidence of adult circumcision across the United States. METHODS: Using IBM MarketScan® Commercial Database from 2015 to 2018, we obtained claims for circumcision in men between 18 and 64 years of age. We calculated the incidence of adult circumcision over the study period and across the United States. We also collected data on indications for surgery using International Classification of Diseases codes. RESULTS: We identified a total of 12,298 claims for adult circumcisions. The mean age was 39 (±12.9) years. The average incidence rates remained relatively constant from 98.1 per 100,000 person-years in 2015 to 98.2 per 100,000 person-years in 2018 (Δ+0.1%). The age-standardized incidence rates varied significantly across the United States (from 0 to 194.8 per 100,000 person-years) with South Dakota having the highest rate. The most common indications for adult circumcision were phimosis (52.5%), routine/ritual circumcision (28.7%), phimosis + balanitis/balanoposthitis (6.8%), balanitis (3.8%) and balanoposthitis (2.6%), and significantly varied by age groups. CONCLUSION: This study suggested a wide geographic variation in rates of adult circumcision between states with highest incidences in the Northeast United States. Future studies can identify the underlying causes for the observed variations.
Asunto(s)
Balanitis , Circuncisión Masculina , Fimosis , Adulto , Balanitis/cirugía , Conducta Ceremonial , Humanos , Incidencia , Masculino , Fimosis/cirugía , Estados Unidos/epidemiologíaAsunto(s)
Balanitis/cirugía , Circuncisión Masculina , Prepucio/cirugía , Células Plasmáticas/patología , Administración Cutánea , Adulto , Anciano , Antiinfecciosos/administración & dosificación , Antiinflamatorios/administración & dosificación , Balanitis/tratamiento farmacológico , Balanitis/patología , Biopsia , Quimioterapia Combinada , Prepucio/efectos de los fármacos , Prepucio/patología , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Células Plasmáticas/efectos de los fármacos , Resultado del TratamientoRESUMEN
INTRODUCTION: Circumcision is the most common surgical procedure performed worldwide. However, there is a dearth of literature regarding medical indications for adult circumcisions. Here, we describe our experience with adult circumcision and contemporary demographics, indications and complications. MATERIALS AND METHODS: We reviewed all circumcisions performed in our institution between July 2008 and January 2015. Patient demographics, procedure indications and postoperative complications were recorded, and patients were grouped by age as either less than 50 years old or 50 years and older. RESULTS: A total of 202 charts were reviewed. The most common indications for circumcision were phimosis (46.5%), dyspareunia (17.8%), balanitis (14.4%), and concurrent phimosis and balanitis (8.9%). Older patients were more likely to undergo circumcision for concurrent phimosis and balanitis or cancer, whereas younger patients sought circumcision for dyspareunia. The complication rate was 3.5% and there was no significant difference in complication rates between the two age groups. CONCLUSION: Circumcision is performed in the adult population for a variety of reasons. Circumcision remains a safe surgical option for patient management with a low complication rate.
Asunto(s)
Balanitis/cirugía , Circuncisión Masculina , Dispareunia/cirugía , Fimosis/cirugía , Complicaciones Posoperatorias/epidemiología , Adulto , Anciano , Estudios de Seguimiento , Humanos , Incidencia , Masculino , Persona de Mediana Edad , New York/epidemiología , Estudios Retrospectivos , Resultado del Tratamiento , Población UrbanaRESUMEN
In this report we describe a case of the Zoon's balanitis in a boy with HIV (AIDS B2). The clinical presentation, failure of topical treatment, cure by circumcision, and the histopathology findings are presented.
Asunto(s)
Balanitis/patología , Balanitis/cirugía , Circuncisión Masculina , Infecciones por VIH/complicaciones , Biopsia , Niño , Humanos , Masculino , Células Plasmáticas/patología , Resultado del TratamientoRESUMEN
Eight elderly patients (average age 76.1±4.3 years) with balanitis xerotica obliterans (BXO) accompanied by phimosis presented with difficulty in urination. Preoperative average international prostate symptom score, average maximum urinary flow rate, and average volume of residual urine were 20.7±6.3 points (nï¼8), 5.1±3.6 ml/s (nï¼5), and 85.4±77.3 ml (nï¼8), respectively. Some of the patient's complaints, such as severe dribbling of urine, urinary stream division, and ballooning of the foreskin, were not included in the items of the major questionnaire on urination. Dorsal incision and circumcision was performed in all patients, and all were pathologically diagnosed with BXO. Meatoplasty was performed in one patient with a meatal stenosis. No coexistence of penile cancer was observed. Statistically significant improvements were observed in subjective and objective findings after treatment. In conclusion, BXO with phimosis in elderly patients should be considered as a cause of lower urinary tract symptoms.
Asunto(s)
Balanitis/cirugía , Fimosis/complicaciones , Anciano , Anciano de 80 o más Años , Balanitis/complicaciones , Balanitis/fisiopatología , Humanos , Masculino , Micción , Trastornos Urinarios/etiologíaRESUMEN
BACKGROUND: Lichen sclerosus (LS) is a sclerosing skin disease of presumably autoimmune origin affecting mainly the anogenital area. The aetiology is not completely understood. Comorbidity between genital LS and atopy in girls has been described but so far no controlled study has been performed. OBJECTIVES: A prospective epidemiological case-control study was designed to clarify if there is comorbidity between genital LS and atopic skin diathesis (AD) in boys. METHODS: The study included a total of 92 boys aged between 1 and 17 years. The disease group consisted of 48 boys who underwent surgery for phimosis that was histologically confirmed as LS. The control group included 44 boys who were circumcised for phimosis for other medical reasons. Both groups were examined and the parents were interviewed following the criteria of the validated Diepgen atopy score. Patients with a score > 9 were assumed to have AD. RESULTS: Within the LS group (median age 8·7 years) 12 boys were diagnosed with AD (25%), while there were only three boys with AD (7%) in the control group (median age 5·3 years). The difference was significant using an age-adjusted logistic regression (P < 0·05). Prior to our study nine boys of the LS group (19%) and four boys of the control group (9%) had already been diagnosed with AD. CONCLUSIONS: We have demonstrated a significant comorbidity between LS and AD in boys. AD seems to be a priming precondition for the development of LS in boys.
Asunto(s)
Dermatitis Atópica/complicaciones , Enfermedades de los Genitales Masculinos/etiología , Liquen Escleroso y Atrófico/etiología , Adolescente , Balanitis/cirugía , Estudios de Casos y Controles , Niño , Preescolar , Circuncisión Masculina , Humanos , Masculino , Fimosis/cirugía , Proyectos Piloto , Estudios ProspectivosRESUMEN
A high-functioning 82-year-old man presented with lower lumbar pain and pubic tenderness. On admission he was afebrile with a normal white count. A grossly elevated C reactive protein was noted. CT scan of the pelvis showed a fluid collection anterior to the pubic symphysis and to the right of the midline measuring 2.0 × 2.2 cm. Pseudomonas aeruginosa was cultured from the fluid collection. The patient had no history of intravenous drug use, pelvic surgeries, malignancies or trauma. We report what we believe is the first documented case of P aeruginosa infection of the pubic symphysis in an elderly patient that did not have any of the traditional risk factors associated with neither P aeruginosa septic arthritis nor infections of the pubic symphysis. Instead, we propose that phimosis with chronic infection of the foreskin and balanitis may have led to septic arthritis.
Asunto(s)
Artritis Infecciosa/microbiología , Infecciones por Pseudomonas/complicaciones , Pseudomonas aeruginosa , Sínfisis Pubiana/microbiología , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Artritis Infecciosa/diagnóstico por imagen , Artritis Infecciosa/tratamiento farmacológico , Balanitis/complicaciones , Balanitis/cirugía , Ciprofloxacina/uso terapéutico , Circuncisión Masculina , Humanos , Masculino , Fimosis/complicaciones , Fimosis/cirugía , Infecciones por Pseudomonas/diagnóstico por imagen , Infecciones por Pseudomonas/tratamiento farmacológico , Sínfisis Pubiana/diagnóstico por imagen , Radiografía , Factores de RiesgoAsunto(s)
Balanitis/diagnóstico , Eritema/diagnóstico , Pene/patología , Anciano , Balanitis/tratamiento farmacológico , Balanitis/patología , Balanitis/cirugía , Circuncisión Masculina , Clotrimazol/uso terapéutico , Eritema/tratamiento farmacológico , Eritema/patología , Humanos , Hidrocortisona/uso terapéutico , Masculino , Metaplasia/diagnóstico , Metaplasia/patologíaRESUMEN
Balanitis, phimosis and foreskin adhesions are common indications for foreskin surgery during childhood. In phimosis, the foreskin cannot be drawn behind the glans penis because of the narrow external opening of the former. It is important to be able to distinguish between physiologic and pathologic phimosis, since their treatment is different. In adulthood, the need for surgery can be caused by phimosis, a difficult sequel of paraphimosis, recurrent inflammations of the glans penis and foreskin, diseases and cancers of the skin as well as difficulties at intercourse due to the shortness of the frenulum of the prepuce of the penis.
Asunto(s)
Balanitis/cirugía , Prepucio/cirugía , Fimosis/cirugía , Adulto , Balanitis/patología , Niño , Coito/fisiología , Prepucio/patología , Humanos , Masculino , Parafimosis/patología , Parafimosis/cirugía , Neoplasias del Pene/patología , Neoplasias del Pene/cirugía , Fimosis/patologíaAsunto(s)
Balanitis/virología , Carcinoma Verrugoso/virología , Queratosis/virología , Papillomaviridae/aislamiento & purificación , Infecciones por Papillomavirus/virología , Neoplasias del Pene/virología , Balanitis/cirugía , Biopsia , Carcinoma Verrugoso/cirugía , Circuncisión Masculina , ADN Viral/aislamiento & purificación , Humanos , Queratosis/cirugía , Masculino , Persona de Mediana Edad , Papillomaviridae/genética , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/cirugía , Neoplasias del Pene/cirugía , Reacción en Cadena de la Polimerasa , Recurrencia , Resultado del TratamientoRESUMEN
OBJECTIVE: We propose a modification to urethroplasty for stricture due to lichen sclerosus (balanitis xerotica obliterans). METHODS: We combine two-stage bucal mucosa graft and onlay ventral island flap. RESULTADOS/CONCLUSIONES: This technique offers enlargement of the graft with the island flap and removal of the pathological skin.
Asunto(s)
Balanitis/cirugía , Uretra/cirugía , Estrechez Uretral/cirugía , Humanos , Masculino , Estrechez Uretral/etiología , Procedimientos Quirúrgicos Urológicos Masculinos/métodosRESUMEN
Principally, surgical procedures in children should be performed in specialized pediatric centers. Some minor procedures on older children could eventually take place in general hospitals, provided that pediatric medical and nursing competence is available. Adequate infrastructure and an environment appropriate for children are required as well. The comfort of therapy in an adjacent general hospital should not lead to an increased risk for the child. Principles of clinical diagnosis and treatment strategies of frequent pediatric urological entities are described and discussed in this article.
Asunto(s)
Hospitales Generales , Hospitales Pediátricos , Anomalías Urogenitales/cirugía , Balanitis/diagnóstico , Balanitis/cirugía , Niño , Preescolar , Circuncisión Masculina/métodos , Competencia Clínica/normas , Femenino , Humanos , Lactante , Masculino , Fimosis/diagnóstico , Fimosis/cirugía , Torsión del Cordón Espermático/diagnóstico , Torsión del Cordón Espermático/cirugía , Anomalías Urogenitales/diagnóstico , Vulva/anomalías , Vulva/cirugíaRESUMEN
Balanitis xerotica obliterans (BXO) is the most common cause of pathological phimosis in boys. Presented here is the case of a previously well 13-year-old boy who developed obstructive renal impairment (serum creatinine = 190 micromol/l) at least in part from phimosis due to BXO. A circumcision and, 2.5 months later, meatal dilatation were done. Nine months after his initial presentation, his serum creatinine returned to a permanently elevated nadir of 119 mumol/l. Presentation with the complications of phimosis can be delayed in teenage boys because they may feel embarrassed to come forward. Circumcision remains the definitive treatment of BXO induced phimosis though if the penile meatus is involved, more complex surgery is sometimes required. Topical steroids are useful for residual disease. Follow-up is very important due to the frequent involvement of the skin of the glans. In the very long term there is an increased chance of penile malignancy, which can occur even after circumcision.
Asunto(s)
Balanitis/complicaciones , Fimosis/etiología , Insuficiencia Renal/etiología , Adolescente , Balanitis/diagnóstico , Balanitis/cirugía , Circuncisión Masculina/métodos , Cistoscopía , Diagnóstico Diferencial , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Fimosis/diagnóstico , Fimosis/cirugía , Insuficiencia Renal/diagnóstico , Factores de TiempoAsunto(s)
Circuncisión Masculina/métodos , Pene/cirugía , Fimosis/cirugía , Técnicas de Sutura , Adolescente , Balanitis/cirugía , Niño , Preescolar , Humanos , Lactante , Recién Nacido , Masculino , Neoplasias del Pene/cirugía , Poliglactina 910 , Neoplasias Cutáneas/cirugía , Suturas , Infecciones Urinarias/cirugíaRESUMEN
Squamous cell carcinoma of the penis is an uncommon cancer, though in one study it accounted for 90% of all penile cancers. Its association with balanitis xerotica obliterans (BXO) is a rare though recognized occurrence. We describe a case of a 46-year-old Caucasian male who first presented to our open-access clinic with a mild phimosis. An elective circumcision was performed and histological examination of the circumcision specimen showed BXO. He was lost to follow-up but re-presented three years later with a persistent tender penile ulcer which on biopsy showed no obvious sinister pathology. He returned a further two years later with a short history of bleeding from the ulcer, and another biopsy now confirmed penile squamous cell carcinoma. Our case emphasizes the importance of regular review of patients with BXO, in particular those with persistent symptoms.
Asunto(s)
Balanitis/complicaciones , Balanitis/patología , Carcinoma de Células Escamosas/etiología , Neoplasias del Pene/etiología , Balanitis/cirugía , Balanitis/terapia , Humanos , Masculino , Persona de Mediana Edad , Pene/patología , Pene/cirugíaRESUMEN
BACKGROUND: Plasma cell balanitis or Zoon's balanitis is an idiopathic benign condition of the genitalia that mostly presents as a solitary, persistent plaque on the glans primarily in uncircumcised, middle-aged to older men. METHODS: One hundred twelve patients with a clinical diagnosis of plasma cell balanitis were studied between January 1985 and April 2003. RESULTS: The age of the patients ranged from 24 to 70 years. The majority of patients had symptoms for more than 12 months. Lesions involved the prepuce and glans in the majority of patients (66; 58.92%), the prepuce only in 26 patients (23.21%), and the glans only in 20 patients (17.85%). Tissue for histopathology was available in 96 patients. Histologically, epidermal edema, a dense upper dermal band of chronic inflammatory cells, including many plasma cells, dilated capillaries, extravasated red blood cells, and hemosiderin deposition, was seen. In most, cases, plasma cell balanitis was successfully treated by circumcision. CONCLUSIONS: This report describes our experience with plasma cell balanitis and reviews its clinical and histopathologic aspects. The treatment modalities are also reviewed, and the importance of circumcision as the treatment of choice is emphasized.
Asunto(s)
Balanitis/tratamiento farmacológico , Balanitis/cirugía , Circuncisión Masculina , Células Plasmáticas/patología , Adulto , Anciano , Balanitis/patología , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
PURPOSE: Balanitis xerotica obliterans (BXO) is a chronic dermatitis of unknown etiology most often involving the glans and prepuce but sometimes extending into the urethra. We report our 10-year experience with BXO in pediatric patients. MATERIALS AND METHODS: Our pathology database was queried for all tissue diagnoses of BXO from 1992 to 2002. Available charts were reviewed and patient presentation, clinical and referral history, operative procedure(s) and postoperative course were recorded. RESULTS: A total of 41 patients had a tissue confirmed diagnosis of BXO. Median patient age was 10.6 years. Of the patients 85% were 8 to 13 years old and all had referrals available for review. The most common referral diagnoses were phimosis (52%), balanitis (13%) and buried penis (10%). No patient had the diagnosis of BXO at referral. Of the patients 19 (46%) underwent curative circumcision or redo circumcision and had no recurrence at a mean followup of 12.5 months (range 1 to 57). A total of 11 patients (27%) had BXO involvement of the meatus and underwent circumcision combined with meatotomy or meatoplasty. Nine patients (22%) required extensive plastic operation(s) of the penis, including buccal mucosa grafts in 2. CONCLUSIONS: The incidence of BXO in pediatric patients may be higher than previously reported, with the diagnosis rarely made by pediatricians. Our study demonstrates that older patients, those with BXO involvement of the meatus and those with a history of surgery for BXO tend to have a more severe and morbid clinical course.
Asunto(s)
Balanitis/diagnóstico , Balanitis/cirugía , Balanitis/epidemiología , Niño , Circuncisión Masculina , Humanos , Masculino , Derivación y Consulta , Estudios RetrospectivosRESUMEN
This prospective study was designed to address the incidence and clinical and histologic characteristics of balanitis xerotica obliterans in a large random pediatric population with phimosis. We investigated 1178 boys who presented consecutively with phimosis between 1991 and 2001. All patients who underwent complete circumcision and surgical specimens were typed histologically as early, intermediate, or late forms of this disorder or as nonspecific chronic inflammation. Patients with balanitis xerotica obliterans were controlled at 1, 6, and 12 months postoperatively, then yearly. Balanitis xerotica obliterans was found in 471 of the 1178 patients (40%), with the highest incidence in boys aged 9 to 11 years (76%). Secondary phimosis occurred in 93% of boys with balanitis xerotica obliterans and in 32% of those without the disorder. In six instances of balanitis xerotica obliterans, meatotomy and in one meatoplasty was performed, as well as circumcision. On histologic evaluation, we found 19% had early, 60% intermediate, and 21% late form of balanitis xerotica obliterans. Glanular lesions disappeared completely within 6 months in 229 out of 231 patients. Our data strongly suggest that the true incidence of childhood balanitis xerotica obliterans is higher than previously assumed. Its incidence peaks in the 9 to 11 years age group, in whom secondary phimosis was almost exclusively caused by balanitis xerotica obliterans.