Vitiligo is an acquired systemic disease of the skin characterized by circumscribed patches of complete pigment loss due to destruction of melanocytes. A 28-year old male patient presented with generalized depigmented patchs. We performed microscopic studies of cultured melanocytes from this patient and compared them with those of normal neonatal foreskin. Phase contrast microscopic findings revealed no difference between the two groups of melanocytes, but transmission electron microscopic findings showed dilated circular rough endoplasmic reticulum in cultured melanocytes from our vitiligo patient. We could observe the innate cellular structural aberration of melanocytes from the vitiligo subject.
Adult ; Endoplasmic Reticulum, Rough ; Foreskin ; Humans* ; Male ; Melanocytes* ; Skin ; Vitiligo*

PURPOSE: We evaluated the effect of a topical steroid(0.05% clobetasol propionate[Dermovate(R)]) on phimosis. MATERIALS AND METHODS: Between May 2005 and May 2007, 30 boys with phimosis were assigned to receive topical application of Dermovate(R). Of the 30 boys, 19 boys had concealed penises. The parents of the boys were instructed to retract the foreskin gently without causing pain, and to apply the topical steroid over the stenotic opening of the prepuce twice daily for 4 weeks then for another 4 weeks if no improvement was achieved. Retractibility of the prepuce was graded from 1-6. Response to treatment was arbitrarily defined as improvement in the retractibility score(complete response, score 5 and 6; partial response, score 3 and 4; no response, score 1 and 2). The effect of treatment was studied with respect to the duration of treatment, age, and an associated concealed penis. RESULTS: The pretreatment grade in all patients was a retractibility score of 1. The mean age of the patients was 48.5+/-27.6 months(range, 7-108 months). The complete response rates in boys treated for 4 and 8 weeks were 50% and 73.3%, respectively. In boys younger than 3 years of age (n=12) and older than 3 years of age(n=18), the complete response rates were 75% and 72.2%, respectively(p=0.866). In boys with or without an associated concealed penis(n=19 and n=11, respectively), the complete response rates were 63.1% and 90.9%, respectively(p=0.199). No adverse effect was encountered in all patients. CONCLUSIONS: Our data suggest that the application of topical steroids for 8 weeks as a first line treatment of phimosis may be effective, although further studies are needed to establish the definite efficacy and safety of this procedure.
Child ; Clobetasol ; Female ; Foreskin ; Humans ; Male ; Parents ; Penis ; Phimosis ; Steroids

In the repair of hypospadia, the use of bladder mucosal grafts in cases in which previous adequate foreskin for urethral reconstruction is lacking or in which previous repairs have failed, is feasible. The bladder mucosal graft offers several theoretical advantages. It is of the same histologic character as the normal urethra, is not hair bearing, tends to re-epithelialize exposed surfaces and has great dispensability. We have experienced two cases of the perineal and penoscrotal hypospadias repaired successfully by the bladder mucosal graft technique.
Female ; Foreskin ; Hair ; Hypospadias* ; Male ; Transplants* ; Urethra ; Urinary Bladder*

PURPOSE: Penoscrotal transposition is found in cases with severe form of hypospadias. In those cases, severe chordee generally coexists and a long length of urethra may be necessary for its correction. We evaluated the clinical outcome of surgical repairs for 12 patients of proximal hypospadias with penoscrotal transposition. MATERIALS AND METHODS: Out of 12 cases, there were 2 with penoscrotal type, 7 with scrotal type and 3 with perineal type hypospadias. All cases had moderate to severe chordee. Five cases were treated with one-stage repair and seven cases with multi-stage repair. We analysed operative methods, postoperative complications and those managements between the cases of one-stage and multi-stage repairs. RESULTS: For one-stage repair, we used transverse preputial island flap method in 3 cases and urethroplasty using scrotal skin flap in 2 cases. For multi-stage repair, we performed Thiersh-Duplay urethroplasty in 2 cases, bladder mucosal graft in 2 cases and Belt-Fugua urethroplasty in 3 cases. Correction of penoscrotal transposition was performed successfully in all cases. In all cases, a paucity of skin was the most difficult problem. The overall complication rate was 50.0%. In cases treated with one-stage repair, there were two cases with urethrocutaneous fistulas. However, in cases treated with multi-stage repair, there were four cases with complications such as urethral strictures, urethrocutaneous fistulas with or without large skin defect. Overall the complications in cases with multi-stage repair were more severe than those in cases with one-stage repair. CONCLUSIONS: Our experience suggests that multi-stage operation may be not superior to one-stage operation in cases with proximal hypospadias associated with penoscrotal transposition. Thus we recommand one-stage repair in those cases despite a paucity of foreskin.
Female ; Fistula ; Foreskin ; Humans ; Hypospadias* ; Male ; Postoperative Complications ; Skin ; Transplants ; Urethra ; Urethral Stricture ; Urinary Bladder

BACKGROUND: Trans-4-aminomethylcyclohexanecarboxylic acid (tranexamic acid) has recently been reported to inhibit prostaglandin synthesis and hinder the pigmentation caused after UV radiation. OBJECTIVE: we evaluated the influence of tranexamic acid on the viability, morphogenesis and melanization of cultured normal human melanocytes. METHOD: The cultured melanocytes from neonatal foreskin were exposed to UVB 20mJ/cm2, then treated with tranexamic acid [0.05microgram/ml, 0.05microgram/ml, and 0.5microgram/ml]. After 24 hours, the viability of melanocytes and the melanin concentration was measured. The number and length of the melanocytes' dendrites, and the expression level of tyrosinase, TRP-1 and TRP-2 were also evaluated. RESULTS: The viability of the melanocytes was decreased by tranexamic acid in a dose dependent manner (p<0.05). The increased melanin synthesis by UVB irradiation was decreased by tranexamic acid in a dose dependent manner (p<0.05). Also, the increased expressions of TRP-1, TRP-2 and tyrosinase after exposure to UV were statistically decreased by tranexamic acid in a dose dependent manner (p<0.05). CONCLUSION: tranexamic acid may prevents UVB induced pigmentation.
Dendrites ; Foreskin ; Humans* ; Melanins ; Melanocytes* ; Monophenol Monooxygenase ; Morphogenesis ; Pigmentation ; Tranexamic Acid

A paraffinoma is a type of inflammatory lipogranuloma that develops after the injection of an artificial mineral oil, such as paraffin or silicon, into the foreskin or the subcutaneous tissue of the penis for the purpose of penis enlargement, cosmetics, or prosthesis. The authors experienced a case of macro-paraffinoma associated with sexual dysfunction, voiding dysfunction, and pain caused by a buried glans penis after a paraffin injection for penis enlargement that had been performed 35 years previously. Herein, this case is presented with a literature review.
Foreskin ; Granuloma* ; Male ; Mineral Oil ; Oils ; Paraffin* ; Penis ; Prostheses and Implants ; Silicon ; Subcutaneous Tissue

The distribution of pemphigus subclass autoantibodies in a patient with pemphigus vulgaris (PV) has been investigated by semiquantitative indirect immunofluorescence (IIF), using the HP series monoclonal antibodies specific for four human IgG subclasses on human foreskins. IgG1 and IgG4 intercellular substance-specific autoantibodies were detected in the serum of the patient, whereas IgG2 and IgG3 autoantibodies were absent. In addition to foreskins, human tonsillar epithelia were used as substrates of IIF for detecting the PV autoantibodies and it was one of satisfactory substitutes for monkey esophagus.
Antibodies, Monoclonal ; Autoantibodies* ; Esophagus ; Fluorescent Antibody Technique, Indirect ; Foreskin ; Haplorhini ; Humans ; Immunoglobulin G* ; Pemphigus*

OBJECTIVETo search for a simple surgical procedure for the treatment of concealed penis that may have better effect and less complications.

METHODSWe used a modified surgical method in the treatment of 58 patients with concealed penis aged from 3 to 15 (mean 6.8) years. The operation was simplified and involved the following steps: wholly unveiling the penis glans, half-degloving the foreskins, cutting off all the adhesive fibers up to the penile suspensory ligaments, and liberating the external penis.

RESULTSThe operation was successful in all the patients, with the operative time of 15 -45 (mean 33) minutes, hospital stay of 2 - 5 (mean 3.5) days, but no complications except mild foreskin edema in 5 cases. The external penis was prolonged from 0.5 - 2.8 (mean 1.4) cm preoperatively to 3.2 - 8.5 (mean 3.9) cm postoperatively. The patients were followed up for 1 -3 years, all satisfied with the length and appearance of the penis, and their sexual and reproductive functions were normal.

CONCLUSIONThe modified surgical procedure for concealed penis is simple and effective, with desirable outcomes, few postoperative complications and no damage to sexual and reproductive functions.

Adolescent ; Child ; Child, Preschool ; Foreskin ; surgery ; Humans ; Male ; Penis ; abnormalities ; surgery ; Reconstructive Surgical Procedures ; methods

A clinical observation of the prepuce was made on 3,302 men from examined in the Department of Urology, Capital Military Hospital and the following results were obtained. 1. Redundant prepuces were found in 2,789 cases with incidence of 84.5%. 2. Phimosis were found in 17 cases with incidence of 0.6%. Of 17 cases, 12 cases were congenital phimosis and 5 cases were found acquired phimosis. 3. Paraphimosis were found in 8 cases giving a rate of 0.3%. 4. Circumcised men were found in 166 cases, with incidence of 5.0% of all cases.
Animals ; Female ; Foreskin* ; Hospitals, Military ; Humans ; Incidence ; Male ; Paraphimosis ; Penis* ; Phimosis ; Urology

PURPOSE: Phimosis is the inability to retract the foreskin of the penis over the glans of the penis. Even though phimosis is not pathogenic, the presence of phimosis is known to increase the risk of urinary tract infection in infancy. The use of topical steroids has been advocated as a safe and economical alternative to surgical intervention. The purpose of the study was to assess the effectiveness of topical steroids for the treatment of phimosis in young boys. METHODS: A total of 53 boys with phimosis were divided into two groups to distinguish between the efficacy of low-potency topical steroid (group 1, 27 cases) and of high-potency topical steroid (group 2, 26 cases). RESULTS: The success rate increased in the process of time. After 6 weeks, the success rate was 21 cases in group 1 and 22 cases in group 2. There was no significant differences in treatment outcomes between the two groups. The age of the boys, the appearance of prepuce prior to treatment, and the presence of previous symptoms, including symptoms of UTI, and ballooning of the prepuce at micturation had no significant difference on treatment outcomes. CONCLUSION: Topical steroid was effective in treatment of phimosis in boys younger than 4 years old. Although treatment outcomes between low- and high-potency topical steroids were not significantly different, those treated with a high-potency steroid cream showed more fast improvement. Further studies are necessary to assess systemic side effects of steroid treatment, duration of treatment and prevention of genitourinary tract infection in male infants.
Child, Preschool ; Female ; Foreskin ; Humans ; Infant ; Male ; Penis ; Phimosis* ; Steroids ; Urinary Tract Infections