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

OBJECTIVETo investigate new methods of treatment for penile hypospadias. METHODS Urethroplasty was performed for penile hypospadias using inner preputial skin grafts combined with preputial island flap.

RESULTSA total of 10 patients have received this procedure. After a mean follow up of one year, no fistula or urethral stricture was found. All patients obtained excellent cosmetic results.

CONCLUSIONSThis method allows for adequate correction of severe chordee. It is a useful procedure for selected cases of primary hypospadias with severe incurvation.

Adolescent ; Child ; Child, Preschool ; Foreskin ; transplantation ; Humans ; Hypospadias ; etiology ; surgery ; Infant ; Male ; Penis ; surgery ; Reconstructive Surgical Procedures ; methods ; Skin Transplantation ; methods ; Surgical Flaps ; Urethra ; surgery

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

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

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

The risk-benefit profile of neonatal circumcision is not clear. Most studies have focused on urinary tract infections but other health sequelae have not been evaluated. While evidence supports benefits of circumcision, a lack of randomized trials has been cited as a weakness. National guidelines provide mixed recommendations regarding neonatal circumcision. We review the weight of evidence and utilize current statistical methodology on observational data to examine the risks and benefits of neonatal circumcision.
Foreskin ; Hypertension ; Male ; Penis ; Pyelonephritis ; Risk Assessment ; Urinary Tract Infections* ; Urinary Tract*

Condyloma acuminatum is a common lesion of the penis and genitalia. It uncommonly involves the urethra but when it does the lesions are difficult to eradicate. Treatment has included excision, fiuguration, podophyline and thiotepa0 none of which has been entirely successful. We report a case of intraurethral condyloma acuminatum treated with thiotepa instillation in 27 years old male patient
Adult ; Genitalia ; Humans ; Male ; Penis ; Thiotepa* ; Urethra

OBJECTIVETo investigate the expression of zinc finger E-box binding homebox 1 (ZEB1) in the prepuce of hypospadias children and its relationship to the incidence of hypospadias.

METHODSPrepuce tissues were collected from 37 children aged 6-15 months undergoing hypospadias repair and 11 age-matched controls receiving circumcision. Based on the position of the urethral meatus, the hypospadias cases were classified as severe (n = 13) and mild-moderate (n = 24). The mRNA and protein expressions of ZEB1 were determined by immunohistochemistry and RT-PCR.

RESULTSThe expression of the ZEB1 protein was remarkably higher in the severe (100% [13/13]) and mild-moderate hypospadias patients (75.0% [18/24]) than in the controls (9.1% [1/11]), with statistically significant differences between any two groups (P < 0.05). RT-PCR showed the integrated density value (IDV) of the ZEB1 mRNA expression to be (0.67 ± 0.21), (0.81 ± 0.24), and (1.55 ± 0.29) in the control, mild-moderate, and severe hypospadias patients, respectively, significantly higher in the severe hypospadias than in the control and mild-moderate hypospadias groups (P < 0.05), but with no significant difference between the latter two (P = 0.64).

CONCLUSIONThe expression of ZEB1 is significantly increased in hypospadias patients, and its upregulation is positively correlated with the severity of hypospadias, which suggests that the overexpression of ZEB1 may contribute to the development of hypospadias.

Biomarkers ; metabolism ; Case-Control Studies ; Circumcision, Male ; Foreskin ; metabolism ; Homeodomain Proteins ; genetics ; metabolism ; Humans ; Hypospadias ; classification ; etiology ; metabolism ; Immunohistochemistry ; Infant ; Male ; Penis ; RNA, Messenger ; metabolism ; Transcription Factors ; genetics ; metabolism ; Up-Regulation ; Urethra ; Zinc Finger E-box-Binding Homeobox 1

OBJECTIVETo summarize the experience of urethral reconstruction using circular fasciocutaneous flap for the treatment of complex anterior urethral strictures.

METHODThe circular fasciocutaneous flap was harvested from the distal penile shaft or foreskin. Then the circular configuration was converted into longitudinal strip of skin which was rotated to ventral side to repair the exposured urethral strictures using the ventral onlay method. The surveillance protocol after urethroplasty was urination observation, regularly uroflowmetry and urethrography examination.

RESULTSFrom Nov. 2006 to Oct. 2012, 15 cases were treated. The mean age was 45 years (20-76 years) and mean follow-up period was 18 months(3 months-3 years). Stricture was caused by chronic urethritis in 4 cases, long-term urethral catheterization in 3 cases, transurethral perfusion chem other aphy in 3 cases, transurethral prostatectomy in 3 cases and hypospadias after surgery in 2 patients. The mean stricture length was 7.0 cm (3.5-12.0 cm). The overall success rate was 80.0% (12/15). Recurrence stenosis was noted in 2 cases and diverticulum formation in 1 case.

CONCLUSIONSThe penile circular fasciocutaneous flap can be used for anterior urethral stricture in nearly any length. The flap has the characteristics of hairless, adequate mobile and length, well-vascularized pedicle and easy to harvest. The onlay reconstruction provides excellent cosmetic results, less trauma, higher success rate. Therefore it should be one of the preferred techniques for complex anterior urethral stricture repair.

Follow-Up Studies ; Foreskin ; Humans ; Hypospadias ; surgery ; Male ; Penis ; surgery ; Prostatectomy ; adverse effects ; Recurrence ; Surgical Flaps ; transplantation ; Urethra ; surgery ; Urethral Stricture ; etiology ; pathology ; surgery ; Urologic Surgical Procedures, Male ; Wound Healing