PURPOSE: To evaluate the cause of asymptomatic bacteriuria (AB) or aseptic pyuria (AP) on physiologic phimosis and to evaluate the effect of topical steroid therapy and preputial hygiene on the resolution of AB and AP. METHODS: Ninety uncircumcised boys (age 1-72 month, median 16 month) with AB or AP were examined for physiologic phimosis and allocated by the preputial retractibility into the non-retractile group (n=59) or the retractile group (n=31). Topical steroid therapy [topical application of hydrocortisone (0.1%) cream with physiotherapy] were prescribed (three times a day) and the method of preputial hygiene (gentle retraction of prepuce and water cleansing) was instructed to the non- retractile group . After 2-4 weeks, the preputial retractibility was reevaluated and urine examination was repeated. To the retractile group, only the method of preputial hygiene was instructed and urine examination was repeated two weeks later. RESULTS: Among 90 boys with AB and AP, 65.6% (59/90) had the nonretractile prepuces and nonperformed preputial hygiene. In the nonretractile group, the prepuces became retractile in 81.4 % (48/59) after topical steroid therapy. Among boys (n=48) whose prepuces became retractile after topical steroid therapy, AB or AP resolved in 77.1%, decreased in 18.7% and persisted in 4.2%, which were significantly different to 18.2%, 2.37%, 54.5% in boys (n=11) whose prepuces were persistently nonretractile (P=0.0114). In the retractile group (n=31), 65.2% was compliant to preputial hygiene. In boys (n=23) who were compliant to preputial hygiene, AB or AP resolved in 65.2%, decreased in 26.0% and persisted in 8.2%, which were significantly different to 12.5%, 50%, 37.5% in boys (n=8) who were not compliant (P=0.0457). CONCLUSION: Physiologic phimosis was an important cause of AB or AP. Simple topical steroid therapy on the nonretractile prepuces and good preputial hygiene could improve AB or AP.
Bacteriuria ; Female ; Hydrocortisone ; Hygiene ; Phimosis ; Pyuria ; Water

The beginning of the circumcision was originated from the rite of the ancient Israel historically. The circumcision has performed for the purpose of penile hygiene and for the treatment of phimosis, paraphimosis, balancposthitis and so on. In the way of the circumcision the conventional circumcision was mostly used, but we used Gomco clamp and the incision was made 3mm away from the metal edge of the instrument. And the merits in the use of the instruments were as follows: 1) the short time operation, 2) safety and cosmetically satisfactory performance without need of assistant for the procedure, 3) no bleeding on operation.
Animals ; Circumcision, Male* ; Female ; Hemorrhage ; Hygiene ; Israel ; Male ; Paraphimosis ; Phimosis

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

PURPOSE: Circumcision is widely practiced in Korea, but its implementation is still controversial, especially among younger parents. Using a questionnaire study, we tried to determine the rate of circumcision among elementary school boys and to determine parental concerns about phimosis and circumcision. We then compared our findings with previously published literature. MATERIALS AND METHODS: Between May and June 2007, we randomly selected five elementary schools and distributed self-administered questionnaires to the parents of 2,712 boys from these schools. Questions were related to children's circumcision status, age at the time of circumcision, and opinions concerning circumcision, such as its necessity and benefits. Completed questionnaires were collected and analyzed. RESULTS: The response rate was 66.2%. The overall circumcision rate of boys in elementary school was 15.4%. Some 40.3% of those boys underwent circumcision in the neonatal period, and 37.3% underwent the procedure between ages 9 and 12 years. The circumcision rate was significantly higher in boys in the higher income bracket group(29.5%) compared to boys in the middle and low income bracket groups(15.4% and 12.8%, respectively). Most boys were circumcised based on the intent of their parents(64.2%). Some 44.5% of parents believed that circumcision was necessary, while 36.3% of parents believed it was not necessary. The most common motive for circumcision was "hygiene benefits"(80.2%). CONCLUSIONS: The rates of actual circumcision practice and of approval of circumcision were lower in this report compared to previous reports. It seems that more clinical research on circumcision is needed. Physicians should provide information about circumcision to boys and their parents.
Circumcision, Male ; Female ; Humans ; Korea ; Male ; Parents ; Phimosis

A statistical observation was made on congenital anomalies of the genito-urinary tracts of the out-patients and in-patients in the Department of Urology, Han Ill Hospital during the period April, 1969 through Mar. 1970 and the following results were obtained. I. Statistics on out-patients. 1) During the period, 2,115 cases (1.653 males, 462 females) bad seen at our out-patient Department, 53 cases (40 males, 13 females) bad congenital anomalies of the genito-urinary tracts, giving a rate of 2.5% (male 1.9%, female 0. 6%). 2) Of 53 cases, 49 cases (92.5%) were seen by us at the ages of 39 years or below, and 4 cases (7.6%) at the ages of 40 years or above. 3) Of the anomalies (54.7%) were in penile. 13 cases (24.5%) in renal, 5 cases (9.4%) in ureteral, 3 cases (5.7%) in urethral and 3 cases (5.7%) in testicular. 4) Congenital complete phimosis was observed in 54. 7% of all the anomalies, wandering kidney in 13.3%, ureterocele in 5.7% and hypospadia in 5. 7%. II. Statistics on in-patients 1) During the period, of 156 cases hospitalized (96 males, 60 females), 11 cases (4 males, 7 females) had congenital anomalies of the genito-urinary tracts, giving a rate of 7.1% (male: 2. 6%, female: 4.5%). 2) Of 11 cases, 10 cases (90.9%) were seen by us at the ages of 40 years or above. 3) Of the anomalies, 7 cases (63.6%) were in renal, 3 cases (27.3%) in ureteral, 1 case (9.1%) in urethral. 4) Wandering kidney was observed in 27.3% of all anomalies, ureterocele in 18.2% and double kidney in 18.2%.
Female ; Humans ; Hypospadias ; Kidney ; Male ; Outpatients ; Phimosis ; Ureter ; Ureterocele ; Urology

A statistical observation was made on congenital anomalies of the genitourinary tract of the out-patients and in-patients in the Department of Urology, Seoul National University Hospital during the period January, 1954 through December, 1964 and the following results were obtained. I. Statistics on out-patients. 1) During the period, 17,177 cases(14,909 males and 2,268 females) seen at our out-patient Department, 262 cases (239 males, 23 females) had congenital anomalies of the genito-urinary tracts, giving a rate of 1.53%(male: 1.31 %, female: 0.22 %). 2) A gradual tendency of annual increase is observed. 3) Of 262 cases, 234 cases or 89.3 % were seen by us at the ages of 39 years or below, and 28 cases or 10.7% at the ages of 40 years or above. 4) Of the anomalies, 86 cases or 32.8 % were testicular, 77 cases or 29.3 % urethral, 54 cases or 20.6 % penile, and 1 case or 0.3% vesical, the lowest. 5) Hypospadia is observed in 31.6 % of all the anomalies, cryptorchidism in 23.6 % and congenital complete phimosis in 18.7 % II. Statistics on in-patients. 1) During the period, of 1,158 cases hospitalized (886 males, 272 females), 88 cases (76 males, 12 females) had congenital anomalies of the genito-urinary tracts, giving a rate of 7.6 % (male: 6.5%, female: 1.1%). 2) A gradual tendency of annual increase is observed. 3) Of 88 cases, 71 cases or 80.7% were seen by us at the ages of 29 years or below, and 17 cases or 19.3 % at the ages of 30 years or above. 4) Of the anomalies, 34 cases or 38.6 % were urethral, 25 cases or 28.5 % renal, 21 cases or 23.9 % testicular and 1 case or 1.1 % vesical, the lowest. 5) Hypospadia is observed in 37.5 % of all the anomalies, cryptorchidism in 23.6 % and nephroptosis in 15.9%.
Cryptorchidism ; Female ; Humans ; Hypospadias ; Male ; Outpatients ; Phimosis ; Seoul ; Urology

OBJECTIVETo introduce the advantages of the circumcision with a scalpel by inserting a piece of gauze between the inner prepuce and superficial fascia.

METHODSFrom November 2000 to March 2006, 2 100 patients with redundant prepuce, aged 6-78 years, averaging 23, were circumcised with a scalpel by inserting a piece of gauze between the inner prepuce and superficial fascia. Of all the cases, 1 799 (85.7%) were classified as Type I, 237 (11.3%) as Type II and 64 (3.0%) as Type III redundant prepuce. The mean operation time was 20 minutes (15-35 min).

RESULTSThe incisions were all healed in one stage, with good appearance, no infection and no disruption. Bleeding occurred in 12 cases 648 hours after the operation and delayed bleeding in 3 cases.

CONCLUSIONThe circumcision with a scalpel by inserting a piece of gauze between the inner prepuce and superficial fascia, with easier performance, fewer complications and less bleeding, and capable of preserving more and continuous superficial fascia and giving a better appearance, well deserves to be popularized in clinical practice.

Adolescent ; Adult ; Aged ; Child ; Circumcision, Male ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Surgical Sponges

OBJECTIVETo evaluate the safety and clinical outcomes of the novel simplified no-flip surgical approach to Shang Ring male circumcision in adults.

METHODSA total of 528 adult males, aged 18 - 58 (mean 35) years, 63 with phimosis and 465 with redundant prepuce, underwent no-flip Shang Ring circumcision with or without removal of the outer ring. The operation time and intraoperative blood loss were recorded and observations were made on such complications as postoperative bleeding, infection, edema, and wound dehiscence.

RESULTSThe operation time, intraoperative blood loss, and 2-hour postoperative pain score were (3.8 +/- 0.3) min, (0.6 +/- 0.1) ml, and 7.3 +/-0.3, respectively. Spontaneous ring detachment occurred at 21.6 +/- 2.1 days postoperatively in 12.7% of the patients (67/528) who had chosen not to remove the rings. Of those who preferred removal of the outer ring (87.3% [461/528]), none experienced any pain at the ring removal 7 days after the operation. Postoperative complications included infection in 3 cases (0.56%) and mild edema in 9 (1.70%), but no bleeding and wound dehiscence. Totally, 518 (98.1%) of the patients felt satisfied with the postoperative penile appearance.

CONCLUSIONNo-flip Shang Ring circumcision, with no need for removal of the inner ring, is a safe and simple approach for adult males, which is superior to conventional Shang Ring circumcision for requirement of fewer surgical instruments, shorter operation time, lower incidence of complications, and better satisfaction with the penile appearance. However, these advantages are to be further demonstrated by more randomized controlled trials.

Adolescent ; Adult ; Circumcision, Male ; instrumentation ; methods ; Humans ; Male ; Middle Aged ; Phimosis ; surgery ; Postoperative Complications ; Young Adult

Penile squamous cell carcinoma has been commonly reported in the past decades. We describe a rare case of a huge squamous cell carcinoma of the penis in a 65-year-old patient with a 4-year history of tumor growth, for which total penectomy, perineal urethrostomy and bilateral inguinal lymphadenectomy were carried out. We suggest that aggressive surgical intervention should be recommended for those with well-differentiated penile carcinoma regardless of the size of the tumor.
Aged ; Carcinoma, Squamous Cell ; surgery ; Humans ; Male ; Penile Neoplasms ; etiology ; surgery ; Penis ; surgery ; Phimosis ; complications

OBJECTIVETo investigate the safety and efficiency of the disposable circumcision suture device (DCSD) in the surgical treatment of phimosis and redundant prepuce.

METHODSWe randomly assigned 249 outpatients with phimosis or redundant prepuce to be treated with DCSD (n = 129) and by conventional circumcision (CC, n = 120), respectively. Then we compared the safety and efficiency of the two strategies.

RESULTSComparisons between DCSD and CC showed that the operation time was (4.02 +/- 0.69) vs (30.8 +/- 4.05) min, blood loss was (1.07 +/- 1.29) vs (8.72 +/- 2.15) ml, intraoperative pain score was 0.81 +/- 0.81 vs 2.42 +/- 1.15, 24-hour postoperative pain score was 1.84 +/- 1.02 vs 4.99 +/- 1.36, postoperative complication rate was 13. 95% (18/129) vs 9.17% (11/120), wound healing time was (13.99 +/- 9.06) vs (17.48 +/- 3.49) d, satisfaction with the penile appearance was 98.4% (127/129) vs 95% (109/120), and treatment cost was (2215.62 +/- 17.67) vs (576.47 + 15.58) Y RMB. DCSD exhibited obvious superiority over CC for shorter operation time, less blood loss, milder intraoperative pain, sooner wound healing, and better penile appearance, but it also had a higher rate of postoperative complications (P > 0.05) and involved more treatment cost than the latter (P < 0.05).

CONCLUSIONThe disposable circumcision suture device affords ideal clinical effects and therefore deserves clinical popularization.

Circumcision, Male ; instrumentation ; Disposable Equipment ; Follow-Up Studies ; Humans ; Male ; Phimosis ; surgery ; Surgical Staplers ; Treatment Outcome