Human papillomavirus (HPV) infection is one of the worldwide sexually transmitted diseases (STD), and the DNA of HPV can exist in the normal epithelium of reproductive organs of both men and women. Because the majority of HPV infections are asymptomatic, healthy HPV-carriers become the main source of the infection. Studies show that HPV infection in men is correlated with STD, infertility, tumor of reproductive organs, and infection in the sexual partners. Therefore, measures should be taken to reduce male HPV infection, including circumcision, fewer sexual partners, and condom use.
Adult ; Asymptomatic Infections ; Carrier State ; virology ; Circumcision, Male ; Female ; Humans ; Infertility, Male ; virology ; Male ; Papillomaviridae ; Papillomavirus Infections ; complications ; prevention & control ; transmission ; Reproductive Health ; Risk Factors ; Sexual Partners ; Sexually Transmitted Diseases ; virology

Male circumcision (MC) is one of the most common surgical procedures in the world, but its medical benefits remain under debate. In the context of evidence-based medicine, MC is beneficial in reducing the risks of infantile urinary tract infection, viral-mediated sexually transmitted diseases, penile/cervical cancers, and poor hygiene. The claims of opponents against MC, such as reduced sexual performance, psychological trauma, and an excess of complications, are gradually losing credibility. Possibly influenced by US troops stationed in Korea following the Korean War, MC is highly prevalent in South Korea, though it has been losing popularity recently. The practice of MC in Korea is different from that in other countries, in that most cases of MC are performed in adolescence under local anesthesia. Although this eliminates the benefit of reducing urinary tract infection in neonates, it still offers the benefits of reducing the risk of viral sexually transmitted diseases and penile/cervical cancers. Moreover, MC can lead to improved hygiene for the majority of Koreans who are willing to undergo the procedure. The practice of MC in adolescence may reduce the risk of significant complications, though the risk of bleeding may be higher than for neonates.
Adolescent ; Anesthesia, Local ; Circumcision, Male* ; Evidence-Based Medicine ; Female ; Hemorrhage ; Humans ; Hygiene ; Infant, Newborn ; Korea ; Korean War ; Male ; Male* ; Phimosis ; Psychological Trauma ; Sexually Transmitted Diseases ; Sexually Transmitted Diseases, Viral ; Urinary Tract Infections

BACKGROUND: Although circumcision for phimosis in children is a minor surgical procedure, it is followed by pain and carries the risk of increased postoperative anxiety. This study examined predictive factors of postoperative pain and anxiety in children undergoing circumcision. METHODS: We conducted a prospective cohort study of children scheduled for elective circumcision. Circumcision was performed applying one of the following surgical techniques: sutureless prepuceplasty (SP), preputial plasty technique (PP), and conventional circumcision (CC). Demographics and base-line clinical characteristics were collected, and assessment of the level of preoperative anxiety was performed. Subsequently, a statistical model was designed in order to examine predictive factors of postoperative pain and postoperative anxiety. Assessment of postoperative pain was performed using the Faces Pain Scale (FPS). The Post Hospitalization Behavior Questionnaire study was used to assess negative behavioral manifestations. RESULTS: A total of 301 children with a mean age of 7.56 +/- 2.61 years were included in the study. Predictive factors of postoperative pain measured with the FPS included a) the type of surgical technique, b) the absence of siblings, and c) the presence of postoperative complications. Predictive factors of postoperative anxiety included a) the type of surgical technique, b) the level of education of mothers, c) the presence of preoperative anxiety, and d) a history of previous surgery. CONCLUSIONS: Although our study was not without its limitations, it expands current knowledge by adding new predictive factors of postoperative pain and postoperative anxiety. Clearly, further randomized controlled studies are needed to confirm its results.
Anxiety* ; Child* ; Circumcision, Male* ; Cohort Studies* ; Demography ; Education ; Female ; Hospitalization ; Humans ; Male ; Models, Statistical ; Mothers ; Pain Measurement ; Pain, Postoperative* ; Phimosis ; Postoperative Complications ; Predictive Value of Tests ; Prospective Studies* ; Siblings ; Surgical Procedures, Minor

Plastibell is one of the three most common devices used for neonatal circumcision in the United States, with a complication rate as low as 1.8%. The Plastibell circumcision device is commonly used under local anesthesia for religious circumcision in male neonates, because of cosmetic reasons and ease of use. Occasionally, instead of falling off, the device may get buried under the skin along the shaft of the penis, thereby obstructing the normal flow of urine. Furthermore, the foreskin of neonates is highly vascularized, and hence, hemorrhage and infection are possible when the skin is cut. Necrosis of penile skin, followed by urethral obstruction and renal failure, is a serious surgical mishap requiring immediate corrective surgery and medical attention. We report a case of fulminant urosepsis, acute renal failure, and pyelonephritis in a 4-day-old male neonate secondary to impaction of a Plastibell circumcision device. Immediate medical management was initiated with fluid resuscitation and mechanical ventilation; thereby correcting life threatening complications. Pediatricians and Emergency Department physicians should be cognizant of the complications from Plastibell circumcision device in order to institute appropriate and timely management in neonates.
Acute Kidney Injury* ; Anesthesia, Local ; Circumcision, Male* ; Emergency Service, Hospital ; Female ; Foreskin ; Hemorrhage ; Humans ; Infant, Newborn* ; Male ; Necrosis ; Penis ; Pyelonephritis ; Renal Insufficiency ; Respiration, Artificial ; Resuscitation ; Sepsis ; Skin ; Surgical Instruments ; United States ; Urethral Obstruction

PURPOSE: To evaluate the prevalence and type distribution of high-risk human papillomavirus (HPV) infection in genital warts of Korean men, and for the first time, to describe the risk factors associated with high-risk HPV infection in male genital warts. MATERIALS AND METHODS: In a single private clinic, 150 consecutive male patients with histopathologic-confirmed genital warts who underwent HPV genotyping by use of polymerase chain reaction (PCR) were included in this study. We detected HPV DNA in male genital warts and evaluated HPV type distribution, especially high-risk HPV types, by use of PCR. The associations between HPV prevalence and various characteristics, such as age, circumcision status, type of genital warts diagnosis (new vs. recurrent), number of lesions, site of lesions, and gross morphology, were assessed by use of unconditional multiple logistic regression. RESULTS: High-risk HPV types were detected in 31 cases (23.5%), and of these, 27 cases (20.5%) contained both high-risk and low-risk HPV types. The most frequently detected high-risk HPV types were HPV16 (6.8%), HPV33 (4.5%), HPV18 (2.3%), and HPV68 (2.3%). In particular, the prevalence of infection with HPV16 and/or HPV18 was 8.3% (11 of 132). In the multivariate analysis, lesions located at sites including the base of the penis or the pubic area, papular or mixed genital warts, and lack of circumcision significantly increased the association with high-risk HPV infection in male genital warts. CONCLUSIONS: The prevalence of high-risk HPV infection was substantial in male genital warts. The site and morphology of lesions and circumcision status were significantly associated with the prevalence of high-risk HPV infection.
Circumcision, Male ; Condylomata Acuminata* ; Diagnosis ; DNA ; Female ; Human papillomavirus 16 ; Humans* ; Logistic Models ; Male* ; Multivariate Analysis ; Papillomavirus Infections* ; Penis ; Polymerase Chain Reaction ; Prevalence* ; Risk Factors

Increasingly accumulated results from randomized controlled trials and other clinical studies have demonstrated that male circumcision reduces the risks of acquisition and transmission of HIV, HPV, HSV-2, and other sexually transmitted infections, and thus has a potential role in preventing cervical cancer, penile cancer and prostate cancer. The prevalence of male circumcision in China is currently less than 5%. The clinical evaluation studies and randomized controlled trials of the Shang Ring device showed excellent safety profiles, extremely high acceptability, and satisfaction among the participants and service providers in Africa and China. Given the recent recommendations by the World Health Organization and the Joint United Nations Program on HIV/AIDS (UNAIDS), voluntary medical male circumcision should be promoted in China at the national level as an important alternative intervention to reduce reproductive tract infections and prevent both males and females from reproductive tract cancers. More emphasis is required on the studies of the long-term health benefits of male circumcision in uro-andrology.
China ; Circumcision, Male ; Female ; HIV Infections ; prevention & control ; Humans ; Male ; Penile Neoplasms ; prevention & control ; Prevalence ; Randomized Controlled Trials as Topic ; Sexually Transmitted Diseases ; prevention & control ; Urinary Tract Infections ; prevention & control ; Uterine Cervical Neoplasms ; prevention & control ; World Health Organization

Plasma cell balanitis (Balanitis circumscripta plasmacellularis or Zoon's balanitis) is an idiopathic, benign condition of the glans penis or prepuce. It occurs mostly as a solitary, persistent plaque among middle-aged to older uncircumcised males. It is characterized by chronic, shiny, smooth, red-orange plaques with small, dark red stippling. When the plasma cell balanitis is suspected clinically, diagnosis can be readily confirmed by microscopic examinations of the lesion. Differentiating this lesion from similar lesions such as premalignant, infective and other inflammatory penile lesions is important. The current preferred treatment is circumcision and this disorder can be treated relatively easily by circumcision. We, herein, report an interesting case of plasma cell balanitis on preputial mucosa.
Balanitis ; Circumcision, Male ; Female ; Humans ; Male ; Mucous Membrane ; Penis ; Plasma ; Plasma Cells

Circumcision is one of the most common rituals in Jewish and Islamic cultures. It may also be performed for phimosis correction or the treatment of recurrent balanitis. Although circumcision is considered to be a technically easy and safe surgical procedure with no significant risk, it may lead to severe complications such as necrotizing fasciitis or total penis amputation. In this report, we present a case of penis amputation at two levels occurring with third-degree burns due to electrocautery during circumcision. Although penile replantation was attempted, it was unsuccessful due to burn damage to the veins. After restoration of the functional structures, the penis was buried in the inguinal area by reepithelization to maintain blood circulation. The recovery of the penis was successful. This case is presented as a novel example of groin flap surgery to achieve a functionally and aesthetically acceptable outcome in a salvage operation for a penis with significant traumatic injury, which has not been previously reported in the literature.
Amputation ; Balanitis ; Blood Circulation ; Burns ; Ceremonial Behavior ; Circumcision, Male ; Electrocoagulation ; Fasciitis, Necrotizing ; Female ; Groin ; Islam ; Male ; Penis ; Phimosis ; Replantation ; Veins

PURPOSE: In this study, we evaluated the effect of preputial type on bacterial colonization and wound healing in boys undergoing circumcision. MATERIALS AND METHODS: This study consisted of 78 boys consecutively admitted to our clinic for circumcision between 2009 and 2011. Preputial status was classified into five types on the basis of preputial retractability. One sterile culture swab was swept circumferentially once around the surface of the glans starting just proximal to the urethral meatus. Three weeks following circumcision, control swabs from the same regions of the same patients were taken and inoculated. Thus, the same patients formed the control group. Patients were evaluated on days 1 and 7 after the operation to assess whether the preputial type affected healing. RESULTS: The mean age of the children was 46.3 months. In our study, the growth rate was 71.8% in pre-circumcision patients, whereas the rate was 10.25% in the post-circumcision group. Types 1, 2, 3, 4, and 5 had 100%, 93.8%, 71.4%, 44.4%, and 53.6% colonization, respectively. A significant difference was observed among these types in terms of colonization. The most common agent was Enterococcus species (33%). When postoperative patients were evaluated, all had local swelling and hyperemia on postoperative day 1, whereas there was a significant difference on day 7. CONCLUSIONS: There was a significant correlation between preputial type and bacterial colonization, and the preputial type affected post-circumcision wound healing. Practitioners should keep in mind that the healing period will be longer in patients with type 1, 2, and 3 preputium.
Child ; Circumcision, Male ; Colon ; Enterococcus ; Female ; Humans ; Hyperemia ; Male ; Wound Healing

Adult ; Circumcision, Male ; Female ; Foreskin ; Humans ; Male ; Papillomaviridae ; Papillomavirus Infections ; etiology ; Retrospective Studies ; Sexual Partners