Introduction: Aside from religious circumcisions, the indications for circumcision are few. However, in the cultural context, many patients are unnecessarily referred for circumcision for physiological phimosis (adhesions). Due to parental concerns and misperceptions by general practitioners, nonretractile prepuce is one of the most common indications for referral to a paediatric surgeon in many countries. This study aimed to determine whether preputial adhesiolysis successfully managed symptomatic non-retractile foreskin and therefore prevented the need for circumcision. Methods: A retrospective review was performed of the health records of children who presented with preputial adhesion. We included 65 symptomatic patients (ballooning of the prepuce in all cases and additional dysuria in three cases) who underwent preputial adhesiolysis. All cases were followed up for 2 years. Circumcision was subsequently carried out for patients who developed fibrous scarring resulting in difficult retraction due to the development of thick adhesions or skin fissuring with persistence of symptoms. Results: Of the 65 boys, 58 (89.2%) achieved complete retraction of the prepuce. The remaining 7 boys (10.8%) presented with recurring symptoms and thick fibrosed prepuce, and they underwent circumcision due to the dense adhesions. Histopathological examination of the circumcised prepuces revealed balanitis xerotica obliterans in two cases. Conclusion Preputial adhesiolysis is a safe and effective treatment for symptomatic preputial adhesions in boys younger than 5 years old. The procedure avoids circumcision and its associated risks. Preputial adhesiolysis should be offered as a primary treatment instead of circumcision.
Phimosis ; Circumcision, Male ; Balanitis Xerotica Obliterans

Balanitis ; diagnosis ; Candida ; Candidiasis ; diagnosis ; Diagnosis, Differential ; Humans ; Hyperplasia ; Male ; Vascular Neoplasms ; diagnosis

Mycoplasma genitalium (MG) was first isolated by Tully from the urinary tract of the male patient with non-gonococcal urethritis (NGU) in 1981. MG is extremely difficult to be cultured and was rarely studied until the development and application of molecular biology technology. The research on MG in China is still in the primary stage. However, relevant studies abroad have found that it is an important pathogen causing human genitourinary tract infection and spreading worldwide. Male MG infection is reportedly related to NGU, prostatitis, epididymitis, balanoposthitis, male HIV infection, and male infertility. This review outlines the advances in the studies of MG in male urogenital diseases.
Balanitis ; microbiology ; China ; Epididymitis ; microbiology ; HIV Infections ; microbiology ; Humans ; Male ; Male Urogenital Diseases ; microbiology ; Mycoplasma Infections ; Mycoplasma genitalium ; Urethritis ; microbiology

A 46-year-old male presented with skin lesion on the tip of penis, occurring a month ago. Erythematous macules and grouped vesicles on the glans penis and upper side of prepuce area were noticed. In addition, scales were noticed on the tip of glans penis. The lesion was first diagnosed as herpes genitalis based on the clinical manifestation, but had failed to improve with systemic and topical antiviral and topical antibiotics. KOH examinations were performed on his upper glans penis, and we detected pseudo hyphae and spores. Fungal culture and polymerase chain reaction (PCR) study were revealed as Candida albicans. He was successfully treated with topical isoconazole cream twice a day. Candida balanitis refers to candida infections of glans penis. Infectious balanitis presented various clinical presentations, it is not easy to diagnose with clinical presentation only. Therefore, it is essential to include other examination such as KOH examination, microorganism exam, and/or biopsy in the differential diagnosis when cutaneous lesions are noticed in patients. Herein, we present a candida balanitis with atypical features that clinically mimicked herpes genitalis.
Anti-Bacterial Agents ; Balanitis* ; Biopsy ; Candida albicans ; Candida* ; Diagnosis, Differential ; Herpes Genitalis* ; Humans ; Hyphae ; Male ; Middle Aged ; Penis ; Polymerase Chain Reaction ; Skin ; Spores ; Weights and Measures

Objective: To assess the effect of traversing the vertical pedicle flap (TVPF) for the treatment of severely buried penis in children. METHODS: Totally 43 children with severely buried penis underwentTVPF (n = 21)or modifiedShiraki surgery (control, n = 22) in our hospitalfrom February to December 2014. Wecompared the operation time, intra-operation blood loss, foreskin swelling time, and parents' satisfaction with penile appearance between the two groups. RESULTS: No statistically significant differences were observed between the TVPFand control groups in the operation time (［45.0 ±6.8］ vs ［42.0 ±5.3］ min, P>0.05) or intra-operation blood loss(［5.0 ±1.2］ vs ［6.0 ±0.8］ ml, P>0.05). The average foreskin swelling time was markedly shorter in the TVPFgroup than in the control (［9.0 ±2.3］ vs ［15.0 ±4.8］ d, P<0.05)and the parents' satisfaction with penile appearancewas higher in the former than in the latter (95.23vs31.81 %, P<0.05). The elastic bandages were removedfor all the patientsat 3 days postoperatively, and 3 to 6-month follow-up revealed no penile retraction or relapse. CONCLUSIONS The method of traversing the vertical pedicle flap is a feasible surgical option for the treatment of severely buried penis in children, which can make a rational use of the foreskin,remove the tight ring, and achieve a satisfactory appearance of the penis.
Balanitis ; etiology ; Blood Loss, Surgical ; Child ; Foreskin ; Humans ; Male ; Operative Time ; Penis ; abnormalities ; surgery ; Postoperative Complications ; etiology ; Postoperative Period ; Surgical Flaps ; transplantation ; Urologic Surgical Procedures, Male ; methods

BACKGROUND: A variety of infectious, inflammatory, and neoplastic dermatoses can develop on the glans penis, and definitive diagnosis in such cases may be difficult owing to their non-specific symptoms and clinical appearance. Furthermore, data on dermatoses of the glans penis in Korea are limited. OBJECTIVE: In the present study, we aimed to determine the prevalence of dermatoses of the glans penis in Korea and provide clinical data to assist in making an accurate diagnosis. METHODS: We retrospectively reviewed the medical records, clinical photographs, and histologic slides of 65 patients with dermatoses of the glans penis that visited the Pusan National University Hospital between January 2004 and August 2013. RESULTS: Twenty-six types of dermatoses were identified: inflammatory dermatosis was the most common (38/65, 58.5%), followed by infectious (13/65, 20.0%), neoplastic (10/65, 15.4%), and other dermatoses (4/65, 6.2%). The most common dermatosis of the glans penis was seborrheic dermatitis, followed by lichen planus, herpes progenitalis, condyloma accuminatum, erythroplasia of Queyrat, Zoon's balanitis, and psoriasis. In the topographic analysis, the most common type of dermatosis was dermatoses that localized to the glans penis (39/65, 60.0%), followed by dermatoses involving the extra-genitalia and glans penis (22/65, 33.9%), and the genitalia (glans penis plus other genital areas) (4/65, 6.2%). CONCLUSION: This study shows the usefulness of a topographic approach in the diagnosis of dermatoses of the glans penis in Korea. The findings could be used as baseline data for establishing an accurate diagnosis in Koreans.
Balanitis ; Busan ; Dermatitis, Seborrheic ; Diagnosis ; Erythroplasia ; Genitalia ; Humans ; Korea* ; Lichen Planus ; Male ; Medical Records ; Penis* ; Prevalence ; Psoriasis ; Retrospective Studies ; Skin Diseases*

OBJECTIVETo evaluate the effect of meatoplasty with the pedicle flap in the treatment of meatal stenosis secondary to chronic balanitis.

METHODSWe retrospectively analyzed 32 cases of meatal stenosis secondary to chronic balanitis treated by meato- plasty with the pedicle flap. All the patients had a history of chronic balanitis and had received meatal dilatation or simple ventral mea- totomy without significant effect. Their mean maximum urinary flow rate (Qmax) was (4.3 ± 2.4) ml/s. During the operation, A "/\"-shaped incision was made in the healthy epidermis and a flap was harvested from the frenulum. After complete removal of the scar, the flap was placed into the urethral wall, followed by reconstruction of the external urethral orifice.

RESULTSThe patients were fol- lowed up for 6 to 30 months, which revealed smooth urination in all the patients with Qmax of (26.7 ± 4.5) ml/s and normal erectile function and uresiesthesis.

CONCLUSIONWith little invasiveness and few complications, meatoplasty with the pedicle flap is an ideal surgical method for the treatment of meatal stenosis secondary to chronic balanitis. However, there might be some change in the normal appearance of the balanus postoperatively, and its long-term effect needs further observation.

Balanitis ; complications ; Constriction, Pathologic ; etiology ; surgery ; Dilatation ; Humans ; Male ; Postoperative Period ; Reconstructive Surgical Procedures ; Retrospective Studies ; Surgical Flaps ; Urethra ; surgery ; Urethral Stricture ; etiology ; surgery ; Urination

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

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

BACKGROUNDCandidal balanoposthitis (CB) is a common male genital infection. Autoimmune mechanisms may play an important role in the pathogenesis of CB. Interleukin-2 (IL-2) is an important molecule in cell-mediated immunity.

METHODSOne hundred and one patients were diagnosed with CB using mycology culture in the dermatology and urology clinics in our hospital. Ninety-four healthy males were randomly selected as controls. We studied serum levels of IL-2 of patients with CB using ELISA and analyzed the correlations between serum IL-2 and clinical data.

RESULTSSerum IL-2 concentrations in CB patients were significantly lower than that in the control group ((7.80 ± 4.78) vs. (15.44 ± 7.90) ng/L; t = 2.27, P < 0.05). The incidence of CB in the low-level group was significantly higher than that in the high-level group (70% (71/101) vs. 36% (30/84), P < 0.05). Low levels of serum IL-2, comorbidity with other sexually transmitted diseases (STDs), and sexual partners with vulvovaginal candidiasis (VVC) increased the risk of CB.

CONCLUSIONThe pathogenesis of CB is a complex procedure that includes internal autoimmune factors.

Adult ; Aged ; Balanitis ; blood ; microbiology ; Candidiasis ; blood ; Humans ; Interleukin-2 ; blood ; Logistic Models ; Male ; Middle Aged ; Young Adult