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International Urology and Nephrology Mar 2016We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
We evaluated a systematic review on the therapeutic efficacy of topical steroids in children with phimosis to provide data for the clinical options of pediatric phimosis.
METHODS
We searched the related original studies on topical steroid therapy in pediatric phimosis before August 2014. Two reviewers independently performed the study selection, data extraction, risk of bias and reporting quality assessment with confirmation by cross-checking. The quality of eligible studies was appraised with the 'Cochrane handbook.' The meta-analysis was performed by REVMAN 5.2 software.
RESULTS
Eleven studies were included with 1669 patients among which 1093 received topical steroids and 576 cases treated with placebo or only manual reduction. Significant difference of the treatment efficacy was detected among the three methods [OR 7.46, 95 % CI (4.42, 12.58), p < 0.00001]. In subgroup analysis, significant difference of the treatment efficacy was also detected whether with placebo or manual reduction only [respectively, OR 5.04, 95 % CI (3.19, 7.95), p < 0.00001; OR 16.28, 95 % CI (6.06, 43.69), p < 0.00001].
CONCLUSIONS
Compared to the placebo or manual reduction method, the topical steroid therapy is more effective in the treatment of phimosis in children. Although there is still controversy in the different type and dosage of steroid, this could be used against phimosis before circumcision.
Topics: Administration, Topical; Glucocorticoids; Humans; Male; Phimosis; Treatment Outcome
PubMed: 26725071
DOI: 10.1007/s11255-015-1184-9 -
Vestnik Oftalmologii 2017This is a review of the literature on capsule contraction syndrome (CCS) in pseudophakic patients that involves severe fibrosis along the margin of the anterior... (Review)
Review
This is a review of the literature on capsule contraction syndrome (CCS) in pseudophakic patients that involves severe fibrosis along the margin of the anterior capsule's opening and progressive contraction of the capsular bag. Possible causes of CCS and principles of its prevention and treatment have been analyzed.
Topics: Anterior Capsule of the Lens; Capsulorhexis; Disease Management; Fibrosis; Humans; Postoperative Complications; Pseudophakia
PubMed: 29165419
DOI: 10.17116/oftalma2017133592-97 -
International Journal of Dermatology Jul 2019Balanitis xerotica obliterans (BXO), or penile lichen sclerosus, is a progressive sclerosing inflammatory dermatosis of the glans penis and foreskin. It is associated... (Review)
Review
Balanitis xerotica obliterans (BXO), or penile lichen sclerosus, is a progressive sclerosing inflammatory dermatosis of the glans penis and foreskin. It is associated with significant morbidity and may result in impaired urinary and sexual function. It was initially described by Stuhmer in 1928, named after its pathological features, and is considered the male equivalent of vulvar lichen sclerosis (LS). The etiology of BXO is uncertain; however, autoimmune disease, local trauma, and genetic and infective causes have been proposed. BXO occurs most commonly on the prepuce and glans penis. It is considered to have premalignant potential to transform into squamous neoplasia. This postulation rests on retrospective studies and parallels drawn with vulvar LS and squamous cell carcinoma (SCC) development. Histologically, BXO and vulvar LS are considered the same disease. There is a paucity of evidence-based guidelines to assist with appropriate follow-up for patients with BXO.
Topics: Administration, Topical; Balanitis Xerotica Obliterans; Carcinoma, Squamous Cell; Circumcision, Male; Dermatology; Diagnosis, Differential; Glucocorticoids; Humans; Male; Penile Neoplasms; Penis; Phimosis; Practice Guidelines as Topic; Precancerous Conditions; Sexual Dysfunction, Physiological; Urination Disorders
PubMed: 30315576
DOI: 10.1111/ijd.14236 -
Climacteric : the Journal of the... Aug 2017Female lichen sclerosus is a chronic inflammatory dermatitis, with a predilection for the anogenital area, which in some cases can become seriously distorted (atrophy of... (Review)
Review
Female lichen sclerosus is a chronic inflammatory dermatitis, with a predilection for the anogenital area, which in some cases can become seriously distorted (atrophy of the labia minora, phimosis, introital stenosis, etc.). Most cases are diagnosed in postmenopausal women, but it can affect women of any age. Lichen sclerosus is usually a pruriginous condition, although it can also be asymptomatic. It is associated with an increased risk of vulvar cancer, even though it is not a premalignant condition itself. The true precursor of cancer associated with lichen sclerosus is vulvar intraepithelial neoplasia, differentiated type. The diagnosis is usually clinical, but in some cases a biopsy can be performed, especially to exclude vulvar intraepithelial neoplasia or cancer. The treatment of lichen sclerosus aims at controlling the symptoms, stopping further scarring and distortion and reducing the risk of cancer. The gold standard in treatment is ultra-potent topical steroids (clobetasol propionate). Second-line treatments include calcineurin inhibitors, retinoids, and immunosuppressors. Surgery is used only for the treatment of complications associated with lichen sclerosus. Follow-up must be kept indefinitely.
Topics: Atrophy; Autoimmune Diseases; Diagnosis, Differential; Female; Humans; Infections; Lichen Sclerosus et Atrophicus; Middle Aged; Postmenopause; Puberty; Risk Factors; Sexual Dysfunction, Physiological; Vagina; Vulva; Vulvar Diseases; Vulvar Neoplasms
PubMed: 28661705
DOI: 10.1080/13697137.2017.1343295 -
Urology Jan 2020Phimosis is considered virtually universal in newborn males and likely to resolve within a few years. Persistent phimosis can result in pain, sexual dysfunctions,...
CONTEXT
Phimosis is considered virtually universal in newborn males and likely to resolve within a few years. Persistent phimosis can result in pain, sexual dysfunctions, increased risk of penile inflammatory conditions and penile cancer. There are two forms - primary phimosis and secondary phimosis - the latter often representing a consequence of lichen sclerosis, diabetes and obesity.
OBJECTIVES
To conduct a systematic review to determine the prevalence of phimosis at different ages.
DATA SOURCES
PubMed, Google Scholar, the Cochrane Library, and bibliographies of original studies were searched using the keyword phimosis.
STUDY SELECTION
Studies containing original data on phimosis at any age.
DATA EXTRACTION
Two reviewers independently verified study design, extracted data and rated studies for quality.
RESULTS
Forty-three eligible studies were included: 27 from PubMed, 4 from Google Scholar, and 12 from bibliography searches. Phimosis was reported in most newborns, then gradually decreased in prevalence. Most studies did not differentiate primary from secondary phimosis, so values reported were net phimosis prevalence. There were 13 studies with data for males age ≥18 years. In all, 962 of 17,136 men had been diagnosed with phimosis (range 0.5%-13%). A random effects model found risk of phimosis in men was 3.4% (95% CI 1.8-6.6).
CONCLUSION
Phimosis takes many years to resolve. Apart from spontaneous resolution, clinical interventions also contribute to the gradual reduction in prevalence among uncircumcised boys. The wide range of phimosis prevalence reported in adulthood may reflect variability in the extent of foreskin-preserving treatment of phimosis in different study cohorts.
Topics: Diabetes Mellitus; Humans; Lichen Sclerosus et Atrophicus; Male; Obesity; Phimosis; Prevalence
PubMed: 31655079
DOI: 10.1016/j.urology.2019.10.003 -
Translational Andrology and Urology Oct 2017Penile cancer is a rare neoplasm representing less than 1% of all malignancies in the USA and Europe but is a significant public health hazard in the developing world.... (Review)
Review
Penile cancer is a rare neoplasm representing less than 1% of all malignancies in the USA and Europe but is a significant public health hazard in the developing world. Male neonatal circumcision has been associated with a dramatic decrease in penile cancer rates with countries such as Israel, where circumcision is widely performed, having the lowest incidence in the world at <0.1% of malignancies. Many risk factors have been identified for penile cancer including phimosis, lack of circumcision, obesity, lichen sclerosis, chronic inflammation, smoking, UVA phototherapy, socioeconomic status, human papillomavirus (HPV) infection and immune compromised states. The relationship between these factors and invasive disease varies and continues to be investigated. Our objective was to present a contemporary overview of the epidemiology and risk factors for invasive penile cancer.
PubMed: 29184774
DOI: 10.21037/tau.2017.05.19 -
International Journal of Preventive... 2017Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We... (Review)
Review
Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We conducted a systematic review of the medical literature on PubMed, EMBASE, and Cohrane databases using keywords "balanitis," "posthitis," "balanoposthitis," "lichen sclerosus," "penile inflammation," and "inflammation penis," along with "circumcision," "circumcised," and "uncircumcised." Balanitis is the most common inflammatory disease of the penis. The accumulation of yeasts and other microorganisms under the foreskin contributes to inflammation of the surrounding penile tissue. The clinical presentation of inflammatory penile conditions includes itching, tenderness, and pain. Penile inflammation is responsible for significant morbidity, including acquired phimosis, balanoposthitis, and lichen sclerosus. Medical treatment can be challenging and a cost burden to the health system. Reducing prevalence is therefore important. While topical antifungal creams can be used, usually accompanied by advice on hygiene, the definitive treatment is circumcision. Data from meta-analyses showed that circumcised males have a 68% lower prevalence of balanitis than uncircumcised males and that balanitis is accompanied by a 3.8-fold increase in risk of penile cancer. Because of the high prevalence and morbidity of penile inflammation, especially in immunocompromised and diabetic patients, circumcision should be more widely adopted globally and is best performed early in infancy.
PubMed: 28567234
DOI: 10.4103/ijpvm.IJPVM_377_16 -
International Journal of Dermatology Dec 2022Balanitis is classically defined as inflammation of the glans penis, often also encompassing the prepuce (balanoposthitis). Several investigations have found that a... (Review)
Review
Balanitis is classically defined as inflammation of the glans penis, often also encompassing the prepuce (balanoposthitis). Several investigations have found that a sizable proportion of urology clinic visits are due to balanitis or related complaints. Balanitis can have numerous complications, including severe pain, urethral stenosis, phimosis, sexual dysfunction, and if untreated, malignancy. Unfortunately, there is no recent or comprehensive review that describes the various etiologies, clinical workup, and treatments for balanitis. Herein this review, we attempt to provide the reader with a complete and updated guide to balanitis in an attempt to improve clinical outcomes.
Topics: Male; Humans; Urology; Dermatology; Balanitis; Phimosis; Penis
PubMed: 34826136
DOI: 10.1111/ijd.15985 -
Current Opinion in Urology Mar 2019Our objective is to present an overview of epidemiologic, clinical, and molecular risk factors with a focus on contemporary literature. (Review)
Review
PURPOSE OF REVIEW
Our objective is to present an overview of epidemiologic, clinical, and molecular risk factors with a focus on contemporary literature.
RECENT FINDINGS
Penile cancer is a rare and aggressive neoplasm that accounts for less than 1% of male malignancies in the United States. Geographical disparities in incidence of disease are evident with high rates concentrated in the developing world (2.8-6.8 per 100 000) where neonatal circumcision is low and socioeconomic conditions predispose patients to multiple risk factors. Western countries have a significantly lower incidence and can be as low as 0.3 per 100 000. Many risk factors have been identified including lack of circumcision, phimosis, balanitis, obesity, lichen sclerosus, smoking, and psoralen UV-A phototherapy. In addition, human papilloma virus (HPV) has been linked to nearly 40% of cases and molecular mediators continue to be investigated.
SUMMARY
Although Penile cancer can be a debilitating disease, several of the known risk factors are modifiable. Public health campaigns aimed to increase awareness, promote better hygiene, and deploy HPV vaccines have had varied success at decreasing disease burden. Focus should be placed on implementing such interventions in developing countries and at-risk populations.
Topics: Circumcision, Male; Humans; Incidence; Male; Obesity; Penile Neoplasms; Phimosis; Risk Factors; United States
PubMed: 30562185
DOI: 10.1097/MOU.0000000000000581 -
Urologiia (Moscow, Russia : 1999) Nov 2022To study the prevalence of functional phimosis determined during erection in patients over 18 years of age, as well as the features of its diagnosis and treatment in...
AIM
To study the prevalence of functional phimosis determined during erection in patients over 18 years of age, as well as the features of its diagnosis and treatment in outpatient practice.
MATERIALS AND METHODS
A retrospective study that included 201 patients who underwent circumcision at a mean age of 42.7 years, was carried out. Complaints, history, initial examination and autophotography of the penis during erection were evaluated. The subjects were divided into 2 groups. The group I (n=38) included patients complaining of the inability to reveal the glans penis during erection, while in group II (n=163) men with similar complaints in a f laccid state of the penis were included. All patients underwent circumcision under local anesthesia.
RESULTS
The proportion of functional phimosis was 18.9%. The mean age in groups I and II was significantly different (29.47+/-8.82 and 45.6+/-19.4 years, respectively, p<0.01). In 14 (36.8%) patients of group I, a short frenulum was also diagnosed. Primary phimosis was detected in 26.3% and 14.1% of patients in groups I and II (p<0.05), respectively. The acquired phimosis was diagnosed in 73.7% and 85.9% (p<0.05) of cases, respectively. There were no concomitant diseases in patients with "functional" phimosis, while in men with "pathological" phimosis, 22.7% of patients had various comorbidities, such as diabetes mellitus, coronary heart disease, hypertension, etc. CONCLUSIONS: Among patients who visit a urologist with a diagnosis of phimosis, almost every fifth man has functional form (18.9%). For the diagnosis of the phimosis, the history taking and autophotography of the penis during erection have an important role. In this category of patients, surgical treatment can be performed on an outpatient basis.
Topics: Male; Humans; Adolescent; Adult; Young Adult; Foreskin; Retrospective Studies; Prevalence; Outpatients; Phimosis; Circumcision, Male; Penis
PubMed: 36382818
DOI: No ID Found