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Indian Journal of Urology : IJU :... Oct 2007To present the outcome of dorsal onlay urethroplasty in 73 patients for stricture urethra over a period of eight years.
OBJECTIVE
To present the outcome of dorsal onlay urethroplasty in 73 patients for stricture urethra over a period of eight years.
MATERIALS AND METHODS
Seventy-three patients of stricture urethra have undergone dorsal onlay urethroplasty from July 1998 to February 2006. Age distribution: 14-58 years.
ETIOLOGY
Trauma 20/73 (27.39%), Balanitis Xerotica Obliterans 2/73 (2.73%), Iatrogenic 26/73(35.61%), Infection 3/73 (4.10%), Idiopathic 22/73 (30.13%). Site: Penobulbar-25/73, bulbar-38/73, membranous-8/73 and long length-2/73. Suprapubic catheter was inserted preoperatively: 21/73 patients. Preputial / distal penile skin was used in all patients. Buccal mucosa was not used in any patient. Hospitalization was for four to five days. Catheter was removed after 21 days. All patients had their first endoscopic checkup after three months. Subsequently they were followed up by uroflometry. Routine imaging of urethra for follow-up was not carried out.
RESULTS
63/73 (86.30%) patients had satisfactory outcome not requiring any further treatment, 8/73 (10.95%) developed anastomotic stricture (3/8-optical internal urethrotomy, 5/8 dilatation alone). 2/73 (2.75%) developed external meatal stenosis. None had urinary fistula and required repeat urethroplasty. Follow-up ranged from three months to eight years.
CONCLUSION
Dorsal onlay urethroplasty using preputial/distal penile skin is a satisfactory procedure. Preputial/distal penile skin is devoid of hair and fat and hence an ideal graft material. Even in circumscribed patients distal penile skin can be harvested. Long-term follow-up is required in judging results of patients with stricture urethra.
PubMed: 19718289
DOI: 10.4103/0970-1591.36706 -
Annals of the Royal College of Surgeons... Jan 2007Preputial problems are a common reason for referral to the paediatric surgical out-patient department. Many boys referred do not need surgical intervention. One...
INTRODUCTION
Preputial problems are a common reason for referral to the paediatric surgical out-patient department. Many boys referred do not need surgical intervention. One indication for intervention is balanitis xerotica obliterans (BXO), a potentially serious condition previously considered rare in childhood.
PATIENTS AND METHODS
Consecutive boys referred to a paediatric general surgical out-patient department with problems relating to their prepuce during a period of 4 years were included. The out-patient diagnosis and management was recorded. All foreskins excised were sent for histological analysis.
RESULTS
A total of 422 boys were referred, median age 6 years 2 months (range, 3 months to 16 years). Over half the boys referred simply required re-assurance that all was normal with their penis. However, 186 boys (44.1%) were listed for surgical procedures - 148 circumcision, 33 preputial adhesiolysis, and 5 frenuloplasty. There were histological abnormalities in 110 specimens (84.8%); chronic inflammation (n = 69; 46.6%), BXO (n = 51; 34.5%), and fibrosis (n = 4; 2.7%). Nineteen (12.8%) specimens were reported as histologically normal. The overall prevalence of BXO in the boys referred was 12.1%.
CONCLUSIONS
In this series, the percentage of boys circumcised and the prevalence of BXO were both higher than in other published series. BXO may be more common and present at a younger age than previously thought.
Topics: Adolescent; Algorithms; Balanitis Xerotica Obliterans; Child; Child, Preschool; Circumcision, Male; Humans; Infant; Male; Patient Care Planning; Penile Diseases; Referral and Consultation; Workload
PubMed: 17316525
DOI: 10.1308/003588407X160828 -
The Ceylon Medical Journal Sep 2004Although literature on childhood nocturnal enuresis and its persistence into adulthood is abundant, recent onset nocturnal enuresis in adults is a poorly studied symptom.
INTRODUCTION
Although literature on childhood nocturnal enuresis and its persistence into adulthood is abundant, recent onset nocturnal enuresis in adults is a poorly studied symptom.
OBJECTIVE
To determine the significance of recent onset nocturnal enuresis in adult males in relation to lower urinary tract pathology, and its treatment.
METHODS
All men with recent onset nocturnal enuresis attending a urology unit over a period of 12 months were evaluated prospectively. Their treatment and outcome were recorded.
RESULTS
There were 30 patients (mean age 64 years). Ultrasonography revealed upper urinary tract dilatation in 22 patients. Another six patients had post-void residual urine volume over 500 mL without upper tract dilatation. Only two patients did not have ultrasonographic evidence of bladder outflow obstruction. Elevated blood urea was noted in 14 patients. Twenty patients underwent transurethral resection of the prostate (TURP) and one patient with balanitis xerotica obliterans had circumcision and meatotomy. Three patients were taught clean intermittent self catheterisation, and three patients preferred indwelling urethral catheters. One patient while awaiting TURP died of a myocardial infarction. Eight patients, who were treated with alpha-adrenergic antagonists initially, required further intervention later as the response to medical therapy was poor.
CONCLUSIONS
Recent onset nocturnal enuresis in adult males is a symptom closely associated with significant lower urinary tract pathology requiring early urological intervention. Considering its impact on management it is reasonable to classify recent onset nocturnal enuresis as a lower urinary tract symptom in adult men and including it in symptom scores used to assess bladder outflow obstruction.
Topics: Adult; Age of Onset; Aged; Aged, 80 and over; Enuresis; Humans; Male; Middle Aged; Prospective Studies; Urinary Bladder Neck Obstruction; Urologic Diseases
PubMed: 15524224
DOI: 10.4038/cmj.v49i3.3244 -
Journal of the Royal Society of Medicine Sep 2003Foreskin complaints in childhood, if not manageable conservatively, are usually treated by circumcision. A less radical surgical option, when balanitis xerotica...
Foreskin complaints in childhood, if not manageable conservatively, are usually treated by circumcision. A less radical surgical option, when balanitis xerotica obliterans is absent, is preputioplasty. We sent questionnaires to the parents of 23 boys who had had this procedure and 22 replied. Mean interval since operation was 20 months (range 3-36). The main indications for surgery had been irretractable foreskin in 9, recurrent balanoposthitis in 10 and ballooning on voiding in 3 and the operation had dealt successfully with these in 7, 7, and 3, respectively. In all but one case the parents were satisfied with the cosmetic result. However, in 8 cases (36%) the parents said they would have preferred circumcision and 3 of the boys had been listed for further surgery. Preputioplasty is a satisfactory alternative to circumcision in selected cases.
Topics: Child; Child, Preschool; Humans; Infant; Male; Parents; Patient Satisfaction; Penile Diseases; Penis; Plastic Surgery Procedures; Surveys and Questionnaires; Treatment Outcome
PubMed: 12949202
DOI: 10.1177/014107680309600909 -
Journal of the Royal Society of Medicine Sep 2003To assess the reasons for and outcomes of referrals concerning the foreskin, 100 consecutive patients seen in paediatric clinics were followed to discharge. 18 referrals...
To assess the reasons for and outcomes of referrals concerning the foreskin, 100 consecutive patients seen in paediatric clinics were followed to discharge. 18 referrals were for circumcision on religious grounds. Of the other 82, the main reason for referral was non-retractability or phimosis. At clinic, 24 (29%) of these were deemed normal for age, 31 (38%) were treated with topical steroid (successfully in 25), 9 (11%) were listed for preputioplasty, 7 (9%) were listed for adhesiolysis, 7 (9%) were listed for circumcision, and 4 were listed for other forms of surgery. 6 patients were identified as having balanitis xerotica obliterans (BXO), a condition that had not been suggested on referral. With the advent of new treatments for foreskin disorders, circumcision is decreasingly necessary. Knowledge of the natural history of the foreskin, and the use of topical steroids, could shift the management of paediatric foreskin problems from the hospital outpatient department to primary care. BXO is not sufficiently recognized as a form of phimosis that requires operation.
Topics: Administration, Topical; Balanitis; Child; Child, Preschool; Circumcision, Male; Humans; Infant; Infant, Newborn; Male; Penile Diseases; Penis; Phimosis; Prospective Studies; Referral and Consultation; Steroids
PubMed: 12949201
DOI: 10.1177/014107680309600908 -
Genitourinary Medicine Aug 1995To determine the prevalence of human papillomavirus (HPV) types 6, 11, 16 and 18 in foreskin biopsies from patients with balanitis xerotica obliterans (BXO) and other...
OBJECTIVES
To determine the prevalence of human papillomavirus (HPV) types 6, 11, 16 and 18 in foreskin biopsies from patients with balanitis xerotica obliterans (BXO) and other penile conditions.
MATERIALS AND METHODS
Foreskin biopsy specimens from 24 patients with penile lesions and 5 control patients were analysed by type-specific polymerase chain reaction (PCR).
RESULTS
HPV6 or HPV16 were not detected in patients with BXO. HPV6 was detected in 2 controls.
CONCLUSIONS
Genital papillomaviruses do not have a strong association with BXO.
Topics: Balanitis; Base Sequence; Humans; Male; Molecular Sequence Data; Papillomaviridae; Papillomavirus Infections; Polymerase Chain Reaction; Tumor Virus Infections
PubMed: 7590713
DOI: 10.1136/sti.71.4.228 -
Canadian Family Physician Medecin de... Oct 1994
Topics: Administration, Topical; Adult; Anti-Inflammatory Agents; Balanitis; Glucocorticoids; Humans; Lichen Sclerosus et Atrophicus; Male
PubMed: 7950467
DOI: No ID Found -
Journal of the Royal Society of Medicine Jun 1992One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36,...
One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor in 15 patients. The implications of this survey are that a large proportion of general practitioners have difficulty in discriminating between a true phimosis and a developmentally non-retractile foreskin. This diagnostic inaccuracy was greatest when the referring doctor did not examine the patient.
Topics: Adolescent; Child; Child, Preschool; Circumcision, Male; Diagnosis, Differential; Humans; Infant; Male; Phimosis; Physicians, Family; Referral and Consultation
PubMed: 1625262
DOI: No ID Found -
CA: a Cancer Journal For Clinicians 1976
Topics: Adult; Aged; Balanitis; Bowen's Disease; Carcinoma in Situ; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Condylomata Acuminata; Erythroplasia; Humans; Leukoplakia; Male; Melanoma; Mesenchymoma; Middle Aged; Neoplasm Metastasis; Penile Neoplasms; Precancerous Conditions
PubMed: 819110
DOI: 10.3322/canjclin.26.3.130 -
The British Journal of Venereal Diseases Jun 1962
Topics: Balanitis; Balanitis Xerotica Obliterans; Humans; Hydrocortisone; Lichen Sclerosus et Atrophicus; Male
PubMed: 13877396
DOI: 10.1136/sti.38.2.75