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Current Urology Mar 2020It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by . Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with... (Review)
Review
BACKGROUND
It is estimated that between 50 and 89% of non-gonococcal urethritis is not caused by . Associations between non-chlamydial non-gonococcal urethritis (NCNGU) with balanoposthitis, epididymo-orchitis and reactive arthritis have been suggested, but evidence to support these often-theoretical relationships is sparse and further investigation is called for. Concerns over increasing antimicrobial resistance has rendered the need for clarity over this question ever more pressing in recent years. A review of the current evidence on the complications of NCNGU in men is therefore urgently warranted.
OBJECTIVE
This systematic review summarizes and evaluates the available evidence that NCNGU, whether symptomatic or asymptomatic, causes the significant complications that are already well-recognized to be associated with non-gonococcal urethritis. These significant complications are epididymo-orchitis, balanoposthitis, and sexually-acquired reactive arthritis (Reiter's syndrome) including arthritis or conjunctivitis.
SUMMARY
We conducted a systematic review and qualitative synthesis using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework. Five databases (PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, and British Nursing Index) were searched. We included studies that measured clinical outcome after diagnosis of NCNGU in men. Bias was assessed using variations of the Newcastle-Ottawa scale. Data were extracted and entered into a pre-written data abstraction proforma. Seven peer-review studies were included. This included 2 retrospective cohort studies, 1 case series, 2 case reports and 2 cross-sectional studies. The studies described and analyzed 3 types of complication: balanitis, posthitis and/or meatitis; reactive arthritis and/or conjunctivitis; and epididymitis. All studies reported one or more complications.
KEY MESSAGES
This review identifies an important avenue for future research: while the available evidence suggests that NCNGU has the potential to cause significant complications in men, with the strongest evidence existing for balanitis, posthitis and/or meatitis, the nature and significance of these relationships is far from clear. The findings of this review suggest that prospective, adequately powered research into whether there is a causal link between NCNGU and significant clinical complications in men would be highly worthwhile. The findings of this review raise important questions about the utility of the term NCNGU in research and clinical practice.
PubMed: 32398991
DOI: 10.1159/000499266 -
Genitourinary Medicine Jun 1994To assess whether there might be an association between genital papillomavirus infection (GPVI) and balanoposthitis.
OBJECTIVE
To assess whether there might be an association between genital papillomavirus infection (GPVI) and balanoposthitis.
DESIGN
Retrospective HPV DNA examination of biopsy specimens from 23 men suffering from balanoposthitis and exhibiting acetowhite lesions that were penoscopically and histologically concurrent with HPV infection.
SETTING
The STD clinics at Karolinska Hospital and South Hospital, Stockholm, Sweden.
PARTICIPANTS
Randomly selected men attending with long-lasting and/or recurrent penile symptoms and exhibiting a clinical picture of balanoposthitis, who revealed a penoscopical and histopathological picture of epidermal lesions that were concordant with accepted criteria for typical or conspicuous GPVI. Asymptomatic controls were selected retrospectively on the basis of identical penoscopy and histology criteria.
RESULTS
A history of previous condylomata was obtained in eight (35%) of 23 men. At penoscopic evaluation tiny condylomatous lesions were observed in five (22%) patients. The in situ hybridisation (ISH) assay using specific probes for the HPV types 6/11, 16/18, 31/33 and 42 was positive in 13/23 (56%) of the patient samples, but in only 26% of the 19 control samples. In patient biopsies the oncogenic HPV types 16/18 and/or 31/33 were found in 7/13 samples, whereas HPV 6/11 and/or 42 were present in another six cases. PCR performed on the ten ISH negative patient biopsies, were negative in all cases.
CONCLUSION
Symptoms included redness, itching, burning, tenderness, dyspareunia, fissuring and in two cases penile oedema and inguinal adenopathy. All patients fulfilled penoscopical and histopathological criteria for HPV infection. We demonstrate some tentative evidence that HPV might be associated with long-lasting balanoposthitis, although our data still are circumstantial for a causative association. The results also elucidate the diversity in clinical presentation of GPVI.
Topics: Adult; Balanitis; DNA, Viral; Humans; In Situ Hybridization; Male; Middle Aged; Papillomaviridae; Papillomavirus Infections; Retrospective Studies; Tumor Virus Infections
PubMed: 8039781
DOI: 10.1136/sti.70.3.175 -
BMJ (Clinical Research Ed.) Feb 1993
Topics: Balanitis; Circumcision, Male; Humans; Male; Skin Diseases
PubMed: 8461794
DOI: 10.1136/bmj.306.6877.583-c -
American Family Physician Jan 2010Family physicians commonly diagnose and manage penile cutaneous lesions. Noninfectious lesions may be classified as inflammatory and papulosquamous (e.g., psoriasis,... (Review)
Review
Family physicians commonly diagnose and manage penile cutaneous lesions. Noninfectious lesions may be classified as inflammatory and papulosquamous (e.g., psoriasis, lichen sclerosus, angiokeratomas, lichen nitidus, lichen planus), or as neoplastic (e.g., carcinoma in situ, invasive squamous cell carcinoma). The clinical presentation and appearance of the lesions guide the diagnosis. Psoriasis presents as red or salmon-colored plaques with overlying scales, often with systemic lesions. Lichen sclerosus presents as a phimotic, hypopigmented prepuce or glans penis with a cellophane-like texture. Angiokeratomas are typically asymptomatic, well-circumscribed, red or blue papules, whereas lichen nitidus usually produces asymptomatic pinhead-sized, hypopigmented papules. The lesions of lichen planus are pruritic, violaceous, polygonal papules that are typically systemic. Carcinoma in situ should be suspected if the patient has velvety red or keratotic plaques of the glans penis or prepuce, whereas invasive squamous cell carcinoma presents as a painless lump, ulcer, or fungating irregular mass. Some benign lesions, such as psoriasis and lichen planus, can mimic carcinoma in situ or squamous cell carcinoma. Biopsy is indicated if the diagnosis is in doubt or neoplasm cannot be excluded. The management of benign penile lesions usually involves observation or topical corticosteroids; however, neoplastic lesions generally require surgery.
Topics: Adult; Aged; Balanitis; Humans; Male; Middle Aged; Penile Diseases; Penile Neoplasms; Practice Guidelines as Topic; Practice Patterns, Physicians'; Skin Diseases; Skin Diseases, Infectious; Skin Diseases, Parasitic; Skin Diseases, Viral; Young Adult
PubMed: 20082512
DOI: No ID Found -
Indian Journal of Dermatology 2024Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's... (Review)
Review
Zoon's balanitis or balanitis plasmacellularis circumscripta is a chronic inflammatory disorder of the genital mucosa that can affect both males and females (Zoon's vulvitis). It is not a sexually transmitted disease but can still cause anxiety to the patients because of its chronic nature. Hence, proper diagnosis and early management are necessary. It is a clinical mimicker of other commoner genital dermatoses and is mostly a diagnosis of exclusion when other diseases have been ruled out. It is characterised by a well-demarcated shiny erythematous patch or plaque over the genital mucosa. Histopathological examination becomes necessary when we are unable to differentiate it from premalignant lesions. It reveals lozenge-shaped keratinocytes with siderophages, haemorrhages and variable plasma cell infiltrate in the dermis. Dermoscopy shows spermatozoa-like, convoluted vessels with structureless red orange areas. Response to topical therapy alone is not always satisfactory. However, lasers and surgical management can provide long-term remission.
PubMed: 38572053
DOI: 10.4103/ijd.ijd_834_22 -
Indian Dermatology Online Journal 2021
PubMed: 34211931
DOI: 10.4103/idoj.IDOJ_738_20 -
British Medical Journal Sep 1964
Topics: Antihypertensive Agents; Balanitis; Dequalinium; Drug Therapy; Humans; Male; Quinolines; Toxicology; Uricosuric Agents
PubMed: 14171106
DOI: 10.1136/bmj.2.5410.688-a -
Journal of Clinical Medicine Dec 2022The nuclear factor-κB transcription factors 1 and 2 (NFKB1 and NFKB2) are key components of the NF-κB pathway, which responds to inflammatory signals. Since the...
BACKGROUND
The nuclear factor-κB transcription factors 1 and 2 (NFKB1 and NFKB2) are key components of the NF-κB pathway, which responds to inflammatory signals. Since the NFKB1/2 factors are activated via different inflammatory molecules, we aimed to check their expression levels in penile cancer (PC), penile dermatoses: lichen sclerosus (PLS) and zoon balanitis (ZB).
METHODS
Skin biopsies from altered and healthy looking foreskin were obtained from 59 (49 LS; early PLS: 13, moderate PLS: 32, severe PLS: 4; 6 PC; 4 ZB) and unchanged foreskin from 13 healthy control adult males undergoing circumcision. NFKB1/2 mRNA levels were quantified by qPCR.
RESULTS
The highest levels of NFKB1 and NFKB2 were observed in PC, ca. 22 and 3.5 times higher than in control, respectively. NFKB1 expression was correlated with PLS progression (rs = 0.667) and was ca. 20 times higher in advanced PLS than in controls and early PLS. Occurrence of micro-incontinence was associated with elevated NFKB1 levels in PLS.
CONCLUSION
This is the first study regarding gene profiles of NFKB1/2 in PC and penile dermatoses. New drugs targeting modulation of canonical-activated NF-κB pathway should be studied and introduced to the treatment of PLS and PC apart from other treatments.
PubMed: 36555871
DOI: 10.3390/jcm11247254 -
International Braz J Urol : Official... 2015To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure.
OBJECTIVE
To review the technique and outcome of perineal urethrostomy or urethral perineostomy and to identify factors related to the procedure failure.
MATERIAL AND METHODS
We studied 17 patients who underwent perineal urethrostomy between 2009-2013 in a single hospital. Success was defined as no need for additional surgical treatment or urethral dilatation. We reviewed the clinical data related to age, weight, previous urethral surgery, diabetes, hypertension, ischemic cardiopathy, lichen sclerosus and other causes and studied their association with the procedure failure (univariate analysis). We completed the analysis with a multivariate test based on binary regression.
RESULTS
The average follow-up was 39.41 months. From all the causes, we found Lichen Sclerosus in 35 %, idiopathic etiology in 29 % and prior hypospadia repair in 18 %. Postoperative failure occurred in 3 patients, with a final success of 82.4 %. The binary regression model showed as independent risk factors ischemic cardiopathy (OR: 2.34), and the presence of Lichen Sclerosis (OR: 3.21).
CONCLUSIONS
The success rate with the perineal urethrostomy technique shows it to be a valid option above all when we preserve the urethral blood supply and plate. Lichen sclerosus and ischemic vascular problems are risk factors to re-stenosis.
Topics: Aged; Aged, 80 and over; Analysis of Variance; Balanitis Xerotica Obliterans; Female; Follow-Up Studies; Humans; Lichen Sclerosus et Atrophicus; Male; Middle Aged; Ostomy; Perineum; Radiography; Regression Analysis; Reproducibility of Results; Retrospective Studies; Risk Factors; Treatment Failure; Urethra; Urethral Stricture; Urologic Surgical Procedures
PubMed: 25928514
DOI: 10.1590/S1677-5538.IBJU.2015.01.13 -
Acta Medica Portuguesa Nov 2022
Topics: Humans; Male; Balanitis; Syphilis
PubMed: 35543623
DOI: 10.20344/amp.16763