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Medicinski Pregled 2012The prepuce envelops the glans as a variant of a mucocutaneous tissue presenting with a lot offunctions, the most important of them being to protect the infant's glans... (Review)
Review
INTRODUCTION
The prepuce envelops the glans as a variant of a mucocutaneous tissue presenting with a lot offunctions, the most important of them being to protect the infant's glans from feces and ammonia in diapers, to protect the glans from abrasions and trauma throughout life, and to provide sufficient skin in erection. Circumcision was recognized as a method of solving foreskin problems a long time before Christ. Practicing male circumcision in history was customary several thousand years ago and has spread worldwide. Today it depends on races, and it is often an initiation ceremony near the age of puberty. In everyday practice in pediatric urology outpatient department the foreskin problems have been noticed as a phimosis in 9.91% cases and prepuce adhesions in 3.98%. Congenital anomalies are present in different numbers. Other problems, such as paraphimosis, balanoposthitis, are recorded as accidental cases. Over-all prepuce pathology can be observed in 12%-25% of patients. The article presents a review of foreskin conditions, clinical manifestation, therapy and arguments for patient's benefits.
CLINICAL PRESENTATION
The term phimnosis describes a foreskin that is unable to retract. It is necessary to distinguish normal anatomic situation in neonate and infantile period, when prepuce has not been separated yet from true pathologic phimosis due to fibrosis and sclerosis. Up to six years of age the tip of the prepuce is elastic and might be retracted by gentle manipulations. In cases when the foreskin is trapped behind the glans penis and cannot be pulled back to normal position, paraphimosis is present and can be treated as a medical emergency by manual manipulation, or by dorsal slit (incision). Many studies have demonstrated that frequency of urinary tract infection increases in uncircumcised males and that is a reason for routine circumcision. The others are against routine circumcision. The contraindications are newborns, especially prematurely born. and congenital penile anomalies. Condition in which the frenulunm of penis is short with consequent restriction of movement of the prepuce can be easily treated by frenulotomy. Hooded prepuce is a condition of incomplete circumferential formation of foreskin with a dorsal component present and ventral component absent. In cases without any penile anomalies this is only a cosmetically unattractive appearance and could be corrected by circumcision. Infection of the foreskin due to bacterial colonization could be both prevented and treated easily However, an infection due to peno-preputial incisions in adolescent age is serious and has to be cured promptly.
CONCLUSION
As a part of external genitalia, the foreskin has a lot of functions. Despite its natural role many advocates routine circumcision due to problematic condition that can develop. Routine circumcision is not generally recommended. Improved education for physicians and parents with regard to the foreskin development and management is required.
Topics: Adolescent; Child; Circumcision, Male; Foreskin; Humans; Infant, Newborn; Male; Phimosis; Urinary Tract Infections
PubMed: 22924249
DOI: 10.2298/mpns1208295d -
Cirugia Pediatrica : Organo Oficial de... Jan 2022Congenital megaprepuce is a urological pathology typical of childhood. It can be easily mistaken for other clinical entities such as physiological phimosis or buried...
Congenital megaprepuce is a urological pathology typical of childhood. It can be easily mistaken for other clinical entities such as physiological phimosis or buried penis. Owing to the risk of associated complications - primarily infectious and obstructive complications, with upper urinary tract involvement -, achieving an accurate diagnosis proves particularly significant for early treatment initiation. We present three cases of congenital megaprepuce diagnosed and operated on at our department from January 2019 to May 2020. Diagnosis, therapy, and clinical progression are described.
Topics: Diagnosis, Differential; Humans; Male; Penis; Phimosis; Prognosis; Urologic Surgical Procedures, Male
PubMed: 35037442
DOI: 10.54847/cp.2022.01.20 -
Medicina (Kaunas, Lithuania) 2008Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This... (Comparative Study)
Comparative Study
Lichen sclerosus et atrophicus is a chronic inflammatory sclerotic and atrophic disease of unknown cause that predominantly affects male and female genital skin. This study was designed to evaluate histological characteristics of congenital and acquired phimoses among pediatric (n=60) and adult (n=60) male patients who were admitted for circumcision to the Clinics of Urology and Pediatric Surgery of Kaunas University of Medicine Hospital between 2000 and 2003 and to determine the rate of lichen sclerosus et atrophicus and other histological diagnoses among them. This study demonstrates that 45.1% of congenital and 62.3% of acquired phimoses show histological signs of lichen sclerosus et atrophicus. The rate of lichen sclerosus et atrophicus was statistically significantly higher among patients with acquired than congenital phimosis. Boys with acquired narrowing of prepuce were statistically significantly 3.9 times more likely to develop lichen sclerosus et atrophicus than those with congenital phimosis. There were no statistically significant differences between rates of lichen sclerosus et atrophicus and other dermatological diagnoses among pediatric and adult male patients if the type of phimosis (acquired or congenital) was considered. Histological features of lichen sclerosus et atrophicus and other histological diagnoses in boys and men with phimosis were detected with equal frequency irrespective the age of the subjects. The rate of lichen sclerosus et atrophicus was similar among all boys (56.7%) and men (53.3%) treated for phimosis. Only the type of phimosis had a statistically significant influence on the rate of lichen sclerosus et atrophicus and other histological diagnoses.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Analysis of Variance; Chi-Square Distribution; Child; Child, Preschool; Circumcision, Male; Data Interpretation, Statistical; Diagnosis, Differential; Histological Techniques; Humans; Incidence; Lichen Sclerosus et Atrophicus; Logistic Models; Male; Middle Aged; Phimosis; Skin
PubMed: 18660641
DOI: No ID Found -
Case Reports in Urology 2019Congenital megaprepuce (CMP) is a type of buried penis characterized by extensive redundancy and ballooning of the inner prepuce as a result of preputial stenosis and...
Congenital megaprepuce (CMP) is a type of buried penis characterized by extensive redundancy and ballooning of the inner prepuce as a result of preputial stenosis and phimosis. The malformation typically presents with difficulty voiding, often requiring manual expression of stagnant urine. Multiple techniques have been reported for the treatment of CMP with varying levels of positive outcomes. The authors provide a review of published literature, in addition to describing the procedure and results of our surgical technique in three children aged eleven months, two years, and twelve years. The literature review was conducted using PubMed with keywords "congenital megaprepuce," "megaprepuce," "buried penis," "CMP," and "correction." Results were then differentiated based on presence or absence of true congenital megaprepuce and the surgical correction thereof. Regarding our cases, all patients completed the procedure with excellent cosmesis and without complication. Our technique is shown to provide consistent, excellent esthetic outcome across a wide range of ages and may be replicated by others.
PubMed: 31218089
DOI: 10.1155/2019/4584609 -
The Canadian Veterinary Journal = La... Mar 2020An 18-hour-old colt was presented for abdominal discomfort, preputial swelling, and frequent posturing to urinate. Examination of the scrotum confirmed 2 testes and no...
An 18-hour-old colt was presented for abdominal discomfort, preputial swelling, and frequent posturing to urinate. Examination of the scrotum confirmed 2 testes and no scrotal or inguinal hernia. Transabdominal ultrasound identified a distended bladder and no free fluid in the peritoneal cavity. Inspection of the preputial cavity revealed that the internal lamina of the prepuce was mostly attached to the glans penis. The preputial cavity was lubricated and manual traction was applied to detach the internal lamina of the prepuce from the glans penis. The colt urinated spontaneously 1 hour after the procedure, and the preputial swelling slowly resolved over 7 days. Key clinical message: Congenital phimosis in a newborn foal was resolved by manual separation of the penile epithelium and preputial lamina.
Topics: Animals; Animals, Newborn; Horse Diseases; Horses; Male; Penis; Phimosis; Scrotum; Testis
PubMed: 32165746
DOI: No ID Found -
British Medical Journal Jul 1964
Topics: Amenorrhea; Cervix Uteri; Congenital Abnormalities; Diagnosis; Dysmenorrhea; Female; Gynecology; Humans; Male; Phimosis; Surgical Procedures, Operative; Vagina
PubMed: 14147773
DOI: 10.1136/bmj.2.5400.30 -
African Journal of Paediatric Surgery :... 2021Early management of congenital megaprepuce (CMP) is necessary to address recurrent urinary tract infections and parental concerns. Different procedures, mostly using the...
INTRODUCTION
Early management of congenital megaprepuce (CMP) is necessary to address recurrent urinary tract infections and parental concerns. Different procedures, mostly using the inner preputial skin to cover the phallus, have been described. However, cosmetic appearance with the inner preputial covering of the penis is suboptimal. Owing to this, we conducted this study using outer preputial skin in the form of Byar's flaps to cover the penile shaft and analysed the results.
PATIENTS AND METHODS
This prospective study included 19 patients with CMP operated by a single surgeon using the Byar's flap technique. Following surgery patients were assessed on the 4 post-operative day, at 3 months and 1-year post-operative for cosmetic and functional outcomes. Parental satisfaction about cosmetic results was evaluated using a subjective score. Data were collected and analysed.
RESULTS
Nineteen patients with CMP were studied with a mean age of 6.3 months. Nineteen patients (100%) patients presented with buried penis and preputial ballooning, malodorous infected urine in 15 (78.9%) patients, thin stream of urine in 17 (89.4%) and dysuria in 12 (63%) patients. One of the patients had associated glanular hypospadias and the other two had isolated chordee. There were no significant complications except for one patient who developed meatal stenosis which was later managed by a meatoplasty. All patients had satisfactory cosmetic appearance.
CONCLUSION
CMP is an uncommon but easily identifiable condition. Early surgical correction is recommended to prevent complications. Byar's flap technique yields very good functional and cosmetic results in the management of CMP.
Topics: Foreskin; Humans; Hypospadias; Infant; Male; Prospective Studies; Surgical Flaps; Treatment Outcome
PubMed: 34341303
DOI: 10.4103/ajps.AJPS_144_20 -
Acta Medica Portuguesa 1999A review is made of the three most frequent benign andrological pathologies in children and teenagers. The clinical and physiopathological aspects are analysed both... (Review)
Review
A review is made of the three most frequent benign andrological pathologies in children and teenagers. The clinical and physiopathological aspects are analysed both practically and theoretically. The therapeutic measures most commonly taken in treatment are referred.
Topics: Adolescent; Child; Circumcision, Male; Humans; Male; Phimosis; Testicular Hydrocele; Varicocele
PubMed: 10423888
DOI: No ID Found -
Case Reports in Urology 2016. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare...
. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations. . To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery's body of knowledge of the subject matter. . A nine-month-old boy was admitted for an impalpable right testis and phimosis. At the time of surgical exploration, there appeared to be polyorchid testis on the right-hand side, with three masses that potentially appeared to be undescended testes. . Proponents of a conservative approach argue that infertility is common in patients with polyorchidism and, by preserving a potentially functional SNT, there may be improved spermatogenesis. When performing definitive surgical treatment, meticulous intra-abdominal and intrainguinal exploration must be undertaken. Orchiopexy should be performed to reduce the chances of torsion, malignancy, and infertility. . Our case is important to the literature as it is the first known case of polyorchidism with 3 SNT on the right side, located intra-abdominally, and in a patient less than 1 year of age.
PubMed: 27722006
DOI: 10.1155/2016/2729614