Medicine › Surgery

Genital Health and Disease

Works Count: 54409

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This cluster of papers focuses on the role of male circumcision in reducing the risk of HIV infection, preventing penile cancer, and addressing related conditions such as human papillomavirus infection and lichen sclerosus. It also explores the impact of circumcision on sexually transmitted infections and the surgical management of penile health.

Keywords

Male Circumcision; HIV Prevention; Penile Cancer; Human Papillomavirus; Lichen Sclerosus; Sexually Transmitted Infections; Penile Carcinoma; Vulvar Disease; Autoimmune Disease; Surgical Management

Vulvar Vestibulitis Syndrome

2013-01-01

E G Friedrich

Circulating Fibrocytes Define a New Leukocyte Subpopulation That Mediates Tissue Repair

1994-11-01

Richard Bucala , Lori Spiegel , Jason Chesney +2 more

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Detection and Typing of Human Papillomavirus DNA in Penile Carcinoma

2001-10-01

Mark A. Rubin , Bernard Kleter , Ming Zhou +4 more

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Human Immunodeficiency Virus Infection among Men with Sexually Transmitted Diseases

1988-08-04

J. Neil Simonsen , D. William Cameron , Michael N. Gakinya +7 more

Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily in Africa but less commonly in North America and Europe. We conducted a case-control study among men attending … Heterosexual transmission of the human immunodeficiency virus (HIV) appears to occur readily in Africa but less commonly in North America and Europe. We conducted a case-control study among men attending a clinic for sexually transmitted diseases in Nairobi to determine the prevalence of HIV infection and the risk factors involved. HIV antibody was detected in 11.2 percent of 340 men who enrolled in the study. Reports of nonvaginal heterosexual intercourse and homosexuality were notably rare. Recent injections and blood transfusions were not associated with HIV infection. Travel and frequent contact with prostitutes were associated with HIV seropositivity. Men who were uncircumcised were more likely to have HIV infection (odds ratio, 2.7; P = 0.003), as were those who reported a history of genital ulcers (odds ratio, 7.2; P<0.001). A current diagnosis of genital ulcers was also associated with HIV seropositivity (odds ratio, 2.0; P = 0.028). Multivariate analysis revealed an independent association of genital ulcers with HIV infection in both circumcised and uncircumcised men. Uncircumcised men were more frequently infected with HIV, regardless of a history of genital ulcers. Our study finds that genital ulcers and an intact foreskin are associated with HIV infection in men with a sexually transmitted disease. Genital ulcers may increase men's susceptibility to HIV, or they may increase the infectivity of women infected with HIV. The intact foreskin may operate to increase the susceptibility to HIV. (N Engl J Med 1988; 319:274–8.)

On Some Morbid Appearances of the Absorbent Glands and Spleen

1832-01-01

Hodgkin

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Vulvar Lichen Sclerosus

2004-01-01

Yolanda R. Smith , Hope K. Haefner

Male circumcision and risk of HIV infection in sub-Saharan Africa: a systematic review and meta-analysis

2000-10-01

Helen A. Weiss , Maria Quigley , Richard Hayes

Objective To systematically review studies of male circumcision and the risk of HIV-1 infection in men in sub-Saharan Africa, and to summarize the findings in a meta-analysis. Design A meta-analysis … Objective To systematically review studies of male circumcision and the risk of HIV-1 infection in men in sub-Saharan Africa, and to summarize the findings in a meta-analysis. Design A meta-analysis of observational studies. Methods A systematic literature review was carried out of studies published up to April 1999 that included circumcision as a risk factor for HIV-1 infection among men in sub-Saharan Africa. A random effects meta-analysis was used to calculate a pooled relative risk (RR) and 95% confidence interval (CI) for all studies combined, and stratified by type of study population. Further analyses were conducted among those studies that adjusted for potential confounding factors. Results Twenty-seven studies were included. Of these, 21 showed a reduced risk of HIV among circumcised men, being approximately half that in uncircumcised men (crude RR = 0.52, CI 0.40–0.68). In 15 studies that adjusted for potential confounding factors, the association was even stronger (adjusted RR = 0.42, CI 0.34–0.54). The association was stronger among men at high risk of HIV (crude RR = 0.27; adjusted RR = 0.29, CI 0.20–0.41) than among men in general populations (crude RR = 0.93; adjusted RR = 0.56, CI 0.44–0.70). Conclusion Male circumcision is associated with a significantly reduced risk of HIV infection among men in sub-Saharan Africa, particularly those at high risk of HIV. These results suggest that consideration should be given to the acceptability and feasibility of providing safe services for male circumcision as an additional HIV prevention strategy in areas of Africa where men are not traditionally circumcised.

Penile cancer: epidemiology, pathogenesis and prevention

2008-07-07

Maaike Bleeker , Daniëlle A.M. Heideman , Peter J.F. Snijders +3 more

Genital ulceration as a risk factor for human immunodeficiency virus infection

1988-02-01

Ruth M. Greenblatt , Sheila A. Lukehart , Frank Plummer +7 more

Among 115 heterosexual men who presented with genital ulcers to a sexually transmitted disease clinic in Nairobi, Kenya, the prevalence of serum antibody to HIV was 16.5%. A past history … Among 115 heterosexual men who presented with genital ulcers to a sexually transmitted disease clinic in Nairobi, Kenya, the prevalence of serum antibody to HIV was 16.5%. A past history of genital ulcers was reported by 12 (63%) of 19 men with antibody to HIV versus 30 (31 %) of 96 without antibody (P = 0.008). HIV infection was also positively associated with lack of circumcision, but was not associated with the etiology of the current genital ulcer. Logistic regression analysis (adjusted for age, number of recent sex partners, recent prostitute contact, circumcision, tribal ethnic identity, past history of urethritis, and current diagnoses) confirmed only the association between prior history of genital ulcer disease and HIV infection; (P = 0.04, odds ratio 2.35, 95% confidence limits, 1.01–5.47). The incidence of genital ulcers, particularly chancroid, is much higher in parts of Africa than in Europe or North America. This may contribute to the increased risk of heterosexual transmission of HIV in Africa. Aggressive control of chancroid and syphilis may offer one very feasible approach to reducing transmission of HIV in this region.

Acceptability of Male Circumcision for Prevention of HIV/AIDS in Sub-Saharan Africa: A Review

2006-10-19

Nelli Westercamp , Robin L. Bailey

Based on epidemiological, clinical and experimental evidence, male circumcision (MC) could have a significant impact on the HIV epidemic in selected areas. We reviewed studies of the acceptability of MC … Based on epidemiological, clinical and experimental evidence, male circumcision (MC) could have a significant impact on the HIV epidemic in selected areas. We reviewed studies of the acceptability of MC in sub-Saharan Africa to assess factors that will influence uptake of circumcision in traditionally non-circumcising populations. Thirteen studies from nine countries were identified. Across studies, the median proportion of uncircumcised men willing to become circumcised was 65% (range 29-87%). Sixty nine percent (47-79%) of women favored circumcision for their partners, and 71% (50-90%) of men and 81% (70-90%) of women were willing to circumcise their sons. Because the level of acceptability across the nine countries was quite consistent, additional acceptability studies that pose hypothetical questions to participants are unnecessary. We recommend pilot interventions making safe circumcision services available in conjunction with current HIV prevention strategies and evaluating the safety and acceptability of circumcision.

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CERVICAL RIB*

1927-06-01

Alfred W. Adson , Jay R. Coffey

Rochester, Minn. 1SECTION ON NEUROLOGIC SURGERY, MAYO CLINIC 2FELLOW IN SURGERY, THE MAYO FOUNDATION Rochester, Minn. 1SECTION ON NEUROLOGIC SURGERY, MAYO CLINIC 2FELLOW IN SURGERY, THE MAYO FOUNDATION

PATIENTS WITH PENILE CARCINOMA BENEFIT FROM IMMEDIATE RESECTION OF CLINICALLY OCCULT LYMPH NODE METASTASES

2005-02-11

Bin K. Kroon , Simon Horenblas , Anne P. Lont +3 more

In this retrospective study we compared the clinical outcome of early vs delayed excision of lymph node metastases in patients with penile squamous cell carcinoma.A total of 40 patients with … In this retrospective study we compared the clinical outcome of early vs delayed excision of lymph node metastases in patients with penile squamous cell carcinoma.A total of 40 patients with a T2-3 penile carcinoma with lymph node metastases were included in this study. All patients initially presented with bilateral impalpable lymph nodes. In 20 patients (50%) metastases were removed when they became clinically apparent during meticulous followup (median interval 6 months, range 1 to 24). There were 20 patients (50%) who underwent resection of inguinal metastases detected on dynamic sentinel node biopsy before they became palpable. The histopathological characteristics of the tumors and lymph nodes were reevaluated.The 2 populations were similar in terms of patient age, T-stage, pathological tumor grade, vascular invasion and infiltration depth. Disease specific 3-year survival of patients with positive lymph nodes detected during surveillance was 35% and in those who underwent early resection, 84% (log rank p = 0.0017). In multivariate analysis early resection of occult inguinal metastases detected on dynamic sentinel node biopsy was an independent prognostic factor for disease specific survival (p = 0.006).Early resection of lymph node metastases in patients with penile carcinoma improves survival.

Sequential Changes of Plasma Proteins after Surgical Trauma

1972-01-01

K. F. Aronsen , G. Ekelund , Co. Kindmark +1 more

AbstractThe response of 18 plasma proteins after cholecystectomy has been followed up for 3 weeks. The acute phase reaction has been compared with that after mastectomy. The response to these … AbstractThe response of 18 plasma proteins after cholecystectomy has been followed up for 3 weeks. The acute phase reaction has been compared with that after mastectomy. The response to these tissue lesions were very similar but more intense after cholecystectomy. The finding suggest that a2-macroglobulin may be used as an internal standard since no apparent changes appear. The concentration decreases during the first few postoperative days for albumin, α-lipoproteins, transferrin and prealbumin. No common cause is probable. C-reactive protein and antichymotrypsin begin to rise within eight hours. One day later orosomucoid, fibrinogen, haptoglobin and α1-antitrypsin show a strong reaction. Hemopexin, β1c-globulin, prothrombin, ceruloplasmin, Gc-globulin, α1, easily precipitable glycoprotein, plasminogen and cold insoluble globulin showed a delayed reaction with a moderate increase within a week. The immunoglobulins show insignificant changes.Key Words: Mastectomycholecystectomyplasma proteinimmunochemical analysisacute phase reaction

Systematic review of human papillomavirus prevalence in invasive penile cancer

2008-12-10

Danielle M. Backes , Robert J. Kurman , Jeanne M. Pimenta +1 more

Circumcision for the prevention of urinary tract infection in boys: a systematic review of randomised trials and observational studies

2005-05-13

Davinder Singh‐Grewal

To undertake a meta-analysis of published data on the effect of circumcision on the risk of urinary tract infection (UTI) in boys.Randomised controlled trials and observational studies comparing the frequency … To undertake a meta-analysis of published data on the effect of circumcision on the risk of urinary tract infection (UTI) in boys.Randomised controlled trials and observational studies comparing the frequency of UTI in circumcised and uncircumcised boys were identified from the Cochrane controlled trials register, MEDLINE, EMBASE, reference lists of retrieved articles, and contact with known investigators.Two of the authors independently assessed study quality using the guidelines provided by the MOOSE statement for quality of observational studies. A random effects model was used to estimate a summary odds ratio (OR) with 95% confidence intervals (CI).Data on 402,908 children were identified from 12 studies (one randomised controlled trial, four cohort studies, and seven case-control studies). Circumcision was associated with a significantly reduced risk of UTI (OR = 0.13; 95% CI, 0.08 to 0.20; p<0.001) with the same odds ratio (0.13) for all three types of study design.Circumcision reduces the risk of UTI. Given a risk in normal boys of about 1%, the number-needed-to-treat to prevent one UTI is 111. In boys with recurrent UTI or high grade vesicoureteric reflux, the risk of UTI recurrence is 10% and 30% and the numbers-needed-to-treat are 11 and 4, respectively. Haemorrhage and infection are the commonest complications of circumcision, occurring at rate of about 2%. Assuming equal utility of benefits and harms, net clinical benefit is likely only in boys at high risk of UTI.

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Penile cancer: Importance of circumcision, human papillomavirus and smoking in <i>in situ</i> and invasive disease

2005-04-11

Janet R. Daling , Margaret M. Madeleine , Lisa Johnson +7 more

Abstract Few population‐based case‐control studies have assessed etiologic factors for penile cancer. Past infection with high‐risk human papillomavirus (HPV) is a known risk factor for penile cancer; however, few previous … Abstract Few population‐based case‐control studies have assessed etiologic factors for penile cancer. Past infection with high‐risk human papillomavirus (HPV) is a known risk factor for penile cancer; however, few previous studies have related the HPV DNA status of the tumor to potential demographic and behavioral risk factors for the disease or evaluated whether in situ and invasive penile cancer share risk factors. Little information is available on the role and timing of circumcision in the etiology of penile cancer. We conducted a population‐based case‐control study in western Washington state that included 137 men diagnosed with in situ ( n = 75) or invasive ( n = 62) penile cancer between January 1, 1979, and December 31, 1998, and 671 control men identified through random digit dialing. Cases and controls were interviewed in person and provided peripheral blood samples. Case and control blood samples were tested for antibodies to HPV16 and HSV‐2, and tumor specimens from cases were tested for HPV DNA. Men not circumcised during childhood were at increased risk of invasive (OR = 2.3, 95% CI 1.3–4.1) but not in situ (OR = 1.1, 95% CI 0.6–1.8) penile cancer. Approximately 35% of men with penile cancer who had not been circumcised in childhood reported a history of phimosis compared to 7.6% of controls (OR = 7.4, 95% CI 3.7–15.0). Penile conditions such as tear, rash and injury were associated with increased risk of disease. Among men not circumcised in childhood, phimosis was strongly associated with development of invasive penile cancer (OR = 11.4, 95% CI 5.0–25.9). When we restricted our analysis to men who did not have phimosis, the risk of invasive penile cancer associated with not having been circumcised in childhood was not elevated (OR = 0.5, 95% CI 0.1–2.5). Cigarette smoking was associated with a 4.5‐fold risk (95% CI 2.0–10.1) of invasive penile cancer. HPV DNA was detected in 79.8% of tumor specimens, and 69.1% of tumors were HPV16‐positive. The proportion of HPV DNA‐positive tumors did not vary by any risk factors evaluated. Many risk factors were common for both in situ and invasive disease. However, 3 factors that did not increase the risk for in situ cancer proved significant risk factors for invasive penile cancer: lack of circumcision during childhood, phimosis and cigarette smoking. The high percentage of HPV DNA‐positive tumors in our study is consistent with a strong association between HPV infection and the development of penile cancer regardless of circumcision status. Circumcision in early childhood may help prevent penile cancer by eliminating phimosis, a significant risk factor for the disease. © 2005 Wiley‐Liss, Inc.

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EAU Guidelines on Penile Cancer: 2014 Update

2014-11-01

Oliver W. Hakenberg , Éva Compérat , Suks Minhas +3 more

Extended Pelvic Lymphadenectomy In Patients Undergoing Radical Prostatectomy: High Incidence Of Lymph Node Metastasis

2002-04-01

Axel Heidenreich , Zoltán Varga , Rolf von Knobloch

Lymphadenectomy for prostate cancer is limited to obturator and external iliac lymph nodes, although the internal lymph nodes represent the primary landing zone of lymphatic drainage. We performed anatomically adequate … Lymphadenectomy for prostate cancer is limited to obturator and external iliac lymph nodes, although the internal lymph nodes represent the primary landing zone of lymphatic drainage. We performed anatomically adequate extended pelvic lymphadenectomy to assess the incidence of lymph node metastasis in cases of clinically localized prostate cancer.A total of 103 consecutive patients underwent extended pelvic lymphadenectomy at radical retropubic prostatectomy comprising 9 selective fields, namely the external iliac, internal iliac, obturator and common iliac lymph nodes bilaterally, and the presacral lymph nodes. Histopathological findings were compared with serum prostate specific antigen (PSA), histopathological stage, preoperative biopsy and postoperative prostatectomy Gleason score. Extended pelvic lymphadenectomy was compared with radical retropubic prostatectomy and standard lymphadenectomy in 100 consecutive patients in terms of complications, the number of lymph nodes dissected and operative time.There were no significant differences in age, preoperative PSA or mean biopsy Gleason score in patients who underwent extended pelvic and standard lymphadenectomy. Metastases were diagnosed in 27 of the 103 patients (26.2%) who underwent the extended procedure. A mean of 28 lymph nodes (range 21 to 42) were dissected. Metastases were identified in the internal iliac and presacral regions despite negative obturator lymph nodes. Of the 27 patients 1 to 3 lymph nodes involved with metastasis were detected in 15, 9 and 1, respectively. In 26 of the 27 patients (95.8%) with lymph node metastasis PSA was greater than 10.5 ng./ml. and preoperative biopsy Gleason sum was 7 or greater. A low risk of 2% for lymph node disease was noted in patients with serum PSA less than 10.5 ng./ml. and biopsy Gleason sum less than 7. There were no significant differences in regard to intraoperative and postoperative complications, lymphocele formation or blood loss in the 2 groups.Extended pelvic lymphadenectomy is associated with a high rate of lymph node metastasis outside of the fields of standard lymphadenectomy in cases of clinically localized prostate cancer. Lymphadenectomy including the internal iliac lymph nodes should be performed in all patients with prostate cancer who are at high risk for lymph node involvement, as indicated by PSA greater than 10.5 ng./ml. and biopsy Gleason sum 7 or greater. In the low risk group pelvic lymphadenectomy can be omitted.

Topical treatments for cutaneous warts

2012-09-04

Chun Shing Kwok , Sam Gibbs , Cathy Bennett +2 more

Forearm Flap in One-Stage Reconstruction of the Penis

1984-08-01

Ti-Sheng Chang , Wen-Yi Hwang

From the Department of Plastic and Reconstructive Surgery at the Shanghai Ninth People's Hospital and Shanghai Second Medical College. From the Department of Plastic and Reconstructive Surgery at the Shanghai Ninth People's Hospital and Shanghai Second Medical College.

Lichen sclerosus et atrophicus and autoimmunity—a study of 350 women

1988-01-01

Ranjeny Thomas , C M Ridley , D. McGibbon +1 more

A study of autoimmune related phenomena in 350 women with histologically confirmed lichen sclerosus et atrophicus revealed that 21.5% had one or more autoimmune related diseases, 21% had one or … A study of autoimmune related phenomena in 350 women with histologically confirmed lichen sclerosus et atrophicus revealed that 21.5% had one or more autoimmune related diseases, 21% had one or more first degree relatives with an autoimmune-related disease, 42% had an autoantibody at a titre greater than 1:20, and 59.5% had one or more of these autoimmune-related phenomena. No statistically significant differences in the natural history of lichen sclerosus et atrophicus were demonstrated between those patients with autoimmune-related phenomena and those without.

Surgical-pathologic variables predictive of local recurrence in squamous cell carcinoma of the vulva

1990-09-01

James M. Heaps , Yao Fu , Fredrick J. Montz +2 more

The age distribution of cancer and a multi-stage theory of carcinogenesis

2004-12-01

P. Armitage , Richard Doll

The theory that human cancer is the end-result of several successive cellular changes is tested by examining the age specific mortality rates for 17 types of cancer. On the supposition … The theory that human cancer is the end-result of several successive cellular changes is tested by examining the age specific mortality rates for 17 types of cancer. On the supposition that the carcinogenic factors responsible have remained approximately constant over the past 75 years, the rates for cancer of the oesophagus, stomach, colon, rectum and pancreas in men and for cancer of the stomach, colon, rectum and pancreas in women accord, in general, with the theory. The mortality rates for cancer of the lung, bladder and prostate in men and for cancer of the lung, breast, ovary and cervix and corpus uteri in women also accord with the theory, if it is postulated that the carcinogenic factors responsible have varied in strength. A formula has been obtained which can be used to weight the strengths of the carcinogenic factors at different periods and it is shown that the time when the strength of the factors responsible for the individual changes is of greatest importance varies according to which change in the series is affected. The conclusion provides a possible explanation for the observation that circumcision exerts an important protective effect against the development of cancer of the penis only if it be carried out early in life.

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An approach for the treatment of penile carcinoma

1977-02-01

Ramon M. Cabanas

One hundred cases were studied in detail using lymphangiograms (LAG), anatomic dissections, and/or microscopic evaluation. LAG performed via the dorsal lymphatics of the penis demonstrate the existence of specific lymph … One hundred cases were studied in detail using lymphangiograms (LAG), anatomic dissections, and/or microscopic evaluation. LAG performed via the dorsal lymphatics of the penis demonstrate the existence of specific lymph node center, the so-called sentinel lymph node (SLN). This appears to be the primary site of metastases from penile carcinoma. The SLN is visualized radio-graphically, on the antero-posterior view, at the junction of the femoral head and the ascending ramus of the pubis. Anatomically, the SLN is part of the lymphatic system around the superficial epigastric vein. Forty-six SLN biopsies were performed with 15 positve for metastatic disease. In these 15 patients, an inguinofemoroiliac dissection was performed; in 12 cases there was no involvement of other lymph nodes. Lymphatic channels draining into the iliac lymph nodes without first draining into the sentinel lymph node were never demonstrated, nor were the inguinal-femoral lymph nodes involved in the absence of SLN involvement. On this bases, we recommend preliminary bilateral SLN biopsy to be followed by inguinofemoroiliac dissection when biopsy of the SLN is positive. When biopsy of the SLN is negative for metastatic disease, no further sugical therapy is immediately indicated. With negative SLN, 5-year survival was 90%. When SLN alone was involved, 5-year survival was 70%. Five-year survival was 50% with both SLN and other inguinal nodes involved. When iliac metastases were also present, 3-year survival was 20%.

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The Cambridge encyclopedia of human paleopathology

1999-01-01

Arthur C. Aufderheide , Conrado Rodríguez-Martín , Odin Langsjoen

Preface Acknowledgements 1. History of paleopathology 2. Pseudopathology 3. Traumatic conditions 4. Congenital anomalies 5. Circulatory disorders 6. Joint diseases 7. Infectious diseases 8. Diseases of the viscera 9. Metabolic … Preface Acknowledgements 1. History of paleopathology 2. Pseudopathology 3. Traumatic conditions 4. Congenital anomalies 5. Circulatory disorders 6. Joint diseases 7. Infectious diseases 8. Diseases of the viscera 9. Metabolic diseases 10. Endocrine disorders 11. Hematological disorders 12. Skeletal dysplasias 13. Neoplastic conditions 14. Diseases of the dentition Odin Langsjoen 15. Miscellaneous conditions References Index.

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History of Circumcision, Medical Conditions, and Sexual Activity and Risk of Penile Cancer

1993-01-06

Christopher Maden , Karen J. Sherman , Anna Marie Beckmann +4 more

Background : Epidemiological evidence suggests lack of neonatal circumcision as the strongest risk factor for penile cancer, but the role of sexually transmitted diseases in the etiology of penile cancer … Background : Epidemiological evidence suggests lack of neonatal circumcision as the strongest risk factor for penile cancer, but the role of sexually transmitted diseases in the etiology of penile cancer has remained unclear. Purpose : To further clarify risk factors for penile cancer, we examined the role of circumcision, personal characteristics and habits (such as smoking), sexually transmitted diseases, past sexual activity, and medical conditions of the penis. Methods : A population based, case-control study was conducted in western Washington state and in the province of British Columbia. We interviewed 110 men with penile cancer diagnosed from January 1979 to July 1990 and 355 control subjects from the general population, frequency matched to case subjects on age and date of diagnosis. Tumor tissue from 67 case subjects was tested for human papillomavirus (HPV) DNA by polymerase chain reaction. Results of blood tests from 69 case subjects and 208 control subjects were available for study. Statistically Significant Results : Relative to men circumcised at birth, the risk for penile cancer was 3.2 times greater among men who were never circumcised and 3.0 times greater among men who were circumcised after the neonatal period. For current smokers, the risk was 2.8 times that of men who never smoked. The risk among men reporting a history of genital warts was 5.9 times that of men reporting no such history. Of 67 tumors tested for HPV DNA, 49% were positive; the majority of these positive tumors (70%) were type 16, which has been associated with anogenital carcinoma. Relative risks (RRs) associated with a reported history of penile rash or penile tear were 9.4 and 3.9, respectively. Among men not circumcised at birth, RRs associated with presence of smegma and difficulty in retracting the foreskin were 2.1 and 3.5, respectively. Twenty-eight percent of case subjects, compared with only 10% of control subjects, reported 30 or more sexual partners, and men with HPV. positive tumors were more likely to report a greater number of sexual partners. Conclusions : These results suggest that the absence of neonatal circumcision and potential resulting complications are associated with penile cancer. Additionally, medical conditions of the penis, sexual activity, infection with HPV, and smoking may increase the risk for penile cancer. Implications : A larger study would allow examination of interrelationships of circumcision, infection with HPV, and smoking as risk factors. [J Natl Cancer Inst 85:19–24, 1993]

Male Circumcision, Penile Human Papillomavirus Infection, and Cervical Cancer in Female Partners

2002-04-11

Xavier Castellsagué , F. Xavier Bosch , Núbia Muñóz +7 more

It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner. It is uncertain whether male circumcision reduces the risks of penile human papillomavirus (HPV) infection in the man and of cervical cancer in his female partner.

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Diagnosis and Treatment of Lichen Sclerosus

2012-12-14

Susanna K. Fistarol , Peter Itin

Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant … Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. The role for Borrelia is still controversial. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical calcineurin inhibitors are discussed as alternatives in the treatment of LS in patients who have failed therapy with ultrapotent corticosteroids, or who have a contraindication for the use of corticosteroids. Topical and systemic retinoids may be useful in selected cases. Phototherapy for extragenital LS and photodynamic therapy for genital LS may be therapeutic options in rare cases refractory to the already mentioned treatment. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. This review updates the epidemiology, clinical presentation, histopathology, pathogenesis, and management of LS of the female and male genitals and extragenital LS in adults and children.

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Complications of circumcision in male neonates, infants and children: a systematic review

2010-02-16

Helen A. Weiss , Natasha Larke , Daniel T. Halperin +1 more

Approximately one in three men are circumcised globally, but there are relatively few data on the safety of the procedure. The aim of this paper is to summarize the literature … Approximately one in three men are circumcised globally, but there are relatively few data on the safety of the procedure. The aim of this paper is to summarize the literature on frequency of adverse events following pediatric circumcision, with a focus on developing countries.

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Neoadjuvant Paclitaxel, Ifosfamide, and Cisplatin Chemotherapy for Metastatic Penile Cancer: A Phase II Study

2010-07-13

Lance C. Pagliaro , Dallas Williams , Danai Daliani +6 more

Men with penile squamous cell carcinoma and regional lymph node involvement have a low probability of survival with lymphadenectomy alone. A multimodal approach to treatment is desirable for such patients. … Men with penile squamous cell carcinoma and regional lymph node involvement have a low probability of survival with lymphadenectomy alone. A multimodal approach to treatment is desirable for such patients. We performed a phase II study of neoadjuvant chemotherapy with the objective of determining the response rate, time to progression (TTP), and overall survival (OS) among patients with bulky adenopathy.Eligible patients had stage N2 or N3 (stage III or stage IV) penile cancer without distant metastases. Neoadjuvant treatment (four courses every 3-4 weeks) consisted of paclitaxel 175 mg/m(2) administered over 3 hours on day 1; ifosfamide 1,200 mg/m(2) on days 1 to 3; and cisplatin 25 mg/m(2) on days 1 to 3. Clinical and pathologic responses were assessed, and patient groups were compared for TTP and OS.Thirty men received chemotherapy of whom 15 (50.0%) had an objective response and 22 (73.3%) subsequently underwent surgery. Three patients had no remaining tumor on histopathology. Nine patients (30.0%) remained alive and free of recurrence (median follow-up, 34 months; range, 14-59 months), and two patients died of other causes without recurrence. Improved TTP and OS were significantly associated with a response to chemotherapy (P < .001 and P = .001, respectively), absence of bilateral residual tumor (P = .002 and P = .017, respectively), and absence of extranodal extension (P = .001 and P = .004, respectively) or skin involvement (P = .009 and P = .012, respectively).The neoadjuvant regimen of paclitaxel, ifosfamide, and cisplatin induced clinically meaningful responses in patients with bulky regional lymph node metastases from penile cancer.

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Efficacy of Nonoxynol 9 Contraceptive Sponge Use in Preventing Heterosexual Acquisition of HIV in Nairobi Prostitutes

1992-07-22

Joan K. Kreiss

<h3>Objective.</h3> —To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). <h3>Design.</h3> —Prospective, randomized placebo-controlled trial. <h3>Setting.</h3> —Research clinic for … <h3>Objective.</h3> —To determine the efficacy of the nonoxynol 9 contraceptive sponge in preventing sexual acquisition of the human immunodeficiency virus (HIV). <h3>Design.</h3> —Prospective, randomized placebo-controlled trial. <h3>Setting.</h3> —Research clinic for prostitutes in Nairobi, Kenya. <h3>Patients and Interventions.</h3> —One hundred thirty-eight HIV-seronegative women were enrolled, of whom 74 were assigned to nonoxynol 9 sponge use and 64 to placebo use. These two groups did not significantly differ with respect to demographic characteristics, sexual practices, or prevalence of genital infections at enrollment, except for a lower number of sex partners per week and a higher initial prevalence of genital ulcers among women assigned to nonoxynol 9 sponge use. Among the 116 women who returned for follow-up, the mean durations of follow-up were 14 and 17 months for the two groups, respectively. <h3>Main Outcome Measure.</h3> —HIV seroconversion. <h3>Results.</h3> —Nonoxynol 9 sponge use was associated with an increased frequency of genital ulcers (relative risk [RR], 3.3;<i>P</i><.0001) and vulvitis (RR, 3.3;<i>P</i><.0001) and a reduced risk of gonococcal cervicitis (RR, 0.4;<i>P</i><.0001). Twenty-seven (45%) of 60 women in the nonoxynol 9 sponge group and 20 (36%) of 56 women in the placebo group developed HIV antibodies. The hazard ratio for the association between nonoxynol 9 sponge use and HIV seroconversion was 1.7 (95% confidence interval [CI], 0.9 to 3.0). Using multivariate analysis to control for the presence of genital ulcers at enrollment, the adjusted hazard ratio for the association between nonoxynol 9 sponge use and seroconversion was 1.6 (95% CI, 0.8 to 2.8). <h3>Conclusions.</h3> —Genital ulcers and vulvitis occurred with increased frequency in nonoxynol 9 sponge users. We were unable to demonstrate that nonoxynol 9 sponge use was effective in reducing the risk of HIV infection among highly exposed women. (<i>JAMA</i>. 1992;268:477-482)

The Human Papillomavirus Infection in Men Study: Human Papillomavirus Prevalence and Type Distribution among Men Residing in Brazil, Mexico, and the United States

2008-08-01

Anna R. Giuliano , Eduardo Lazcano‐Ponce , Luisa L. Villa +7 more

Abstract Male sexual behavior influences the rates of cervical dysplasia and invasive cervical cancer, as well as male human papillomavirus (HPV) infection and disease. Unfortunately, little is known regarding male … Abstract Male sexual behavior influences the rates of cervical dysplasia and invasive cervical cancer, as well as male human papillomavirus (HPV) infection and disease. Unfortunately, little is known regarding male HPV type distribution by age and across countries. In samples combined from the coronal sulcus, glans penis, shaft, and scrotum of 1,160 men from Brazil, Mexico, and the United States, overall HPV prevalence was 65.2%, with 12.0% oncogenic types only, 20.7% nononcogenic types only, 17.8% both oncogenic and nononcogenic, and 14.7% unclassified infections. Multiple HPV types were detected in 25.7% of study participants. HPV prevalence was higher in Brazil (72.3%) than in the United States (61.3%) and Mexico (61.9%). HPV16 (6.5%), HPV51 (5.3%), and HPV59 (5.3%) were the most commonly detected oncogenic infections, and HPV84 (7.7%), HPV62 (7.3%), and HPV6 (6.6%) were the most commonly detected nononcogenic infections. Overall HPV prevalence was not associated with age. However, significant associations with age were observed when specific categories of HPV, nononcogenic, and unclassified HPV infections were considered. Studies of HPV type distribution among a broad age range of men from multiple countries is needed to fill the information gap internationally with respect to our knowledge of HPV infection in men. (Cancer Epidemiol Biomarkers Prev 2008;17(8):2036–43)

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Circumcision Policy Statement

2012-08-28

Susan Blank , Michael T. Brady , Ellen Buerk +5 more

Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of … Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.

Male circumcision and risk of syphilis, chancroid, and genital herpes: a systematic review and meta-analysis

2006-03-30

Helen A. Weiss , Samantha Thomas , S K Munabi +1 more

<b>Objectives:</b> Male circumcision is associated with reduced risk of HIV infection. This may be partly because of a protective effect of circumcision on other sexually transmitted infections (STI), especially those … <b>Objectives:</b> Male circumcision is associated with reduced risk of HIV infection. This may be partly because of a protective effect of circumcision on other sexually transmitted infections (STI), especially those causing genital ulcers, but evidence for such protection is unclear. Our objective was to conduct a systematic review and meta-analyses of the associations between male circumcision and infection with herpes simplex virus type 2 (HSV-2), <i>Treponema pallidum</i>, or <i>Haemophilus ducreyi</i>. <b>Methods:</b> Electronic databases (1950–2004) were searched using keywords and text terms for herpes simplex, syphilis, chancroid, ulcerative sexually transmitted diseases, or their causative agents, in conjunction with terms to identify epidemiological studies. References of key articles were hand searched, and data were extracted using standardised forms. Random effects models were used to summarise relative risk (RR) where appropriate. <b>Results:</b> 26 articles met the inclusion criteria. Most syphilis studies reported a substantially reduced risk among circumcised men (summary RR = 0.67, 95% confidence interval (CI) 0.54 to 0.83), although there was significant between study heterogeneity (p = 0.01). The reduced risk of HSV-2 infection was of borderline statistical significance (summary RR = 0.88, 95% CI 0.77 to 1.01). Circumcised men were at lower risk of chancroid in six of seven studies (individual study RRs: 0.12 to 1.11). <b>Conclusions:</b> This first systematic review of male circumcision and ulcerative STI strongly indicates that circumcised men are at lower risk of chancroid and syphilis. There is less association with HSV-2. Potential male circumcision interventions to reduce HIV in high risk populations may provide additional benefit by protecting against other STI.

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EAU Guidelines on Penile Cancer

2004-04-22

E. Gratacós , Ferrán Algaba , Simon Horenblas +2 more

Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial

2005-10-18

Bertran Auvert , Dirk Taljaard , Emmanuel Lagarde +3 more

Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis.A … Observational studies suggest that male circumcision may provide protection against HIV-1 infection. A randomized, controlled intervention trial was conducted in a general population of South Africa to test this hypothesis.A total of 3,274 uncircumcised men, aged 18-24 y, were randomized to a control or an intervention group with follow-up visits at months 3, 12, and 21. Male circumcision was offered to the intervention group immediately after randomization and to the control group at the end of the follow-up. The grouped censored data were analyzed in intention-to-treat, univariate and multivariate, analyses, using piecewise exponential, proportional hazards models. Rate ratios (RR) of HIV incidence were determined with 95% CI. Protection against HIV infection was calculated as 1 - RR. The trial was stopped at the interim analysis, and the mean (interquartile range) follow-up was 18.1 mo (13.0-21.0) when the data were analyzed. There were 20 HIV infections (incidence rate = 0.85 per 100 person-years) in the intervention group and 49 (2.1 per 100 person-years) in the control group, corresponding to an RR of 0.40 (95% CI: 0.24%-0.68%; p < 0.001). This RR corresponds to a protection of 60% (95% CI: 32%-76%). When controlling for behavioural factors, including sexual behaviour that increased slightly in the intervention group, condom use, and health-seeking behaviour, the protection was of 61% (95% CI: 34%-77%).Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa. (Preliminary and partial results were presented at the International AIDS Society 2005 Conference, on 26 July 2005, in Rio de Janeiro, Brazil.).

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EAU Penile Cancer Guidelines 2009

2010-02-05

Giorgio Pizzocaro , Ferrán Algaba , Simon Horenblas +4 more

A Multinational Population Survey of Intravaginal Ejaculation Latency Time

2005-06-15

Marcel D. Waldinger , Paul Quinn , Maria Dilleen +3 more

Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomised controlled trial

2007-02-01

Robin L. Bailey , Stephen Moses , Corette B. Parker +6 more

Male circumcision for HIV prevention in men in Rakai, Uganda: a randomised trial

2007-02-01

Ronald H. Gray , Godfrey Kigozi , David Serwadda +7 more

The Potential Impact of Male Circumcision on HIV in Sub-Saharan Africa

2006-07-06

Brian Williams , James O. Lloyd‐Smith , Eleanor Gouws +6 more

Background A randomized controlled trial (RCT) has shown that male circumcision (MC) reduces sexual transmission of HIV from women to men by 60% (32%−76%; 95% CI) offering an intervention of … Background A randomized controlled trial (RCT) has shown that male circumcision (MC) reduces sexual transmission of HIV from women to men by 60% (32%−76%; 95% CI) offering an intervention of proven efficacy for reducing the sexual spread of HIV. We explore the implications of this finding for the promotion of MC as a public health intervention to control HIV in sub-Saharan Africa. Methods and Findings Using dynamical simulation models we consider the impact of MC on the relative prevalence of HIV in men and women and in circumcised and uncircumcised men. Using country level data on HIV prevalence and MC, we estimate the impact of increasing MC coverage on HIV incidence, HIV prevalence, and HIV-related deaths over the next ten, twenty, and thirty years in sub-Saharan Africa. Assuming that full coverage of MC is achieved over the next ten years, we consider three scenarios in which the reduction in transmission is given by the best estimate and the upper and lower 95% confidence limits of the reduction in transmission observed in the RCT. MC could avert 2.0 (1.1−3.8) million new HIV infections and 0.3 (0.1−0.5) million deaths over the next ten years in sub-Saharan Africa. In the ten years after that, it could avert a further 3.7 (1.9−7.5) million new HIV infections and 2.7 (1.5−5.3) million deaths, with about one quarter of all the incident cases prevented and the deaths averted occurring in South Africa. We show that a) MC will increase the proportion of infected people who are women from about 52% to 58%; b) where there is homogenous mixing but not all men are circumcised, the prevalence of infection in circumcised men is likely to be about 80% of that in uncircumcised men; c) MC is equivalent to an intervention, such as a vaccine or increased condom use, that reduces transmission in both directions by 37%. Conclusions This analysis is based on the result of just one RCT, but if the results of that trial are confirmed we suggest that MC could substantially reduce the burden of HIV in Africa, especially in southern Africa where the prevalence of MC is low and the prevalence of HIV is high. While the protective benefit to HIV-negative men will be immediate, the full impact of MC on HIV-related illness and death will only be apparent in ten to twenty years.

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British Association of Dermatologists’ guidelines for the management of lichen sclerosus 2010

2010-09-20

S. M. Neill , Fiona M. Lewis , F.M. Tatnall +1 more

One of the aims of the British Association of Dermatologists (BAD) is to provide guidelines for the management of skin diseases using all available good-quality evidence-based data.][3] These guidelines for … One of the aims of the British Association of Dermatologists (BAD) is to provide guidelines for the management of skin diseases using all available good-quality evidence-based data.][3] These guidelines for the management of lichen sclerosus (LS) have been prepared for dermatologists on behalf of the BAD.They present evidence-based guidance for investigation and treatment, with identification of the strength of evidence available at the time of preparation of the guidelines.NHS Evidence has accredited the process used by the British Association of Dermatologists to produce guidelines.Accreditation is valid for 3 years from May 2010 and is applicable to guidance produced using the processes described in the British Association of Dermatologists' guidelines development manual (Bell & Ormerod, 2009).

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Male circumcision for prevention of heterosexual acquisition of HIV in men

2009-04-15

Nandi Siegfried , Martie Muller , Jonathan J Deeks +1 more

Male Circumcision for the Prevention of HSV-2 and HPV Infections and Syphilis

2009-03-25

Aaron A.R. Tobian , David Serwadda , Thomas C. Quinn +7 more

Male circumcision significantly reduced the incidence of human immunodeficiency virus (HIV) infection among men in three clinical trials. We assessed the efficacy of male circumcision for the prevention of herpes … Male circumcision significantly reduced the incidence of human immunodeficiency virus (HIV) infection among men in three clinical trials. We assessed the efficacy of male circumcision for the prevention of herpes simplex virus type 2 (HSV-2) and human papillomavirus (HPV) infections and syphilis in HIV-negative adolescent boys and men.We enrolled 5534 HIV-negative, uncircumcised male subjects between the ages of 15 and 49 years in two trials of male circumcision for the prevention of HIV and other sexually transmitted infections. Of these subjects, 3393 (61.3%) were HSV-2-seronegative at enrollment. Of the seronegative subjects, 1684 had been randomly assigned to undergo immediate circumcision (intervention group) and 1709 to undergo circumcision after 24 months (control group). At baseline and at 6, 12, and 24 months, we tested subjects for HSV-2 and HIV infection and syphilis, along with performing physical examinations and conducting interviews. In addition, we evaluated a subgroup of subjects for HPV infection at baseline and at 24 months.At 24 months, the cumulative probability of HSV-2 seroconversion was 7.8% in the intervention group and 10.3% in the control group (adjusted hazard ratio in the intervention group, 0.72; 95% confidence interval [CI], 0.56 to 0.92; P=0.008). The prevalence of high-risk HPV genotypes was 18.0% in the intervention group and 27.9% in the control group (adjusted risk ratio, 0.65; 95% CI, 0.46 to 0.90; P=0.009). However, no significant difference between the two study groups was observed in the incidence of syphilis (adjusted hazard ratio, 1.10; 95% CI, 0.75 to 1.65; P=0.44).In addition to decreasing the incidence of HIV infection, male circumcision significantly reduced the incidence of HSV-2 infection and the prevalence of HPV infection, findings that underscore the potential public health benefits of the procedure. (ClinicalTrials.gov numbers, NCT00425984 and NCT00124878.)

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Latent Papillomavirus and Recurring Genital Warts

1985-09-26

Alex Ferenczy , Masaru Mitao , Nobutaka Nagai +2 more

After anogenital condylomata and intraepithelial neoplasms are removed, they frequently recur. Since these lesions are related to papillomaviruses, it has been suggested that latent papillomavirus infection is responsible for recurrence. … After anogenital condylomata and intraepithelial neoplasms are removed, they frequently recur. Since these lesions are related to papillomaviruses, it has been suggested that latent papillomavirus infection is responsible for recurrence. We studied 20 cases of anogenital lesions that were treated by laser therapy and analyzed biopsy specimens of margins of normal skin adjacent to the lesions for papillomavirus sequences by Southern blot hybridization. In nine cases (45 per cent), papillomavirus sequences were detected in the normal skin margin; lesions recurred in 6 of the 9 patients (67 per cent), in contrast to only 1 of 11 patients (9 per cent) whose margins were negative for the presence of papillomavirus sequences. All but one recurrence developed within 15 mm of the treatment area. Our results demonstrate that clinically and histologically latent papillomavirus exists beyond the treatment area and that its presence influences subsequent recurrences.

Circumcision Policy Statement

1999-03-01

Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits … Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided.

Lichen sclerosus

1999-05-01

JJ Powell , Fenella Wojnarowska

Classification of platelet concentrates (Platelet-Rich Plasma-PRP, Platelet-Rich Fibrin-PRF) for topical and infiltrative use in orthopedic and sports medicine: current consensus, clinical implications and perspectives

2019-01-01

David M. Dohan Ehrenfest , Isabel Andı́a , Matthias A. Zumstein +3 more

Platelet concentrates for topical and infiltrative use -commonly termedPlatetet-Rich Plasma (PRP) or Platelet-Rich Fibrin (PRF) -are used or tested as surgical adjuvants or regenerative medicine preparations in most medical fields, … Platelet concentrates for topical and infiltrative use -commonly termedPlatetet-Rich Plasma (PRP) or Platelet-Rich Fibrin (PRF) -are used or tested as surgical adjuvants or regenerative medicine preparations in most medical fields, particularly in sports medicine and orthopaedic surgery.Even if these products offer interesting therapeutic perspectives, their clinical relevance is largely debated, as the literature on the topic is often confused and contradictory.The long history of these products was always associated with confusions, mostly related to the lack of consensual terminology, characterization and classification of the many products that were tested in the last 40 years.The current consensus is based on a simple classification system dividing the many products in 4 main families, based on their fibrin architecture and cell content: Pure Platelet-Rich Plasma (P-PRP), such as the PRGF-Endoret technique; Leukocyte-and Platelet-Rich Plasma (L-PRP), such as Biomet GPS system; Pure Platelet-Rich Fibrin (P-PRF), such as Fibrinet; Leukocyteand Platelet-Rich Fibrin (L-PRF), such as Intra-Spin L-PRF.The 4 main families of products present different biological signatures and mechanisms, and obvious differences for clinical applications.This classification serves as a basis for further investigations of the effects of these products.Perspectives of evolutions of this classification and terminology are also discussed, particularly concerning the impact of the cell content, preservation and activation on these products in sports medicine and orthopaedics.

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Über Lipoidgranulomatose

1930-12-01

W. Chester

Video endoscopic inguinal lymphadenectomy for nodal management in penile squamous cell carcinoma

2025-06-25

N I Bhuiyan , Md Hasibul Islam , Mohammad Ali Arafat +3 more | Bangladesh Journal of Urology

Background: Important prognostic factor in penile cancer is Inguinal lymph node involvement. Inguinal lymph node dissection allows staging and treatment of inguinal nodal disease. Inguinal lymph node dissection causes morbidity … Background: Important prognostic factor in penile cancer is Inguinal lymph node involvement. Inguinal lymph node dissection allows staging and treatment of inguinal nodal disease. Inguinal lymph node dissection causes morbidity and is associated with complications, such as lymphocele, skin loss and infection. Video Endoscopic Inguinal Lymphadenectomy (VEIL) is an endoscopic procedure, and it seems to be a new and attractive approach duplicating the standard open procedure with less morbidity. We present here a critical perioperative assessment with points of technique. Methods: Five patients with moderate to high grade penile carcinoma with clinically negative inguinal lymph nodes were subjected to elective VEIL. All VEIL were performed at department of urology, square hospital from 2020 to 2024.VEIL was done in standard surgical steps. Perioperative parameters were assessed that is - duration of the surgery, lymph-related complications, time until drain removal, lymph node yield, surgical emphysema and histopathological positivity of lymph nodes. Results: Operative time for VEIL was 150 to 210 minutes. Lymph node yield was 7 to 12 lymph nodes. No skin related complications were seen with VEIL. Lymph related complications, that is, lymphocele, were seen in only one patient. The suction drain was removed after four to eight days (mean 5.1). Overall morbidity was 20% with VEIL. Conclusion: VEIL is a safe and feasible technique in patients with penile carcinoma with non palpable inguinal lymph nodes. It allows the removal of inguinal lymph nodes within the same limits as in conventional surgical dissection and potentially reduces surgical morbidity. Bangladesh J. Urol. 2025; 28(1): 3-9

Use of Nemolizumab in Refractory Scrotal Dysesthesia

2025-06-25

Walter Liszewski | JAMA Dermatology

This case report describes 2 patients with refractory scrotal dysesthesia treated with nemolizumab. This case report describes 2 patients with refractory scrotal dysesthesia treated with nemolizumab.

Bilateral Symmetric Tender Nodules on Elbows and Feet: Challenge

2025-06-25

José A. L. Calbet , María Concepción Campos Mármol | American Journal of Dermatopathology

Clinical Aspects and Reflections on Patau Syndrome: A Literature Review

2025-06-24

Maria Eduarda Borsari Rodrigues , Aline Brandão Queiroz Pratis , Kathelen Luana Nunes Bertoldo +2 more | Revista de Gestão Social e Ambiental

Objective: This study aimed to inform and raise awareness about Patau syndrome, emphasizing the importance of early diagnosis, appropriate treatment, and the ethical reflections related to medical interventions in affected … Objective: This study aimed to inform and raise awareness about Patau syndrome, emphasizing the importance of early diagnosis, appropriate treatment, and the ethical reflections related to medical interventions in affected neonates. Theoretical Framework: Patau syndrome is a genetic disorder characterized by trisomy of chromosome 13, associated with severe congenital malformations, high intrauterine mortality, and low postnatal survival, with an increasing incidence correlated with advanced maternal age. Method: A narrative literature review was conducted, selecting open-access articles published in databases such as SciELO, PubMed, and Brazilian health journals, addressing etiological, diagnostic, therapeutic, and bioethical aspects of the syndrome. Results and Discussion: Data showed that early diagnostic suspicion can arise through ultrasonographic findings, confirmed by amniocentesis. However, there is a significant scarcity of specific research on Patau syndrome, hindering the development of standardized clinical protocols. Moreover, the literature reveals an important ethical debate concerning medical interventions, given the poor prognosis and the potential for prolonging neonatal suffering. Research Implications: Early detection enables more humane management, reduces family distress, and promotes essential bioethical reflections regarding patient care. Originality/Value: This review contributes by highlighting gaps in the literature, encouraging further research, and reinforcing the need for greater awareness about the importance of appropriate diagnosis and management of Patau syndrome.

Investigating the Factors Influencing Traditional Male Circumcision and Its Contribution to HIV Transmission Amongst Men in Lesotho: A Multilevel Binary Logistic Regression Approach

2025-06-24

Sizwe Vincent Mbona , Anisha Ananth , Retius Chifurira | International Journal of Environmental Research and Public Health

Background: Traditional Male Circumcision (TMC) has been practiced in many parts of the world. However, the impact thereof on reducing HIV transmission is still unclear. This study aimed to examine … Background: Traditional Male Circumcision (TMC) has been practiced in many parts of the world. However, the impact thereof on reducing HIV transmission is still unclear. This study aimed to examine the prevalence and determinants of TMC and the associated risk of HIV transmission in Lesotho. Method: Using data from the 2023–24 Lesotho Demographic and Health Survey, the analysis included a weighted sample of 3202 men aged 15–59 years. Missing data was addressed through multiple imputations, and multilevel logistic regression was used to assess the factors associated with TMC, incorporating intra-class correlation to evaluate cluster-level variation. Results: The findings revealed that 51.0% (95% CI: 49.3–52.7) of men in Lesotho had undergone TMC. Older men, particularly those aged 35 years and above, were more likely to be circumcised compared to younger men aged 15–24 years (AOR = 1.63; 95% CI: 1.46–1.86). Other individual-level factors positively associated with TMC included smoking, being married to one partner, previous sexual experience, and rural residence. Conversely, men with formal education, unknown or undisclosed HIV status, residing in the Berea or Maseru districts, and those from middle- or high-income households were less likely to undergo TMC. Conclusion: The study highlights significant variation in TMC practices across communities and identifies both individual and contextual factors influencing its uptake. These insights underscore the need for culturally sensitive, voluntary, and medically safe circumcision programs. Public health initiatives should consider these determinants when designing interventions to ensure a safer and more effective implementation of TMC in Lesotho.

Melanoma vulvar en pediatría. Reporte de caso

2025-06-24

Jennifer A. Obregón-García , Ángel C. Corzo-Centeno , Carolina E. Sánchez-López | Boletín Médico del Hospital Infantil de México

Routine Histological Examination of Prepuce in Pathological Phimosis: A Recommended Sustainable Practice

2025-06-24

Ramanathan Raju , Ankita Sharma , Kiran Mahadevappa +3 more | Cureus

Eritema nodoso, una sfida per il pediatra

2025-06-23

M.F. Catalano , Maria Cristina Memoli , Davide Tambaro +6 more | Medico e Bambino pagine elettroniche

The paper reports the case of a 9-year-old girl presenting with bloody diarrhoea, fever and pretibial nodular lesions suggestive of erythema nodosum and arthritis of the left wrist and fingers. … The paper reports the case of a 9-year-old girl presenting with bloody diarrhoea, fever and pretibial nodular lesions suggestive of erythema nodosum and arthritis of the left wrist and fingers. Initial investigations were inconclusive, but faecal calprotectin was >3.000 mg/kg. Ileocolonoscopy confirmed a diagnosis of colonic Crohn’s disease. Treatment with adalimumab led to full clinical and cutaneous remission. This case highlights erythema nodosum as a potential early extraintestinal manifestation of inflammatory bowel disease.

Unveiling the Mysterious Plasma Cell Lesions of Oral Cavity: A 13-year Institutional Experience

2025-06-23

Akanksha Gupta , Anju Devi , Anjali Narwal +1 more | Journal of Maxillofacial and Oral Surgery

Association between high-risk HPV prevalence and circumcision status among sexually experienced adult males, 2013–2016, United States

2025-06-23

Rayleen M. Lewis , Sarah Brewer , Julia W. Gargano +3 more | Sexually Transmitted Diseases

Randomized control trials in sub-Saharan countries found male circumcision may prevent high-risk human papillomavirus (HR-HPV) acquisition. Using 2013-2016 National Health and Nutrition Examination Survey data, we explored the association between … Randomized control trials in sub-Saharan countries found male circumcision may prevent high-risk human papillomavirus (HR-HPV) acquisition. Using 2013-2016 National Health and Nutrition Examination Survey data, we explored the association between circumcision and HR-HPV among sexually experienced 18-59-year-old males. Self-collected penile specimens were tested for HPV DNA. We estimated weighted HR-HPV prevalence (positivity to ≥1 HR type: HPV16/18/31/33/35/39/45/51/52/56/58/59/66/68) by circumcision status. The association between circumcision and HR-HPV was assessed using multivariable logistic regression models. Effect modification by circumcision on the association between number of lifetime sex partners and HR-HPV was explored. Overall, 77.7% of males reported being circumcised, with large variation by race/ethnicity and country of birth. HR-HPV prevalence was significantly higher among circumcised (25.7%) than uncircumcised (20.4%) males; this was attenuated after adjustment for lifetime and new past-year sex partners (adjusted prevalence ratio: 1.10, 95%CI: 0.92-1.32). There was evidence circumcision modified the association between lifetime partners and HR-HPV, but HR-HPV prevalence increased with increasing number of partners in circumcised and uncircumcised males. Our observed lack of statistical association between circumcision and HR-HPV may differ from randomized trial results due to the differences between circumcised and uncircumcised males or differences in anatomic site sampled or timing of circumcision.

Evaluating follow‐up in patients with lymph node‐negative penile cancer at a high‐volume centre

2025-06-23

Manon Vreeburg , Gerben M. Vaessen , Hielke M. de Vries +7 more | BJU International

To evaluate the current European Association of Urology/American Society of Clinical Oncology follow-up (FU) schedule with routine use of ultrasonography (US) ± US-guided fine-needle aspiration cytology (FNAC) in patients with … To evaluate the current European Association of Urology/American Society of Clinical Oncology follow-up (FU) schedule with routine use of ultrasonography (US) ± US-guided fine-needle aspiration cytology (FNAC) in patients with lymph node (LN)-negative penile squamous cell carcinoma (PSCC). We evaluated FU outcomes for low-risk clinically LN-negative (cN0) and intermediate- to high-risk sentinel node (SN) negative (pathological N-stage [pN]0) patients with PSCC at a high-volume centre. We analysed routine inguinal US ± FNAC (in case of a suspicious LN) during FU. A competing risk analysis was performed to calculate the cumulative risk of LN metastases in these groups, with local recurrence as competing risk. A total of 201 patients with PSCC were analysed, with 2694 inguinal US investigations being evaluated. FNAC was performed during 270 US procedures (10.0%). A LN metastasis was found in four of 270 US + FNAC procedures (1.5%, 0.2% of all US). All tumours were intermediate- to high-risk tumours. Three occurred within the first year after primary treatment, and one at 20 months. The cumulative risk of developing LN metastases in cN0 low-risk tumours was 0% (no events occurred) and in SN-negative intermediate- to high-risk group 2.0%, both at 1 year of FU. Two (out of four) patients with LN recurrence died from disease. After adequate staging and treatment, patients with cN0/pN0 PSCC rarely develop LN metastasis during FU. As these metastases generally occur within 1 year after treatment, we recommend (3-monthly) routine inguinal US only during the first year of FU. Thereafter, the frequency of FU visits and examinations can be reduced in patients capable of self-examination of the penis, resulting in a substantial (up to a 50%) reduction of FU visits compared to current guideline recommendations.

Phalloplasty in Children with Severe Penile Tissue Loss: Single Center Case Series

2025-06-22

Gökhan Demirtaş , Süleyman Tağcı , Derya Yayla +4 more | Medicina

Background and Objectives: Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. … Background and Objectives: Penile tissue loss, which can be an acquired condition due to trauma or infection, but is also seen in congenital anomalies, is a rare condition in children. A standard surgical approach is often not possible due to the different degrees and etiologies of penile tissue loss. The continuing growth and the presence of various congenital anomalies in children require a different penile reconstruction approach than in adults. We aimed to share our experience and surgical results with children in whom we performed penile reconstruction with different techniques due to penile tissue loss. Materials and Methods: Ten cases that underwent penile reconstruction between 2018 and 2023 were evaluated retrospectively. Age at initial operation, associated anomalies, surgical technique, and other related surgical attempts, as well as functional and cosmetic results, were recorded. Results: Ten boys aged between 6 months and 17 years underwent phalloplasty due to penile tissue absence. In six cases, penile tissue loss was due to acquired causes, and in four cases, congenital anomalies were the reason. The most common cause of penile tissue loss was circumcision complications. In four cases, penile reconstruction was achieved by mobilization of the remaining corpus cavernosum tissues, in two cases, the cavernous tissue was adequate and repaired with glansplasty and penile skin graft. Phalloplasty was performed by tubularization of a skin and subcutaneous fat flap, removed from the pubic region and scrotal region, in two cases. A microvascular radial forearm flap was performed in a 17-year-old patient with penile tissue loss because of trauma, and a free skin flap taken from the forearm was used for penile reconstruction. Thirty percent of patients required a second surgery. Urinary continence was present in eight of the cases. Although four cases were classified as cosmetically unsatisfactory in our evaluation, all patients and their families reported being satisfied with the cosmetic results. Conclusions: Penile reconstruction for penile tissue loss in children should be performed in clinics where different scenarios can be applied. With maximum preservation and mobilization of existing cavernous tissues, temporary penile reconstruction with local flaps should be performed in young children at an early stage to minimize the psychological effects of penile absence. Although an esthetically perfect result cannot be guaranteed, patients and families are generally satisfied with the outcome.

Diagnosis of Lichen Sclerosus, Morphea, and Vasculitis Using Deep Learning Techniques on Histopathological Skin Images

2025-06-20

Recep Güler , Zehra Karapιnar Şentürk , Mehmet Gamsızkan +1 more | Sakarya University Journal of Computer and Information Sciences

Skin diseases are very common all over the world. The examination can be done by photographing the relevant area or taking a tissue sample to diagnose skin diseases. Examining tissue … Skin diseases are very common all over the world. The examination can be done by photographing the relevant area or taking a tissue sample to diagnose skin diseases. Examining tissue samples allows examination at the cellular level. This study discussed three skin diseases: lichen sclerosus, morphea, and cutaneous small vessel vasculitis (vasculitis). For this problem, which does not have an open-access dataset in the literature, a dataset consisting of histopathological images belonging to each class was created. Convolutional neural network models were created for this three-class classification problem, and their results were evaluated. In addition, in this problem where it is difficult to obtain sample images, the efficiency of transfer learning methods was evaluated with a limited number of examples. For this purpose, tests were performed with VGG16, ResNet50, InceptionV3, and EfficientNetB4 models, and the results were given. Among all the results, the accuracy value of the VGG16 model was 0.9755 and gave the best result. However, although the accuracy value was quite good, precision, recall, and f1-score metrics values were around 0.65. This shows deficiencies in how often the model correctly predicts the positive class and how well it predicts all positive examples in the dataset.

Penile squamous cell carcinoma related to high risk HPV infection

2025-06-20

Erliana Tantri Harsono , Agnes Sri Siswati , Sonia Diovani +2 more | Deleted Journal

Penile cancer is an uncommon form of malignancy, with squamous cell carcinoma (SCC) being the most common subtype. Human papillomavirus (HPV) infection is strongly associated with the development of penile … Penile cancer is an uncommon form of malignancy, with squamous cell carcinoma (SCC) being the most common subtype. Human papillomavirus (HPV) infection is strongly associated with the development of penile SCC, particularly strains 16 and 18. This report presents two cases of penile SCC related to HPV type 18 infection and discusses the diagnosis and role of HPV in penile cancer. It aims to illustrate the clinical presentation and diagnostic challenges of penile SCC, with emphasis on the role of HPV infection. Case 1 involves a 41 yo man with a verrucous mass on the glans penis, diagnosed as well-differentiated SCC, with HPV type 18 detected. Case 2 is a 54 yo man presenting with multiple ulcerative plaques on the distal glans, also diagnosed as SCC with HPV type 18. Penile SCC can be classified into HPV-associated and non-HPV-associated subtypes. The HPV-associated SCC, more commonly seen in younger patients, is driven by viral oncogenes E6 and E7, which disrupt tumor suppressor proteins. The pathogenesis is similar to that seen in cervical cancer. Diagnosis is confirmed through histopathology and genotyping, while treatment involves surgical excision, with possible radiotherapy and chemotherapy depending on lymph node involvement. Early detection and diagnosis of penile SCC are critical for effective treatment. The HPV infection plays a significant role in the pathogenesis of penile SCC, highlighting the importance of HPV vaccination in prevention. Multidisciplinary management is essential for improving patient outcomes

Targeted temperature management, warm alkaline hydrogen peroxide solutions, and dilute solutions of local anesthetics as safety factors for circumcision

2025-06-20

Aleksandr Urakov , Ilina R. Sagidullina , Петр Д. Шабанов | Reviews on Clinical Pharmacology and Drug Therapy

Foreskin circumcision is the oldest surgical procedure that has become part of Muslim and Jewish cultures and has been performed on healthy boys and men since ancient times. In addition, … Foreskin circumcision is the oldest surgical procedure that has become part of Muslim and Jewish cultures and has been performed on healthy boys and men since ancient times. In addition, circumcision is a surgical method of treating phimosis, balanitis and balanoposthitis, which is used regardless of religion. A review of the literature showed that surgical and medical factors of foreskin circumcision sometimes lead to local complications such as penile ischemia and amputation, wound infection, bleeding, meatal stenosis, cutaneous urethral fistula, urethral erosion, iatrogenic hypospadias, bruising after injection, inflammation, necrosis and abscess. These complications worsen the aesthetic outcome of circumcision, the mood of patients and their relatives, and increase the costs of the healthcare system associated with the treatment of complications. In this regard, the current priority is to improve the safety of surgical procedures and medicinal solutions of the following pharmacological groups: anesthetics (drugs for intravenous anesthesia), local anesthetics, detergents (disinfectants), antiseptic and anti-inflammatory drugs. The fact is that it is these medicinal solutions that are most often used in circumcision. In recent years, targeted changes in local temperature have become very relevant, since hypothermia inhibits the intensity of local complications, increases the viability of damaged, ischemic and excised tissues and hyperthermia potentiates the disinfecting effect of antiseptics and helps stop bleeding. It has been shown that the risk of local complications during circumcision can be reduced by infrared monitoring of the local temperature of the penis and skin at the injection sites, as this ensures early detection of local hyperthermia in inflammation and local hypothermia in ischemia. It has been shown that the risk of ischemic soft tissue injury and amputation can be reduced by therapeutic hypothermia, as cooling increases tissue resistance to ischemia. It has been reported that the risk of wound infection in phimosis, paraphimosis, balanitis and balanoposthitis can be reduced by the use of antiseptic pyolytics, which are warm alkaline hydrogen peroxide solutions, and the risk of post-injection necrosis and abscesses can be reduced by pre-diluting drug solutions with water for injection by 2 or more times.

Amputation of the glans due to sexual abuse in children: case report

2025-06-20

Amenan Kan Sophie Kouassi-Dria , Joseph Ouattara , R. Bonny Obro +3 more | International Journal of Surgery Case Reports

Amputations of the glans in children are rare and have various etiologies. We report a case of glans amputation due to sexual abuse. This is a case of a 4-year-old … Amputations of the glans in children are rare and have various etiologies. We report a case of glans amputation due to sexual abuse. This is a case of a 4-year-old child who was admitted to the hospital with a cut glans following sexual abuse. The child presented with total amputation of the tip of the glans. We performed glans regularization and meatoplasty with a Foley probe. Postoperative management was straightforward. Penile amputations are serious but rare urological emergencies. In the study by Diabaté et al. [4], amputations of the penis accounted for 0.6% of urological emergencies. The most common causes were circumcision performed by untrained personnel and animal bites [1, 3, 4, 6]. Amputation of the glans due to sexual abuse is a medico-legal problem. For investigation and prosecution purposes, the doctor or surgeon must inform the judicial authorities. Glans amputations in children are a tragic reality. They pose psychological, emotional, and, above all, medico-legal challenges.

An Intramedullary Approach to the Management of Pathological Distal Femur Fracture in Genochondromatosis: A Case Report

2025-06-19

Apoorva Kabra , Nitish Jagdish Jyoti , Samarth Mittal +1 more | Cureus

Sexual dysfunction and quality of life in males with genital warts

2025-06-18

Mohamed M. El-Hamady , Rabie Bedir Atallah , Osama Hashem +2 more | Basic and Clinical Andrology

Abstract Background Genital warts caused by human papillomavirus, significantly impact male sexual function and quality of life. However, the extent of dysfunction varies across studies, necessitating further investigation. This study … Abstract Background Genital warts caused by human papillomavirus, significantly impact male sexual function and quality of life. However, the extent of dysfunction varies across studies, necessitating further investigation. This study aims to assess sexual dysfunction and quality of life in men with GWs. Results A cross-sectional study was conducted among men diagnosed with GWs. Sexual function was evaluated using the International Index of Erectile Function while the Dermatology Life Quality Index measured quality-of-life impairment. Data were analyzed to determine the severity and distribution of dysfunction across domains. Erectile dysfunction was prevalent, with a mean International Index of Erectile Function score of 14.3 ± 4.2, indicating moderate dysfunction. Orgasmic satisfaction (5.8 ± 2.1) and overall satisfaction (6.5 ± 2.4) were also moderately affected. Quality of life was significantly impaired, with 36.7% experiencing moderate impact, 26.7% reporting a very large impact, and 8% suffering an extreme impact. Conclusion Genital warts contribute to substantial sexual dysfunction and diminished quality of life. The results highlight the need for routine sexual health assessments and psychological support. Integrating medical and psychosocial care may improve patient outcomes.

Labial Adhesion in Postmenopausal Women: A Case Report

2025-06-18

Abdul Wasay Paracha , V.H. Giang , Andrea Shehaj +2 more | Cureus

P50 A decade of change: Comparing emergency department workup and treatment of renal colic in 2014 vs. 2024

2025-06-16

I. Znotina , K. Rubene , V. Paradnieks +2 more | European Urology Open Science

Penile Ulceration After Local Injection of Metaphedrone During Chemsex

2025-06-16

D. Bettin , M Lamotte , F. Aubin +1 more | Acta Dermato Venereologica

P26 Metastasis of malignant melanoma to the penile urethra: A rare case.

2025-06-16

Paulo de Lima Serrano , B. Oliveira , Pedro Barros +2 more | European Urology Open Science

Comprehensive assessment of lower limb edema and its association with quality of life among men with prostate cancer

2025-06-16

Sandra Jensen , Martin Andreas Røder , Sandra C. Hayes +6 more | Supportive Care in Cancer

Abstract Purpose Lower limb edema (LLE) is characterized by swelling due to fluid accumulation and is an under-recognized condition in men with prostate cancer. This study investigated the prevalence of … Abstract Purpose Lower limb edema (LLE) is characterized by swelling due to fluid accumulation and is an under-recognized condition in men with prostate cancer. This study investigated the prevalence of LLE and explored its impact on daily living, depression, and health-related quality of life (HRQoL). Methods This cross-sectional study included men with prostate cancer who attended follow-up at the Department of Urology, Rigshospitalet, Denmark, during a 3-month period. LLE was defined as an L-Dex ≥ 10, measured by using bioimpedance spectroscopy, combined with self-reported symptoms (≥ 2 of heaviness, swelling, or tightness) using items from European Organisation for Research and Treatment of Cancer Quality of Life (EORTC) QLQ-VU34. HRQoL, depression, and the impact of LLE on daily living were assessed using self-reported questionnaires. Results Among 401 patients, LLE was identified in 45 (11%) patients. Self-reported swelling before diagnosis, comorbidities, BMI ≥ 30, and androgen deprivation therapy (ADT) showed the highest odds of LLE. Patients with LLE demonstrated lower HRQoL scores in global health, physical, role, and social functioning and reported higher bowel and hormonal treatment-related symptoms ( p < 0.05). LLE impacted daily activities, including walking (42%) and clothing choices (41%). Most patients (76%) wanted more information on managing LLE symptoms. Conclusions LLE is prevalent among men with prostate cancer and is associated with poorer HRQoL and daily living. Despite its impact, many patients report a lack of information and express a desire for more knowledge about the condition. Improved patient education and attention to potential underlying causes are crucial for timely treatment of LLE.

Circumcision by CO<sub>2</sub> laser 10600nm

2025-06-15

Amjed Saeed Yaqob , Ahmed Al‐Khazraji , Muhammad Sami | Iraqi Journal of Laser

Background: Male Circumcision is one of the most common surgical procedures performed in children. The indications for circumcision differ from country to country and might include both medical and religious … Background: Male Circumcision is one of the most common surgical procedures performed in children. The indications for circumcision differ from country to country and might include both medical and religious ones. Several different surgical procedures for circumcision have been documented, with various results and complications. Aim of study: to evaluate the safety, effectiveness of the use of CO2 laser in circumcision and asses any possible post-operative complication(s). Patients, Materials & Methods: A prospective study was done for 26 patients who were circumcised by using a CO2 laser at 10600 nm from PLATIN, using continuous wave (CW) power that is set at 6 W with different exposure times during the period from June to August 2022. The patients had been operated under local anesthesia. In all cases, the parents had requested circumcision for religious reasons. The patients were followed up for 14 days, and reported having one or more complications postoperatively (if any). Results: The patients were grouped into three age groups based on their age: the first group was 6–12 months old, the second group was 13–24 months old, and the final group was 25–36 months old, with a mean age of 14.7 ± 8.7 months. All patients had a single-session operation. Twenty patients (76.92%) had moderate pain, four patients (15.38%) had mild pain, and two patients (7.7%) had severe pain. Twenty patients (76.92%) had no bleeding; six patients (23.07%) had bleeding and were treated conservatively. Twenty-four patients (92.3%) had no infection, and only two patients (7.7%) developed a simple surgical site wound infection. Regarding the edema, four patients (15.4%) suffers of null degree: 12 patients (46.2%) of 1st degree: 8 patients (30.8%) of 2nd degree; and 2 patients (7.6%) of 3rd degree after four hours; while 17 patients (65.4%) suffers of null degree; 5 patients (19.2%) of 1st degree; 3 patients (11.5%) of 2nd degree; and 1 patient (3.9%) of 3rd degree after 7 days. 18 patients (69.2%) were completely satisfied. The operative time is less than that of conventional methods. All the patients were discharged after half an hour. Conclusion: A CO2 laser circumcision is a safe and effective procedure, and the device is very beneficial due to precise results with decreased pain, infection, bleeding, and edema following surgery.

Recognizing Mondor’s Disease: A rare cause of benign breast induration

2025-06-14

Marie Lefebvre , Meier Julie , Madison Jerome | European Journal of Obstetrics & Gynecology and Reproductive Biology

The Role of JAK Inhibitors in Pediatric Lichen Sclerosus et Atrophicus: A Case Report

2025-06-13

Shivangi Sharma , Akanksha Bandhade , Mrityunjay Singh +2 more | Cureus

Avances quirúrgicos en la corrección del Labio Leporino.

2025-06-13

Maureen Fernando Barzola Ruiz , Luis Leonel Cuenca Herrera , Andrés David Velarde Varela +2 more | Brazilian Journal of Implantology and Health Sciences

El labio leporino es una anomalía congénita caracterizada por la falta de fusión de estructuras faciales durante el desarrollo embrionario, impactando la estética y función facial, con una incidencia de … El labio leporino es una anomalía congénita caracterizada por la falta de fusión de estructuras faciales durante el desarrollo embrionario, impactando la estética y función facial, con una incidencia de 1 en 700 nacimientos. Este trastorno presenta causas multifactoriales que incluyen factores genéticos y ambientales. El objetivo del estudio es analizar los avances quirúrgicos en su corrección para mejorar los resultados estéticos y funcionales. La metodología empleada fue una revisión de literatura reciente a través de bases de datos médicas, priorizando estudios que evaluaran técnicas quirúrgicas y sus resultados. Las técnicas tradicionales como la de Rotación-Avance de Millard han evolucionado hacia métodos más precisos como la Aproximación de Subunidades Anatómicas de Fisher, las cuales han demostrado mejorar la simetría y reducir cicatrices visibles. Además, la corrección primaria de la nariz durante la cirugía del labio leporino ha optimizado tanto la función nasal como la simetría facial. Los resultados indicaron que estas innovaciones no solo mejoran la estética facial, sino también la calidad de vida al disminuir la necesidad de revisiones quirúrgicas futuras. Esto se refleja en beneficios funcionales y en la aceptación social de los pacientes. Los avances quirúrgicos en la corrección del labio leporino han transformado las expectativas estéticas y funcionales, ofreciendo mejores resultados a través de técnicas más precisas y menos invasivas, aunque persisten desafíos en la estandarización de los enfoques quirúrgicos.

CircRNA Sequencing Analysis Reveals the Regulatory Role of circ_CDR1as in Penile Squamous Cell Carcinoma via the ceRNA Network

2025-06-12

Lin Du , Shanshan Lv , Zhenzhen Jiang +7 more | International Journal of Medical Sciences

The effect of COVID-19 (SARS-CoV-2) vaccines on vulvar condylomata

2025-06-10

Mustafa Şahin , Şeyma Banu Arslanca | Journal of the Turkish-German Gynecological Association

Current evidence concerning the possible clinical effects of coronavirus disease-2019 (COVID-19) vaccines on vulvar lesions is limited. The aim was to describe the effect of vaccines against COVID-19 on the … Current evidence concerning the possible clinical effects of coronavirus disease-2019 (COVID-19) vaccines on vulvar lesions is limited. The aim was to describe the effect of vaccines against COVID-19 on the progression of vulvar condylomas. The data of patients diagnosed with condylomata acuminate and treated with trichloroacetic acid (TCA) between January 2021 and January 2023 in the gynecological oncology surgery clinic were evaluated. The patients were divided into groups based on their vaccination status; vaccinated or unvaccinated. The number/area of condylomas and symptom degrees of the patients before and after TCA treatment were compared. A total of 202 patients, 102 vaccinated and 100 unvaccinated, were included. There was no significant difference between the groups in terms of age, parity, smoking, oral contraceptive use, amount of condyloma and symptom degree (all p>0.05). There was no significant difference in the amount of condyloma between the groups after six months [p=0.589, 95% confidence interval (CI)=0.238-1.566]. Moreover, there was no difference in the degree of symptoms after six months between the groups (p=0.467, 95% CI=1.113-1.799). The systemic effects caused by COVID-19 vaccines are still not fully understood. Considering that this vaccine, like many vaccines, elicits a strong immunogenic reaction, the possible clinical impact of this non-specific systemic inflammatory response on vulvar condyloma is a matter of curiosity. This study showed there was no difference in the amount of condyloma and the degree of symptoms six months after TCA treatment in the unvaccinated and vaccinated group. The low number of patients is the biggest limitation of this study. Larger studies may provide more robust information.

Scrotal Flaps for Penile Skin Reconstruction: A Systematic Review

2025-06-06

Sorin Viorel Parasca , Andrei Dumitrescu , F. Stanescu +1 more | Medicina

Background and Objectives: Infection, trauma, skin cancer, foreign substance injections and lymphedema are among the most frequent causes of penile skin defects. Scrotal flaps are a promising reconstructive option for … Background and Objectives: Infection, trauma, skin cancer, foreign substance injections and lymphedema are among the most frequent causes of penile skin defects. Scrotal flaps are a promising reconstructive option for penile resurfacing, offering improved functional and aesthetic outcomes; however, there is no clear consensus on their superiority. Materials and Methods: A review of the literature was performed in PubMed Central and Scopus, and multiple keywords were employed. The initial search retrieved 9181 articles; 32 articles were finally selected, of which 13 were case reports and 19 were case series. Results: A total of 368 patients were included, the majority (71%) consulting for sclerosing lipogranuloma. Seven types of scrotal flaps were used: unilateral scrotal flap (n = 1), bilateral anterior scrotal flaps (n = 149), two-stage scrotal flap (n = 57), bipedicled bilateral anterior scrotal flaps (n = 140), apron-style scrotal flap (n = 1), scrotal pull-up (n = 13), and island dartos musculocutaneous flap (n = 7). Patient satisfaction was high in all studies. Outcome evaluation was typically conducted using subjective questionnaires with 2 or 5 items or visual analog scales. Few studies employed validated sexual function questionnaires, as the IIEF-5 or the EHS. Conclusions: Scrotal flaps provide good quality tissue for penile resurfacing, having the closest resemblance to normal penis skin. For a better understanding of the outcomes of different scrotal flaps, a thorough evaluation of postoperative complications should be made. The LOS and revision surgery rates may serve as surrogates for the financial burden of the procedure. Erectile function should be thoroughly evaluated with a 10-item Likert scale, IIEF-5, EHS, and POSAS.

Single‐Cell and Spatial Transcriptomic Profiling of Penile Squamous Cell Carcinoma Reveals Dynamics of Tumor Differentiation and Immune Microenvironment

2025-06-05

Hongjian Song , Zhichao Tong , Guoxi Xie +7 more | PubMed

Penile squamous cell carcinoma (PSCC) is a highly aggressive malignancy without effective treatment due to limited knowledge of its development and tumor microenvironment (TME). In this study, single-nucleus RNA sequencing … Penile squamous cell carcinoma (PSCC) is a highly aggressive malignancy without effective treatment due to limited knowledge of its development and tumor microenvironment (TME). In this study, single-nucleus RNA sequencing (snRNA-seq) and high-resolution spatial transcriptomics are employed to comprehensively investigate the development trajectories and the TME. The results revealed that PSCC cells mimicked the differentiation and tissue organization of normal penile epithelium, independent of the human papillomavirus (HPV) infection status. Notably, a spatial subtype, Tum_1, appeared at early stage of tumor differentiation and in tumor-normal boundary regions. This subtype exhibited enhanced basal-like and stemness features and showed high LAMC2 expression, which activated laminin-integrin signaling via ITGA6/ITGB4, promoting tumor invasiveness. Furthermore, the results indicated that HPV-positive basal stem-like neoplasms dampened the immune function of T cells and macrophages, promoting an immunosuppressive environment that facilitates tumor progression. Supporting this, the patients with head and neck squamous cell carcinoma and lung squamous cell carcinoma who have high expression of HPV-positive Tum_1 signatures derived greater benefit from PD-1 blockade therapy. In summary, the findings provide a comprehensive spatial landscape of the PSCC TME and suggest potential treatment approaches targeting laminin-integrin interaction and immunotherapy, especially in HPV-positive patients.

Antoninus and Rabbi’s Circumcision (Bereshit Rabbati Wayera, pp. 86–87)

2025-06-05

Sivan Nir | BRILL eBooks

An open label randomized non-inferiority trial comparing adjuvant platinum plus paclitaxel to platinum plus 5-FU after curative resection in high-risk penile carcinoma.

2025-06-04

Aditya Dhanawat , Vanita Noronha , Nandini Menon +7 more | Journal of Clinical Oncology

LBA5012 Background: There is limited evidence to guide adjuvant therapy in high-risk penile cancer. Methods: Patients with high-risk penile cancer [> 1 inguinal lymph node (LN), perinodal extension, pelvic LN, … LBA5012 Background: There is limited evidence to guide adjuvant therapy in high-risk penile cancer. Methods: Patients with high-risk penile cancer [> 1 inguinal lymph node (LN), perinodal extension, pelvic LN, or LN > 4 cm] who underwent curative resection were randomized 1:1 to receive 4 cycles of platinum plus 5-FU (PF arm) or platinum plus paclitaxel (PP arm), followed by concurrent chemoradiotherapy. Primary endpoint was progression-free survival (PFS); secondary endpoints were overall survival (OS), toxicities and quality of life (QoL). The study was approved by IEC and registered with CTRI. Recruitment began in March 2017 but closed prematurely due to slow accrual. Results: Between March 2017 and October 2024, 49 patients were randomized (Table 1). Median follow-up was 60.1 months. There was no significant difference in median PFS (12.5 vs 35.9 months, p=0.460), 5-year PFS (36.1% vs 38.5%), median OS (21.6 vs 37.2 months, p=0.530) and 5-year OS (45.3% vs 41.1%) between PF and PP arm, respectively. Dose reductions were higher (33.3% vs 4.5%, p=0.015), similar dose delays (33.3% vs 31.8%, p=0.916) and a non-significant increase in drug discontinuation (42.9% vs 18.2%, p=0.078) in the PF arm. Grade 3/4 hematological (28.6% vs 4.5%, p=0.033) and gastrointestinal (33.3% vs 4.5%, p=0.015) toxicities were higher in PF arm. Infections (9.5% vs 13.6%, p=0.674) and hospitalizations (38.1% vs 18.2%, p=0.146) were similar. QoL (EORTC QLQ-C30 and MSHQ) analysis showed no difference in global health status (p=0.094), functional and symptom scales. Patients in PF arm reported more erectile dysfunction-related bother (p=0.018) while other MSHQ domains were similar. Conclusion: Adjuvant platinum plus 5-FU showed similar efficacy to platinum plus paclitaxel in high-risk penile carcinoma after curative resection, albeit with higher hematological and gastrointestinal toxicities, as well as erectile dysfunction-related bother. Clinical trial information: CTRI/2016/12/007567 . Baseline and treatment details. Characteristics 5-FU + Platinum(N = 25) Paclitaxel + Platinum(N = 24) p-value Age (years) Median (Range) 49 (29-70) 51 (26-70) Co-morbidities Hypertension 5 (20%) 5 (20.8%) 0.942 Diabetes Mellitus 5 (20%) 4 (16.7%) 0.763 Coronary Artery Disease 3 (12%) 1 (4.2%) 0.317 Prior phimosis 3 (12%) 1 (4.2%) 0.317 Smoker or smokeless tobacco 9 (36%) 10 (41.7%) 0.773 ECOG PS 0.715 0 2 (8%) 1 (4.2%) 1 21 (84%) 22 (91.6%) 2 2 (8%) 1 (4.2%) Surgery 0.995 Glansectomy 4 (16%) 4 (16.7%) Partial penectomy 17 (68%) 16 (66.6%) Total penectomy 4 (16%) 4 (16.7%) Degree of differentiation 0.566 Grade 1 2 (8%) 2 (8.3%) Grade 2 12 (48%) 8 (33.3%) Grade 3 11 (44%) 14 (58.3%) Pathological T stage 0.525 T1 10 (40%) 6 (25%) T2 8 (32%) 9 (37.5%) T3 7 (28%) 9 (37.5%) Pathological N stage 0.950 N2 4 (16%) 4 (16.7%) N3 21 (84%) 20 (8.3%) LVI or PNI 11 (44%) 9 (37.5%) 0.644 > 3 adjuvant cycles 15 (60%) 22 (91.6%) 0.010 Completed CTRT 12 (48%) 14 (58.3%) 0.469

Buried penis; what buried the penis?

2025-06-02

Mohamed Fawzy , Ahmed T. Hadidi | Frontiers in Pediatrics

To investigate the histological and immuno-histochemical features of dartos fascia in buried penis (BP) as compared to dartos fascia in hypospadias and normal children. The study included 40 children, operated … To investigate the histological and immuno-histochemical features of dartos fascia in buried penis (BP) as compared to dartos fascia in hypospadias and normal children. The study included 40 children, operated on in our center between January 2023 and January 2024. Patients were divided into 3 groups; group A: 13 patients with BP, group B: 14 patients with different grades of distal Hypospadias, and group C with 13 patients who were referred for circumcision (control group). All dartos fascia specimens were blindly examined by the same pathologist. The 3 groups were assessed for histological findings including collagen, elastin, nerve fibers, tactile bodies, fat, smooth muscles. In group A (BP), there was statistically significant dominance of thick collagen fibers (thick fibers) p < 0.001, thick smooth muscle fibers (P < 0.001), thick convoluted nerve fibers (p = 0.004) and less fat (P < 0.001) as compared to the hypospadias and control groups. In the hypospadias group, intermediate collagen fibers were the predominant type of fibers (p < 0.001), in addition to long, thin and short thin elastin fibers (p < 0.001) compared to the buried penis and the control groups. The hypospadias group also had significant predominance of chaotic disorganized nonparallel smooth muscle fibers p = 0.003. The fascia in BP is characterized by abnormally thick collagen fibers, thick smooth muscle fibers and thick convoluted nerve fibers. This may explain why the penis is drawn inwards in BP and suggests that it is probably recommended to excise this abnormal fascia during the surgical correction.

Vulvar lichen sclerosus: unraveling a clinical conundrum

2025-06-01

Vaishnavi Rajaraman , Sobha S. Nair , Abhinandan Badam +1 more | BMJ Case Reports

Vulvar lichen sclerosus is a chronic, progressive inflammatory dermatosis that predominantly affects postmenopausal women but can also present in premenopausal individuals. It can cause significant scarring, leading to anatomical distortion, … Vulvar lichen sclerosus is a chronic, progressive inflammatory dermatosis that predominantly affects postmenopausal women but can also present in premenopausal individuals. It can cause significant scarring, leading to anatomical distortion, urinary dysfunction and impaired quality of life. The author describes a case of a woman in her late 30s with extensive vulvar involvement of lichen sclerosus, resulting in introital stenosis, dyspareunia and painful micturition. The patient was managed with a combination of topical steroids and systemic immunosuppressants, followed by surgical intervention using a Singapore flap for vaginal reconstruction. This case highlights the importance of early diagnosis, individualised treatment approaches and long-term follow-up in managing severe vulvar lichen sclerosus.

Genital Self-Mutilation in a Young Male With Psychotic Symptoms: Klingsor Syndrome – A Case Report

2025-06-01

Walaa Alnammourah , Nizar Marzouqa , Naim Alshaikh +1 more | BJPsych Open

Aims: Genital self-mutilation (GSM) is a rare but severe form of self-harm often linked to underlying psychiatric disorders, particularly psychotic conditions. Approximately 54% of GSM cases occur in patients with … Aims: Genital self-mutilation (GSM) is a rare but severe form of self-harm often linked to underlying psychiatric disorders, particularly psychotic conditions. Approximately 54% of GSM cases occur in patients with psychosis, with substance use disorders being the second most common associated condition. Various triggers, including perceived rejection, lack of social support, and acute substance intoxication, have been implicated in GSM. When GSM arises from psychotic symptoms, it is referred to as Klingsor syndrome. Immediate psychiatric intervention is critical for managing such cases and preventing recurrence. Methods: A 28-year-old divorced male was brought to the nearest hospital by his family following a penile self-amputation with a blade. Immediate surgical repair was performed. Three weeks later, he was admitted to Bethlehem Psychiatric Hospital for further evaluation and treatment. The patient had a history of self-harm that previously necessitated hospitalization. His psychiatric symptoms included commanding auditory hallucinations, delusions of reference, feelings of worthlessness, and psychotic features that emerged after cannabis use. In the weeks leading up to the self-mutilation, the patient exhibited insomnia, social withdrawal, and a growing preoccupation with self-castration. On examination, he appeared distressed, with an irritable affect and poor insight into his actions. He expressed a strong belief that his genitals were “the source of all problems” and reported suicidal ideations, stating he “needed to get rid of his penis or else would commit suicide”. He also exhibited persecutory delusions, delusions of guilt, control, and thought broadcasting. A comprehensive psychiatric assessment confirmed a diagnosis of Schizoaffective Disorder, exacerbated by substance use. He was admitted to the psychiatric ward following medical stabilization and was treated with quetiapine 600 mg/day, titrated as needed, and carbamazepine for mood stabilization. Supportive psychotherapy aimed at improving insight and addressing delusional distress was initiated, alongside family psychoeducation to prevent recurrence. Results: During his four-week inpatient stay, the patient demonstrated gradual improvement in his psychotic symptoms. His insight improved significantly, and he ceased expressing delusional beliefs about his genitals. Upon discharge, he was referred to the Community Mental Health Centre (CMHC) and enrolled in an outpatient psychiatric programme, which included ongoing medication management and psychotherapy. At the few-months follow-up, he remained adherent to his treatment plan with no recurrence of self-harm behaviours. Conclusion: This case highlights the interplay of psychosis and substance use in GSM and underscores the necessity for early intervention and psychiatric care. A multidisciplinary treatment approach including pharmacotherapy, psychotherapy, and family support is essential for prevention of future episodes.

Molecular Subtypes of Balanopreputial and Urethral Male Genital Lichen Sclerosus: Distinct Transcriptomic and Clinicopathological Profiles

2025-06-01

Xianjie Xiu , Zhenwei Yu , Georgios Kravvas +7 more | Laboratory Investigation