Phimosis
Paraphimosis
Betamethasone Valerate
Lichen Sclerosus et Atrophicus
A study of clinical opinion and practice regarding circumcision. (1/31)
AIM: To establish clinical opinion regarding appropriate indications for circumcision and to examine actual clinical practice. METHODS: A questionnaire was sent to all NHS hospital consultants in the Yorkshire region of the UK identified as having a role to play in the management of boys (under 16 years of age) requiring circumcision. Retrospective data on actual clinical practice during a three month study period were also collected via a simple proforma. RESULTS: Of 153 questionnaires sent, 64 were returned. Responses revealed varying opinions regarding appropriate indications for circumcision within each consultant group, and between paediatricians and surgeons. Surgeons were generally more inclined to recommend circumcision for each of the indications listed in the questionnaire. Analysis of clinical practice revealed that almost two thirds of procedures were carried out for phimosis, and nearly half of these children were under the age of 5 years. CONCLUSION: There are differences in the clinical opinions of surgeons and paediatricians on what constitutes an appropriate indication for circumcision. Paediatricians' opinions are generally more in line with current evidence than those of surgeons, possibly resulting in many unnecessary circumcisions. (+info)Circumcision: a refined technique and 5 year review. (2/31)
The vast majority of circumcisions currently performed in the UK are for phimosis or balanitis and the patients are not looking for the denuded glans appearance of a ritual circumcision. We present a refinement of the sleeve technique of circumcision, which involves Horton's test to define the proximal incision margin, and bipolar electro-dissection. A review of all patients undergoing circumcision at the Wordsley Plastic Surgery Unit, in a 5-year period, has shown this technique to be safe with a haematoma rate of only 1.4%, and an overall complication rate of 3%. (+info)Do men having routine circumcision need histological confirmation of the cause of their phimosis or postoperative follow-up? (3/31)
OBJECTIVE: To assess the accuracy of pre-operative diagnosis of preputial pathology ainongst urologists and general surgeons. PATIENTS AND METHODS: Data were collected on 460 adult patients having had circumcision performed by either a general surgeon or a urologist over a 10-year period. RESULTS: Pre-operative diagnosis was consistent with final histology in 83% of cases and further management was never altered by the histological result. Re-referral rates were 0% for general surgeons and 2.7% for urologists (P > 0.05) and there were no cases needing further surgical intervention. CONCLUSIONS: Routine submission of histological specimens for analysis and out-patient follow-up are not required following circumcision. (+info)Troubles with the foreskin: one hundred consecutive referrals to paediatric surgeons. (4/31)
To assess the reasons for and outcomes of referrals concerning the foreskin, 100 consecutive patients seen in paediatric clinics were followed to discharge. 18 referrals were for circumcision on religious grounds. Of the other 82, the main reason for referral was non-retractability or phimosis. At clinic, 24 (29%) of these were deemed normal for age, 31 (38%) were treated with topical steroid (successfully in 25), 9 (11%) were listed for preputioplasty, 7 (9%) were listed for adhesiolysis, 7 (9%) were listed for circumcision, and 4 were listed for other forms of surgery. 6 patients were identified as having balanitis xerotica obliterans (BXO), a condition that had not been suggested on referral. With the advent of new treatments for foreskin disorders, circumcision is decreasingly necessary. Knowledge of the natural history of the foreskin, and the use of topical steroids, could shift the management of paediatric foreskin problems from the hospital outpatient department to primary care. BXO is not sufficiently recognized as a form of phimosis that requires operation. (+info)Treatment of phimosis with topical steroids and foreskin anatomy. (5/31)
OBJECTIVES: To correlate topical steroidal treatment of stenosed foreskin with the different degrees of glans exposure and the length of time the ointment is applied. MATERIALS AND METHODS: We studied 95 patients with phimosis, divided according to the degree of foreskin retraction. Group A presented no foreskin retraction, group B presented exposure of only the urethral meatus, group C presented exposure of half of the glans, and group D presented exposure of the glans, which was incomplete because of preputial adherences to the coronal sulcus. Patients were submitted to application of 0.05% betamethasone ointment on the distal aspect of the prepuce twice daily for a minimum of 30 days and a maximum of 4 months. RESULTS: Of 95 patients, 10 (10.52%) abandoned the treatment and 15 patients in groups C and D were excluded from the study. Among the remaining 70 patients, only 4 patients (5.7%) in group A did not obtain adequate glans exposure after treatment. In group A (38 patients), fully retractable foreskins were obtained in 19 patients (50%) after 1 month of treatment. In group B (28 patients), fully retractable foreskins were obtained in 18 patients (64.2%) after 1 month. CONCLUSIONS: Treatment was successful in 94.2% of patients, irrespective of the type of foreskin anatomy. The improvement may require several months of treatment. Patients with impossibility of urethral meatus exposure present around 10% treatment failure. (+info)Inappropriate circumcision referrals by GPs. (6/31)
One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor in 15 patients. The implications of this survey are that a large proportion of general practitioners have difficulty in discriminating between a true phimosis and a developmentally non-retractile foreskin. This diagnostic inaccuracy was greatest when the referring doctor did not examine the patient. (+info)Kindler syndrome. (7/31)
Kindler syndrome is a rare autosomal recessive disorder associated with skin fragility. It is characterized by blistering in infancy, photosensitivity and progressive poikiloderma. The syndrome involves the skin and mucous membrane with radiological changes. The genetic defect has been identified on the short arm of chromosome 20. This report describes an 18-year-old patient with classical features like blistering and photosensitivity in childhood and the subsequent development of poikiloderma. The differential diagnosis of Kindler syndrome includes diseases like Bloom syndrome, Cockayne syndrome, dyskeratosis congenita, epidermolysis bullosa, Rothmund-Thomson syndrome and xeroderma pigmentosum. Our patient had classical cutaneous features of Kindler syndrome with phimosis as a complication. (+info)Surgical treatment of a rare case of penile squamous cell carcinoma in a 65-year-old man. (8/31)
Penile squamous cell carcinoma has been commonly reported in the past decades. We describe a rare case of a huge squamous cell carcinoma of the penis in a 65-year-old patient with a 4-year history of tumor growth, for which total penectomy, perineal urethrostomy and bilateral inguinal lymphadenectomy were carried out. We suggest that aggressive surgical intervention should be recommended for those with well-differentiated penile carcinoma regardless of the size of the tumor. (+info)Phimosis is a medical condition where the foreskin of the penis, which is the retractable sheath of skin that covers the head or glans of the penis, cannot be pulled back (retracted) over the glans. This condition is normal in uncircumcised infant boys and toddlers, but most boys can retract their foreskins by the time they reach puberty.
In some cases, phimosis may cause no symptoms or problems, while in others it may lead to issues such as discomfort, pain, especially during sexual activity, infection, inflammation, and difficulty urinating. Phimosis can be caused by various factors, including infections, skin conditions, scarring from previous injuries or surgeries, or forceful attempts to retract the foreskin.
Treatment for phimosis depends on the underlying cause and severity of the condition. In some cases, gentle manual stretching exercises may be recommended to gradually increase the foreskin's ability to retract. In other cases, topical creams or medications may be prescribed to reduce inflammation or fight infections. If these treatments are not effective, or if phimosis is causing significant discomfort or complications, circumcision (surgical removal of the foreskin) may be considered as a last resort.
Balanitis is an inflammation of the glans penis, which is the rounded tip of the penis. It's a common condition in uncircumcised males and can affect men of all ages. The symptoms of balanitis include redness, swelling, pain, itching, and soreness on the glans penis. In some cases, there may be a discharge with an unpleasant odor.
Balanitis can have various causes, including poor hygiene, irritants (such as soaps or spermicides), infections (bacterial, fungal, or viral), and skin conditions (like psoriasis or eczema). In rare cases, balanitis can be a sign of an underlying medical condition, such as diabetes.
Treatment for balanitis depends on the cause. For mild cases, good hygiene and avoiding irritants may be enough. More severe cases might require medication, such as antibiotics, antifungals, or corticosteroids. If an underlying condition is causing the balanitis, that will need to be treated as well.
Male circumcision is a surgical procedure to remove the foreskin, which is the skin that covers the head (glans) of the penis. In some cultures and religions, male circumcision is performed as a religious rite or cultural tradition. In other cases, it may be recommended for medical reasons, such as to treat phimosis (a condition in which the foreskin is too tight to be pulled back over the glans) or to reduce the risk of sexually transmitted infections and other conditions. The procedure is typically performed on infants or young boys, but it can also be done on older males.
The foreskin is a double-layered fold of skin that covers and protects the head (glans) of the penis. It is a normal part of male anatomy and varies in length and coverage from person to person. The inner layer of the foreskin is highly sensitive and contains a high concentration of nerve endings, which can contribute to sexual pleasure.
In some cases, the foreskin may become tight or difficult to retract (a condition known as phimosis), which can cause discomfort or pain during sexual activity or other activities that stretch the foreskin. In these cases, medical intervention may be necessary to alleviate the problem. Some people choose to undergo circumcision, a surgical procedure in which the foreskin is removed, for cultural, religious, or personal reasons. However, circumcision is not medically necessary for most people and carries some risks, such as infection, bleeding, and scarring.
Penile diseases refer to a range of medical conditions that affect the penis, including infections, inflammatory conditions, and structural abnormalities. Some common penile diseases include:
1. Balanitis: an infection or inflammation of the foreskin and/or head of the penis.
2. Balanoposthitis: an infection or inflammation of both the foreskin and the head of the penis.
3. Phimosis: a condition in which the foreskin is too tight to be pulled back over the head of the penis.
4. Paraphimosis: a medical emergency in which the foreskin becomes trapped behind the head of the penis and cannot be returned to its normal position.
5. Peyronie's disease: a condition characterized by the development of scar tissue inside the penis, leading to curvature during erections.
6. Erectile dysfunction: the inability to achieve or maintain an erection sufficient for sexual intercourse.
7. Penile cancer: a rare form of cancer that affects the skin and tissues of the penis.
These conditions can have various causes, including bacterial or fungal infections, sexually transmitted infections (STIs), skin conditions, trauma, or underlying medical conditions. Treatment for penile diseases varies depending on the specific condition and its severity, but may include medications, surgery, or lifestyle changes.
Paraphimosis is a urological emergency that occurs when the foreskin of an uncircumcised male gets retracted behind the glans penis and cannot be returned to its normal position, leading to constriction and swelling of the glans. If left untreated, it can result in severe pain, discomfort, infection, and even gangrene, potentially requiring surgical intervention.
Betamethasone valerate is a synthetic corticosteroid drug, which is a derivative of betamethasone. It is used as a topical preparation for the treatment of various skin conditions such as eczema, psoriasis, and dermatitis. The valerate ester of betamethasone provides a sustained release of the active steroid, allowing for less frequent application and improved penetration into the skin.
Betamethasone valerate works by reducing inflammation, suppressing the immune system, and relieving itching and redness in the affected area. It is available in various forms, including creams, ointments, and lotions, and should be used under the direction of a healthcare professional to ensure proper use and minimize potential side effects.
Like other corticosteroids, betamethasone valerate can cause thinning of the skin, increased hair growth, and acne with prolonged or excessive use. It is important to follow the recommended dosage and duration of treatment to avoid these side effects.
Lichen Sclerosus et Atrophicus (LSEA) is a chronic inflammatory skin condition that can affect both males and females, but it's most commonly found in women after menopause. It can occur at any age, including children. The condition typically affects the genital and anal areas, though it can appear elsewhere on the body as well.
The medical definition of Lichen Sclerosus et Atrophicus is:
A skin disorder characterized by white patches (plaques) that can be smooth or wrinkled, thickened, and easily bruised. These patches may merge to form larger areas of affected skin. The condition can cause itching, burning, pain, and blistering. In women, the vulva is often affected, and sexual intercourse may become painful. In men, it can affect the foreskin and glans penis, leading to difficulty urinating or having sex.
The exact cause of Lichen Sclerosus et Atrophicus remains unknown, but it's believed that hormonal imbalances, genetics, and an overactive immune system may play a role in its development. Treatment usually involves topical corticosteroids to reduce inflammation and alleviate symptoms. In some cases, other medications or phototherapy might be recommended. It is essential to consult with a healthcare professional for proper diagnosis and treatment.
Penile neoplasms refer to abnormal growths or tumors in the penis. These can be benign (non-cancerous) or malignant (cancerous). The most common type of penile cancer is squamous cell carcinoma, which begins in the flat cells that line the surface of the penis. Other types of penile cancer include melanoma, basal cell carcinoma, and adenocarcinoma.
Benign penile neoplasms include conditions such as papillomas, condylomas, and peyronie's disease. These growths are usually not life-threatening, but they can cause discomfort, pain, or other symptoms that may require medical treatment.
It is important to note that any unusual changes in the penis, such as lumps, bumps, or sores, should be evaluated by a healthcare professional to determine the underlying cause and appropriate treatment.