Prevalence and risk factors of lower urinary tract symptoms in rural children and adolescents / 现代泌尿外科杂志

【Objective】 To investigate the prevalence and risk factors of lower urinary tract symptoms (LUTS) in rural children and adolescents. 【Methods】 An epidemiological LUTS survey was carried out on 4 100 children and adolescents (aged 6-16 years) in five primary and secondary schools in rural Henan by means of stratified random cluster sampling using anonymous questionnaires. Daytime urinary incontinence (DUI), nocturnal enuresis (NE), and postnatal diaper use and toilet training were investigated. 【Results】 A total of 3 885 valid questionnaires were recovered (with a recovery rate of 94.76%). The total prevalence of the four symptoms of LUTS, including urgency, frequency, DUI and NE, were 16.42%, 10.91%, 7.41% and 7.95%, respectively. As much as 21.13% subjects had at least one symptom. The prevalence of the four symptoms decreased gradually with age, decreased sharply in those aged 6 to 12 years, and then decreased slowly. The prevalence of LUTS in children who stopped using diapers and stared urine training after 1 year of age was significantly higher than that of those within 1 year of age (χ2=21.605, 23.111, 24.189, 23.509, all P<0.05; χ2=102.17, 72.168, 53.656, 197.76, all P<0.05). There were significant differences in the prevalence of LUTS between those with and without toilet training (χ2=315.273, 198.438, 105.723, 272.502, all P<0.05). The prevalence of LUTS in males was significantly higher than that in females (P<0.05). Constipation, prepuce and phimosis in boys were significantly associated with the prevalence of LUTS (P<0.05). 【Conclusion】 Rural children and adolescents have a high prevalence of LUTS. Diaper use after 1 year of age, history of urinary tract infection (UTI), lack of toilet training, constipation, and abnormal prepuce are risk factors of LUTS. Urine training before 1 year of age is a protective factor of LUTS.

Comparison of the clinical efficacy of "one-cut" circumcision and traditional circumcision / 现代泌尿外科杂志

【Objective】 To introduce the key techniques of "one-cut" circumcision, and to compare its clinical efficacy with traditional circumcision. 【Methods】 A retrospective analysis was conducted on 120 cases of circumcision in our center during Jul.2020 and Jul.2022, including 60 cases in the "one-cut" group and 60 cases in the traditional circumcision group. The operation time, postoperative edema time, satisfaction with cosmetics and improvement of sexual life were compared between the two groups. 【Results】 Compared with the tradition group, the "one-cut" group had shorter operation time [(19.2±7.4) min vs. (23.1±1.7) min, P<0.001] , shorter postoperative edema time [(5.5±3.2) d vs. (9.6±5.5) d, P<0.001] , and higher satisfaction with cosmetics [(3.6±0.5) vs. (3.1±0.8), P<0.001)] , but there was no difference in improvement of sexual life between the two groups (P=0.08). 【Conclusion】 "One-cut" circumcision is easy to operate, with short operation time, fast postoperative recovery, neat incision and satisfactory appearance, which is worth popularizing.

Why human prepuce is a valuable resource in science? Histological, ultrastructural, immunohistochemical and statistical analysis / ¿Por qué el prepucio humano es un recurso valioso en la ciencia? Análisis histológicos, ultraestructurales, inmunohistoquímicos y estadísticos

SUMMARY: This research was to examine the histological and ultrastructural characteristics of prepuce samples, as well as vimentin and S100 protein localization and statistical analysis. Urologists have long struggled with the prepuce, which is used to treat a variety of urethral problems. Skin biopsies were collected from the prepuce at the moment of circumcision and processed for light microscopy, electron microscope examination, immunohistochemical techniques, and statistical analysis in a total of six boys. Histologically, the prepuce epidermis displayed focal spiky ridges, which are saw-toothed interspersed with sulci, slight hyperpigmentation, looser connective tissue and plentiful vascular components. Immunohistochemically, the existence of melanocytes and Langerhans cells in the epidermis, as well as smooth muscles in the dermis, was stained positively for vimentin. Also, there was a positive reactivity of the Langerhans cells in the epidermis and around Meissner's corpuscles in the dermis for S100 protein staining. Ultrastructurally, the prepuce's intercellular gaps were widened, melanocytes rested on a folded basement membrane, and desmosomal content was reduced, with a prominent active euchromatic nucleus. Cytoplasmic projections were distended and elongated, and the interstitial blood vessels were surrounded by endothelial cells and rested on a basement membrane. There were also minimal collagen fibers in the interstitium. The prepuce's histological and ultrastructural features, as well as immunohistological studies using vimentin and S100 protein as intermediate filaments and statistical analysis, all demonstrated that it is a useful scientific resource.

RESUMEN: El presente trabajo de investigación se realizó para examinar las características histológicas y ultraestructurales de las muestras de prepucio, así como la localización y el análisis estadístico de la vimentina y la proteína S100. Los urólogos han intentado trabajar durante mucho tiempo con el prepucio, que se usa para tratar una variedad de problemas uretrales. Se recolectaron biopsias de piel del prepucio de seis niños en el momento de la circuncisión y se procesaron para microscopía óptica, examen con microscopio electrónico, técnicas inmunohistoquímicas y análisis estadístico. Histológicamente, la epidermis del prepucio mostraba crestas puntiagudas focales, intercaladas con surcos, hiperpigmentación leve, tejido conectivo más laxo y abundantes componentes vasculares. Inmunohistoquímicamente, la existencia de melanocitos y células dendríticas epidérmicas (células de Langerhans), así como músculo liso en la dermis, se tiñeron positivamente para vimentina. Además, hubo una reactividad positiva de las células dendríticas epidérmicas en la epidermis y alrededor de los corpúsculos del tacto (de Meissner) en la dermis para la tinción de la proteína S100. Ultraestructuralmente, los espacios intercelulares del prepucio se ensancharon, los melanocitos descansaban sobre una membrana basal plegada y el contenido desmosómico se redujo, con un núcleo eucromático activo prominente. Las proyecciones citoplasmáticas estaban distendidas y alargadas, y los vasos sanguíneos intersticiales estaban rodeados por células endoteliales y descansaban sobre una membrana basal. También había fibras de colágeno mínimas en el intersticio. Las características histológicas y ultraestructurales del prepucio, así como los estudios inmunohistológicos utilizando vimentina y proteína S100 como filamentos intermedios y el análisis estadístico, demostraron que es un recurso científico útil.

A new classification of labia minora hypertrophy and surgical methods / 中华整形外科杂志

Objective@#To introduce a method to classify the labia minora hypertrophy and to investigate its significance to the selection of surgical method.@*Methods@#From August 2014 to April 2018, 1 058 patients with labia minora hypertrophy were treated in the Plastic Surgery Hospital. According to the hyperplastic degree of the labia minora and praeputium clitoridis, the labia minora hypertrophy was classified to three types, namely simple clitoridis hypertrophy, simple labia minora hypertrophy and mixed type. For patients with simple labia minora hypertrophy, the methods of margin resection, or wedge resection or combination were applied. For patients with simple clitoridis hypertrophy, the reduction of clitoris hood could be performed. For mixed type, firstly the relationship of clitoris hood and labia minor should be recognized, then the appropriate surgical method should be taken.@*Results@#The age of the patients was 18 to 46 years (mean age was 25 years). 83 cases (7.8%) were simple labia minora hypertrophy. 25 cases (2.4%)were simple clitoridis hypertrophy. And 950 cases (89.8%) were mixed type. All the patients received appropriate surgical method to repair the malformation. All the surgeries were successfully performed and the cosmetic results were satisfying.@*Conclusions@#As the homologous tissues, whether praeputium clitoridis hypertrophy or labia minora hypertrophy could result poor appearance of female vulva. The concept of holism should be kept in mind when repair surgeries are performed. The labia minora hypertrophy was classified to three types and appreciate surgical methods were applied to repair the hypertrophy. The cosmetic result was satisfying.

Correction of clitoris prepuce deformity / 中华整形外科杂志

The abnormality of the clitoral prepuce not only hinders the appearance, but also reduces the sensitivity of the clitoris, affecting sexual intercourse, exercise, and local hygiene. Clitoral hood plastic surgery is the main treatment to correct the deformity, which can improve the appearance and sexual simulation. In recent years, with the rise of female genital cosmetic surgery, surgical correction of abnormal clitoris prepuce have been further developed. The anatomy and classification of the clitoris prepuce and the progress of treatment are reviewed in this article.

Clinical effect of two-person of and one-person operations of disposable circumcision stitching instrument / 国际外科学杂志

Objective To compare the clinical effect of two-person operations of disposable circumcision stitching instrument and one-man operations of disposable circumcision stitching instrument.Methods Clinical data of 340 patients with redundant prepuce or phimosis from March 2015 to August 2017 were randomly divided into control group which patients with two-person operation of disposable circumcision stitching instrument and study group which patients with one-man operation of disposable circumcision stitching instrument were reviewed prospectively.There were 188 patients in the study group,including 22 patients with phimosis and 166 patients with redundant prepuce;Among the 152 patients in the control group,there were 17 cases with phimosis and 135 cases with redundant prepuce.Two groups with operation time,intraoperative blood loss,postoperative skin staple missing,2 hours postoperative pain,postoperative edema,the swelling subsided time,postoperative complications,postoperative patient satisfaction,and so on.Measurement data were represented as (x) ± s,and comparison between groups was analyzed using t test;count data were represented as percentage and comparison between groups was analyzed chi-square.Results All operations were finished successfully for the patients by two-person or one-man of operations of disposable circumcision stitching instrument.In terms of operation,the operation time of the observation group and the control group was (7.76 ±0.45) minutes and (7.86 ±0.91) minutes respectively,and the difference was not statistically significant(P ＞ 0.05).Intraoperative hemorrhage of observation group and control group were (1.77 ± 0.22) ml and (1.72 ± 0.26) ml,and the difference was not statistically significant (P ＞ 0.05).There was no statistically significant difference between the observation group and the control group (P ＞ 0.05) in the postoperative 2 hours pain score and skin staple missing.In the postoperative complications,the deviation rate of the prepuce was 1.11％,significantly lower than the control group 5.92％,and the difference was statistically significant (P ＜ 0.05).There was no statistically significant difference between the observation group and the control group in terms of edema on the third postoperative day,short postoperative anastomosis,patient satisfaction,and postoperative infection.Conclusion The way of one-man operation of disposable circumcision stitching instrumente not only saves labor costs,but also has a good postoperative clinical effect,meanwhile,it has high efficiency and strong operability,and is worthy of promotion for clinical first-line urologists.

Pathogenesis, prevention and management of edema after prepuce surgery / 中华男科学杂志

Prepuce diseases are very common conditions in urology and andrology, and quite a few cases need to be treated by surgery. Preputial edema is a common complication after prepuce surgery, with a higher incidence rate in children than in adults. Although preputial edema is just moderate symptom and does not affect urination, it worries or even distresses the patient both physically and psychologically. In recent years, rapid achievements have been made in prepuce surgery, as in prepuce circumcision, preputial neoplasm excision, and penile degloving repair, which can now be accomplished with shorter time and higher efficiency. Despite constant improvement in the methods and techniques for prepuce surgery, postoperative edema remains difficult to be totally prevented. Pathogenic factors for postoperative preputial edema vary from disturbance of blood circulation to inflammatory factor-induced change in capillary permeability, lymphatic circulation disorders, and neurogenic edema. Elimination of the pathogenic factors and precautionary measures after surgery count significantly to the prevention and management of postoperative preputial edema. This review focuses on the pathogenesis, prevention and treatment of edema after prepuce surgery.

HPV infection of the external genitalia in men whose female partners have cervical HPV infection / 中华男科学杂志

<p><b>Objective</b>Human papilloma virus (HPV) is a necessary cause of cervical cancer and is also closely related to penile cancer, oropharyngeal cancer, and anal cancer in males. However, few studies are reported on male HPV. This study aimed to investigate HPV infection of the external genitalia in men whose female partners have cervical HPV infection.</p><p><b>METHODS</b>We collected the relevant data on the male outpatients whose partners had cervical HPV infection in our Department of Urology and Andrology from August to December 2016. We obtained samples with nylon swabs from the glans penis, corona, inner layer of the prepuce and penile body and detected different types of HPV infection using the Hybribio HPV typing kit, PCR and membrane hybridization.</p><p><b>RESULTS</b>Valid data were collected from 140 males, which showed 83.5% of HPV infection of the external genitalia, including 60 cases of HPV6 (43.2%), 27 cases of HPV16 (19.4%), 14 cases of HPV39 (10.1%), 13 cases of HPV18 (9.4%), 13 cases of HPV58 (9.4%), and 13 cases of HPV52 (9.4%). Redundant prepuce was found in 75.5% of the males, but there was no statistically significant difference in the incidence rate of HPV infection between the normal and redundant prepuce groups (P > 0.05).</p><p><b>CONCLUSIONS</b>Men who have the female partners with positive cervical HPV are at high risk of HPV infection and therefore need to be screened and treated so as to reduce HPV infection in both sexes.</p>

Novas perspectivas no diagnóstico e tratamento da acropostite-fimose em touros / New perspectives in the diagnosis and treatment of acropostitis-phimosis of bulls

A acropostite-fimose é um processo inflamatório da extremidade do prepúcio, diagnosticada com frequência em touros. O presente estudo objetivou avaliar o exame ultrassonográfico na definição da viabilidade do folheto prepucial interno (FPI) e na evolução clínica do pós-operatório, após o emprego de fios de categute ou poliglactina na hemostasia e de algodão ou poliglactina na confecção de sutura padrão Donatti empregada para fixar o FPI à pele prepucial no transoperatório da acropostite-fimose em touros. A sutura utilizada foi captonada ou não captonada, e os animais submetidos ao procedimento cirúrgico apresentavam no mínimo dois terços do FPI viável. Os touros foram alocados, aleatoriamente, em quatro grupos contendo nove animais cada, de acordo com o fio empregado na hemostasia e na confecção da sutura padrão Donatti. O exame ultrassonográfico mostrou-se importante na indicação ou não do tratamento cirúrgico da acropostite-fimose e possibilitou localizar lesões, mensurar a área de reação tecidual e identificar lesões profundas e pontos de estreitamento do FPI. Os animais de GII apresentaram edema mais discreto, observando-se diferença significativa (P<0,05) entre GII e os grupos GI, GIII e GIV. A ocorrência de hiperemia no sétimo dia de pós-operatório também foi menor nos touros do grupo GII, ocorrendo diferença significativa (P<0,05) entre GII e os grupos GI e GIII. A sutura empregando o dispositivo de látex (cápton) e o emprego do fio de poliglactina apresentaram-se como medidas benéficas, resultando em menor número de complicações pós-operatórias.(AU)

Acropostitis-Phimosis is an inflammatory process of the extremity of the prepuce, frequently diagnosed in bulls. The present study aimed to evaluate ultrassound exams in the definition of viability of the internal layer of prepuce and the postoperative clinical evolution. This evaluation is after the employment of catgut or poliglactin threads in homeostasis, and cloth or polyglactin threads in confection of the standard suture, Donatti, used to fix the internal layer of prepuce to the preputial in the postoperative of acropostitis-phimosis in bulls. The suture was captonated and non-captonated and the animals conducted to the surgical procedure showed at least 2/3 of viability of the internal layer of prepuce. The bulls were randomly allocated in four groups, each one containing nine animals, according to the thread used in homeostasis and confection of the Donatti standard suture. Ultrassound was shown to be important in the indication or not of the surgical treatment of acropostitis-phimosis and allowed the identification of lesions, measurement of areas of tissue reaction and locate deep lesions and narrowing points of internal layer of prepuce. The employment of latex device (capton) in suture and the employment of polyglactin thread 910 were shown as beneficial measures, resulting in a lower number of postoperative complications.(AU)

Use of a disposable circumcision suture device versus conventional circumcision: A systematic review and meta-analysis / 亚洲男科学杂志(英文版)

This systematic review assessed the safety and efficacy of the disposable circumcision suture device (DCSD) and conventional circumcision (CC) in the treatment of redundant prepuce and phimosis. Two independent reviewers conducted a literature search for randomized controlled trials (RCTs) using the DCSD and CC for the treatment of redundant prepuce or phimosis in China and abroad. Nine RCTs (1898 cases) were included. Compared with the CC group, the DCSD group had a shorter operative time (standardized mean difference [SMD] = -21.44; 95% confidence intervals [95% CIs] [-25.08, -17.79]; P < 0.00001), shorter wound healing time (SMD = -3.66; 95% CI [-5.46, -1.85]; P < 0.0001), less intraoperative blood loss (SMD = -9.64; 95% CI [-11.37, -7.90]; P < 0.00001), better cosmetic penile appearance (odds ratio [OR] =8.77; 95% CI [5.90, 13.02]; P < 0.00001), lower intraoperative pain score, lower 24-h postoperative pain score, lower incidence of infection, less incision edema, and fewer adverse events. There were no differences between the CC and DCSD groups in the incidences of dehiscence, or hematoma. The results of this meta-analysis indicate that the DCSD appears to be safer and more effective than CC. However, additional high-quality RCTs with larger study populations are needed.

A novel disposable ring versus the suture device in circumcision / 中华男科学杂志

Objective@#To investigate the clinical effect of a novel disposable ring versus that of the suture device in circumcision for redundant prepuce and phimosis.@*METHODS@#We randomly assigned 470 male patients with redundant prepuce or phimosis to receive circumcision with a novel disposable ring (the DR group, n = 235) or the suture device (the SD group, n = 235) and compared the operation time, intraoperative blood loss, pain scores, wound healing time, and postoperative complications and penile appearance between the two groups of patients.@*RESULTS@#All the operations were completed smoothly. Compared with the SD group, the DR group showed significantly shorter operation time (［7.49 ± 1.84］ vs ［3.83 ± 0.42］ min, P 0.05) or while the staples scraping the underpants or at the ring removal (3.49 ± 1.22 vs 3.36 ± 1.41, P >0.05). No obvious postoperative infection or delayed healing was observed except for 3 cases of wound dehiscence (1 in the DR and 2 in the SD group) and 8 cases of delayed removal of the staples in the SD group.@*CONCLUSIONS@#The novel disposable ring, with its advantages of short operation time, less bleeding and pain, good penile appearance, high safety, and simple operation, is obviously superior to the suture device in circumcision and deserves to be applied and popularized clinically. .

Embedding sutures of single inner- and outer-prepuce flap for the treatment of concealed penis: A report of 37 cases / 中华男科学杂志

Objective@#To evaluate the clinical effect of embedding sutures of single inner- and outer-prepuce flap in the treatment of concealed penis.@*METHODS@#This retrospective analysis included 37 cases of concealed penis treated by embedding sutures of single inner- and outer-prepuce flap between July 2011 and May 2015. Catheters were pulled out from the patients within 24 hours and the dressing removed about 1 week after surgery. All the patients were followed up for 12－24 months postoperatively for evaluation of the long-term outcomes of surgery.@*RESULTS@#One-stage wound healing was achieved in all the patients. No foreskin flap necrosis, inflammation, edema, voiding dysfunction, or painful erection was found during the follow-up. The penises were extended by 2－4 cm. No complications were observed axcept 8 cases of mild prepuce edema, which all subsided with 6 months postoperatively.@*CONCLUSIONS@#Embedding sutures of single inner- and outer-prepuce flap, with the advantages of simple operation, rapid recovery and few complications, is a desirable surgical option for the treatment of concealed penis.

Frenulum identification positioning with a disposable suture device in circumcision to prevent postoperative penile frenulum malposition / 中华男科学杂志

Objective@#To investigate the effect of the frenulum identification positioning method with a disposable suture device in circumcision for the prevention of postoperative penile frenulum malposition.@*METHODS@#Totally 212 patients with phimosis or redundant prepuce underwent circumcision from March 2015 to September 2016, including 109 cases of conventional circumcision (the control group) and 103 cases treated by frenulum identification positioning with a disposable suture device (the observation group). We observed the postoperative position of the penile frenulum and median raphe and compared the deviation angles of the frenulum between the two groups of patients.@*RESULTS@#The median of penile frenulum deviation angle (interquartile range) was 0 (3.56) in the observation group, significantly smaller than 12.41 (19.59) in the control (P <0.001, P = 0.000). And the rate of frenulum deviation was remarkably lower in the former (8.74% ［9/103］) than in the latter group (66.06% ［72/109］) (P <0.01).@*CONCLUSIONS@#Circumcision using the frenulum identification positioning method with a disposable suture device can effectively avoid postoperative penile frenulum malposition. With the advantages of safety and easy operation, it deserves clinical application and popularization.

Shang Ring scissor circumcision versus electrotome circumcision for redundant prepuce / 中华男科学杂志

<p><b>Objective</b>To compare the clinical effects of Shang Ring scissor circumcision (SC) and electrotome circumcision (EC) in the treatment of redundant prepuce or phimosis.Methods: Results: Conclusion.</p><p><b>METHODS</b>This retrospective study included 524 patients with redundant prepuce or phimosis, 422 treated by SC and 120 by EC. We made comparisons between the two groups of patients in the operation time, intra- and post-operative pain scores, pain scores before, at and after ring removal, wound healing time, and incidence rates of postoperative edema and incision dehiscence.</p><p><b>RESULTS</b>The operation time was longer in the SC than in the EC group (［59.99±5.39］ vs ［39.94±4.94］ sec, P<0.05), but there were no significant differences between the two groups in the intraoperative pain scores (1.02±0.74 vs 1.08±0.59, P>0.05) or the pain scores within 24 h after operation (6.74±1.01 vs 6.56±1.06, P>0.05), 24 h prior to ring removal (1.14±0.69 vs 1.10±0.64, P>0.05), and after ring removal (2.73±0.74 vs 2.85±0.75, P>0.05) except at ring removal, which was remarkably lower in the SC than in the EC group (3.56±0.47 vs 4.77±0.58, P<0.05). The wound healing time was markedly shorter in the former than in the latter (［14.11±1.26］ vs ［39.78±7.55］ d, P<0.05), but the incidence rate of incision dehiscence showed no significant difference between the two groups (4.03% ［17/422］ vs 9.17% ［11/120］, P>0.05). The rate of postoperative satisfaction with the external penile appearance was 100% in both of the two groups.</p><p><b>CONCLUSIONS</b>Shang Ring scissor circumcision is preferred to electrotome circumcision for its advantages of less pain at ring removal and shorter healing time despite its longer operation time.</p>

Circumcision with "no-flip Shang Ring" and "dorsal Slit" methods for adult males: A single-centered, prospective, clinical study / 亚洲男科学杂志(英文版)

This paper was aimed to compare the clinical effectiveness and safety of adult male circumcision using the Shang Ring™ (SR) with the no-flip technique compared with Dorsal Slit (DS) surgical method. A single-centered, prospective study was conducted at the West China Hospital, where patients were circumcised using the no-flip SR (n = 408) or the DS (n = 94) procedure. The adverse events (AEs) and satisfaction were recorded for both groups, and ring-removal time and percentage of delayed removals were recorded for the SR group. Finally, complete follow-up data were collected for 76.1% of patients (SR: n = 306; DS: n = 76). The average ring-removal time for the SR group was 17.62 ± 6.30 days. The operation time (P < 0.001), pain scores during the procedure (P < 0.001) and at 24 h postoperatively (P < 0.001), bleeding (P = 0.001), infection (P = 0.034), and satisfaction with penile appearance (P < 0.001) in the SR group were superior to those in the DS group. After two postoperative weeks, the percentage of patients with edema in the SR group (P = 0.029) was higher but no differences were found at 4 weeks (P = 0.185) between the two groups. In conclusions, the no-flip SR method was found to be superior to the DS method for its short operation time (<5 min), involving less pain, bleeding, infection, and resulting in a satisfactory appearance. However, the time for recovery from edema took longer, and patients may wear device for 2-3 weeks after the procedure.

Compared the Efficacy of Circumcision Suture Surgery and Surgery Foreskin Cerclage Ring / 现代医院

Objective The curative effect comparison of circumcision suture surgery and surgery foreskin cerclage ring.Methods Selection in our department from July 2013 to October 2016 were selected from children with phimosis or re-dundant prepuce in children with a total of 562 cases as the research object , randomly divided into control group (182 cases) and observation group (380 cases).The observation group using disposable circumcision suture treatment , the control group using prepuce ring resection in the treatment of patients , observe the operation effect , two postoperative pain and complica-tions.Results The observation group operation success rate ( 100%) was significantly higher than the control group (94.09%), observation group operation time , intraoperative bleeding volume , postoperative 24h pain scores were signifi-cantly less than the control group , the adverse reaction rate of observation group ( 6.32%) was significantly lower than the control group (11.54%),the differences between groups were significantly P<0.05.Conclusion Ircumcision surgery su-ture is better than that of ring foreskin cerclage surgery , more safe and reliable .

Prepuce development in Mongolian boys / Монголын Анагаах Ухаан

BackgroundThe prepuce (foreskin) is a simple fold of skin formed from an outer keratinized layer and inner mucosallayer, lining a preputial sac and provides functions such as protective, erogenous, and immunologic. Theprepuce is normally non-retractile during neonatal development, as the inner epithelial lining of prepuceand glans adhere each other. Non retractile prepuces are common among young boys and normalpart of preputial development. However, unnecessary circumcision is widely practiced among youngadolescents due to poor understanding of foreskin and lack of medical indication.GoalTo assess preputial retractibility in Mongolian boys at various ages to determine natural process ofpreputial separation.Material and MethodsWe evaluated 1697 Mongolian boys aged 2 to 12. Preputial condition was classifi ed into 5 types basedon preputial retractability: type I-phimosis, type II–partial phimosis, type III–adhesion of prepuce, IV–normal, V–circumcised. We also prospectively evaluated 30 histological materials of patients (2-12 yearsold), who were treated by complete circumcision. The materials were fi xed 10% solution of formalin,embedded in paraffi n, stained with hematoxylin-eosin and examined by 3 pathologists.ResultsThe incidences of type I was 67.9% in 2 years old, 12% in 6years, and 4.1% in 10 years and1.1% in12 years old, respectively. On the contrary, the incidences of type IV were 15.4% in 2 years old, 29.8%in 6 years, 74.7% in 10 years and 91.6% in 12 years. Thecircumcisionswere0% in 2 years old, 5.7%in 6 years old, 2.9% in 10 years old and 5% in 12 years old. Most patients (76.7%) did not have anyhistological alterations of the skin and infl ammatory alteration, not lichen sclerosis, were observed in23.3% in histological examination followed by circumcision.Conclusion: Preputual separation increases with ages in boys and surgical treatment of the phimosisshould be performed with cautions.

Preputial Calculus in a Neurologically-impaired Child.

Background: Preputial calculi are rarely encountered in childhood. Case characteristics: A 5-year-old boy with symptoms of chronic balanoposthitis. Observation: A preputial stone was documented and removed at circumcision. Outcome: Uneventful postoperative recovery. Message: In children, association between phimosis and neurologic impairment represent predisposing condition for preputial stone formation.

Applications of disposable circumcision stapler with lidocaine cream combined with lidocaine injection anesthesia in circumcision / 中华泌尿外科杂志

Objective To investigate the application efficacy of disposable circumcision stapler with compound lidocaine cream combined with lidocaine injection in the circumcision.Methods From September 2013 to November 2014,120 cases (11 cases of redundant prepuce phimosis patients), were divided into disposable circumcision suture group (S group, 60 cases) and conventional circumcision (T group, 60 eases) ,two groups had no statistically significant difference at patient age and wrapping case (6 cases phimosis of S group,5 cases phimosis of T group) (P ＞0.05.Patient's age ranged from 11 to 49 years.30 patients in each group were treated with lidocaine cream combined with lidocaine injection,and another 30 patients were treated with a local anesthetic lidocaine injection.Comparisons were conducted among the four groups on the operation time, anesthesia, intraoperative and postoperative pain score, blood loss and postoperative complications, postoperative appearance satisfaction, wound healing time.Results For the disposable circumcision stapler with lidocaine cream combined with lidocaine injection group, disposable circumcision stapler with lidocaine injection group, sleeve circumcision with lidocaine cream combined with lidocaine injection group and sleeve circumcision with lidocaine injection group, the operation time was (5.3 ± 1.5) min, (4.9 ± 1.4) min, (31.6 ± 3.4) min, (32.0 ± 3.3) min respectively, blood loss was (0.6 ± 0.4) ml, (0.8 ± 0.5) ml, (6.9 ± 2.4) ml, (7.5 ± 2.1) ml respectively, narcotic pain score was 0.6 ± 0.6,3.2 ±3.9,2.5 ± 1.0,0.5 ±0.6,intraoperative pain score was 0.8 ±0.9,1.4 ±0.8,2.2 ± 1.1,3.1 ± 1.1,postoperative 24 h pain score was 1.6 ±0.9,2.2 ±0.8,2.6 ± 1.3,4.4 ± 1.1, postoperative 48h pain score was 0.7 ±0.6,0.8 ±0.9,2.4 ±0.8,2.8 ±0.7, wound healing time was (13.7 ±1.5)d,(13.5 ± 1.7)d, (14.2 ± 1.3) d, (14.1 ± 1.6) d, the rate of postoperative complications was 6.6％ (2/30), 10.0％ (3/30),26.6％ (8/30), 33.4％ (10/30), satisfaction rate of appearance was 93.4％ (28/30), 96.7％ (29/30),70.4％ (22/30), 80.0％ (24/30).Compared with sleeve circumcision with lidocain injection group,disposable circumcision stapler with lidocaine cream combined with lidocaine injection had a shorter operation time, less pain, less bleeding, higher appearance satisfaction rate and lower incidence of complications (P ＜ 0.05), wound healing time had no significant difference (P ＞ 0.05).Conclusion Application of the disposable circumcision stapler with lidocaine cream combined with lidocaine injection on circumcision is safe and has got better clinical outcomes.

Detection of Leishmania infantum in the smegma of infected dogs / Detecção de Leishmania infantum no esmegma de cães infectados

Considering the venereal transmission of visceral leishmaniasis from dogs to bitches, the aim of this study was to verify if the penile surface and smegma from infected dogs can be the source of parasites in bitches. Twelve Leishmania infantum infected dogs had semen and smegma samples collected for submission to PCR identification of the DNA of the parasite. Semen (41.7 percent) and smegma (50.0 percent) have similar positive incidence (P>0.05; Fisher's exact test), with 58.3 percent of the dogs positive for semen and/or smegma samples. The proportion of positivity for both semen and smegma was 33.3 percent, but 8.3 percent was positive only for semen, and 16.7 percent only for smegma, revealing a moderate agreement between tests (K=0.5; Kappa index). It was concluded that Leishmania infantum is present in the smegma of contaminated dogs and it can be a source of parasites for the semen and the bitch...

Tendo em vista a transmissão venérea da leishmaniose visceral do cão para a cadela, o objetivo deste estudo foi verificar se a superfície peniana e o esmegma de cães infectados poderiam ser a fonte de parasitas para a fêmea. Amostras de sêmen e esmegma de 12 cães infectados com Leishmania infantum foram submetidas à identificação do DNA do parasita por PCR. As incidências de positividade no sêmen (41,7 por cento) e no esmegma (50,0 por cento) foram semelhantes (P>0,05; teste exato de Fisher), sendo 58,3 por cento dos cães positivos para sêmen e/ou esmegma. A positividade para sêmen e esmegma juntos ocorreu em 33,3 por cento, mas em 8,3 por cento dos casos apenas no sêmen, e em 16,7 por cento apenas no esmegma, o que revela uma concordância moderada entre os testes (K=0,5; índice Kappa). Conclui-se que a Leishmania infantum está presente no esmegma de cães contaminados, podendo ser a fonte de parasitas para o sêmen e a cadela...