Factors Associated with Knowledge of and Willingness for Adult Male Circumcision in Changsha, China.

BACKGROUND: Male circumcision (MC) has been shown to reduce the risk of male genital diseases. MC is not commonly practiced among Chinese males and little is known about the factors associated with their knowledge of and willingness for MC. This study was to explore the knowledge regarding the foreskin among Chinese males and to identify factors associated with their willingness to undergo circumcision. METHODS: A total of 237 patients with redundant prepuce/phimosis were interviewed through face-to-face interviews. The items on the questionnaire included: demographics, an objective scale assessing knowledge about the foreskin, willingness to have MC, the attitudes of sexual partners and doctors toward redundant prepuce/phimosis, and the approaches that patients used to acquire knowledge regarding the prepuce. Univariate analysis and multiple logistic regression analysis were performed to identify factors that are associated with willingness to be circumcised (WTC). RESULTS: A total of 212 patients completed the interview. Multivariable logistic regression showed that three factors were significantly associated with WTC: being married (OR = 0.43), perceiving redundant prepuce/phimosis as a disease (OR = 1.93), and if a patient's partner supported MC (OR = 1.39). 58% (n = 122) had received information about the foreskin from another party: 18% (n = 37) from school, 8% (n = 17) from family, 17% (n = 36) from friends, 27% (n = 57) from health care providers. About 4% (n = 8) believed that their partners disliked their redundant prepuce/phimosis. 20% (n = 42) had received doctors' advice to undergo circumcision. CONCLUSION: Knowledge about the foreskin was low among Chinese males. Our study elucidates the factors associated with WTC and suggests that more education of the population about the foreskin can help improve the recognition of a correctible abnormality and help patients assess the potential role of MC in their health.

Hong Kong Chinese parents' attitudes towards circumcision.

OBJECTIVE: To investigate Hong Kong Chinese parents' knowledge and attitudes towards phimosis and circumcision. DESIGN: Questionnaire survey. SETTING: Four primary schools in Hong Kong. PARTICIPANTS: Anonymous questionnaires were sent to Chinese parents of boys, aged 6 to 12 years old, studying in primary school Grades 1 to 6. Their social backgrounds, attitudes and beliefs towards phimosis and circumcision were enquired into. RESULTS: The parents of 1479 pupils answered the questionnaire, giving a response rate of 95.8%. In all, 10.7% of schoolboys had undergone circumcision, and 11.8% of the fathers were circumcised. Regarding non-circumcised boys, 28.9% of their parents believed that their sons had phimosis and 15.6% believed they would require circumcision later. Among these parents, 57.9% would consider circumcision for their boys in public hospitals, 96.9% thought that public institutions should provide such service, and 82.6% thought that doctors' opinions were most important when deciding about circumcision. Most parents believed that circumcision could prevent balanitis (82.8%) and improve hygiene (81.8%). Significantly more parents from Mainland China and of lower social class believed that circumcision could improve cosmesis, growth of the penis, sexual potency and fertility, and prevent sexually transmitted diseases and penile cancer. CONCLUSION: Circumcision is not widely practised in Hong Kong. However, it can be a potential burden on surgical services in public hospitals. There are misconceptions concerning phimosis and circumcision, especially in parents from Mainland China and from lower socio-economic classes. Doctors' opinions are the most important factor guiding parental decisions on circumcision. Thus, family physicians' advice and education are important to avoid unnecessary circumcisions.

[Sexual function and mental state in patients with redundant prepuce or phimosis].

OBJECTIVE: To investigate the correlation of sexual dysfunction with psychological abnormalities by analyzing the sexual function and mental state of the patients with redundant prepuce or phimosis. METHODS: This study included 216 randomly selected patients with redundant prepuce or phimosis and 85 normal male controls. We conducted investigations among the subjects using a questionnaire on the general data of the patients, Chinese Index of Sexual Function for Premature Ejaculation (CIPE), International Index of Erectile Function (IIEF), and Symptom Checklist 90 (SCL-90). Then we assessed the status of premature ejaculation (PE) and erectile dysfunction (ED), calculated the incidence of psychological abnormalities, such as depression and anxiety, and analyzed the correlation of PE and ED with the mental state of the patients. RESULTS: The PE and ED patients scored significantly higher than normal controls on SCL-90, somatization, compulsion, depression, anxiety and other factors (P < 0.05). CIPE scores were correlated with the scores on SCL-90, somatization, compulsion, interpersonal sensitivity, depression, anxiety and other factors, while ED-related scores showed no correlation with the scores on SCL-90 and other factors. CONCLUSION: Patients with redundant prepuce or phimosis have poor mental health, and there is an interaction between PE and the mental state of the patient.

Sexual and social life of men operated in childhood for hypospadias and phimosis. A comparative study.

OBJECTIVE: Hypospadiacs have been reported to be sexually less active, make their sexual debut later, have more negative genital appraisal and have less qualified professions than other men. We studied whether the reported differences are due to circumcised-like penile appearance. METHODS: We compared the social and sexual life of hypospadias patients to circumcised patients. A detailed questionnaire was mailed to 64 patients operated for hypospadias and to 64 age-matched patients circumcised for phimosis 18-31 years ago. RESULTS: Fortysix (75.0%) hypospadiacs and 43 controls (67.2%) returned the questionnaire. Sexual life and success in life in general among hypospadiacs did not differ from those of circumcised patients. Hypospadiacs were markedly more dissatisfied with the result of the operation (33 vs. 5%). Ten hypospadiacs and one control were dissatisfied with the appearance of their penis (p<0. 01). Thirty-seven hypospadiacs (80.4%) had voiding problems compared to 20 controls (46.5%) (p<0.01). CONCLUSIONS: Our results demonstrate that even patients with a less than perfect technical result are able to live a satisfactory sexual life and to succeed in life in general. Minor differences observed in sexual life between men operated for hypospadias and other men seem not to be due to the circumcised appearance of the penis even in cultures where circumcision is uncommon.

[Phimosis, hydrocele and varicocele. 3 frequent pathologies in the male child and adolescent]. / Fimose, hidrocele e varicocele. Três patologias frequentes na criança e no adolescente do sexo masculino.

A review is made of the three most frequent benign andrological pathologies in children and teenagers. The clinical and physiopathological aspects are analysed both practically and theoretically. The therapeutic measures most commonly taken in treatment are referred.