Preputial bacterial colonisation in uncircumcised male children: Is it related to phimosis? (original) (raw)
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International Journal of Innovative Technology and Exploring Engineering, 2020
Phimosis is the inability of the penis to potrude from the prepuce either partially or completely and the preputial retractability increases with age. Circumcision is believed by various parties as a form of defense against pathogens that may cause various abnormalities. Smegma is whitish lump that formed from desquamation of preputial epithelial cells. Smegma and bacteria in the prepuce may cause abnormalities such as genital infections, urinary tract infections, and even malignancy. This study aims to determine the presence between phimosis, smegma, and preputial bacteria, and its relationship with inflammatory status of circumcised patient. A cross sectional analytical study for boys who underwent circumcision at Saiful Anwar General Hospital Malang. The data will be analyzed using chi-square and will be calculated for the relative risk. There were 76 patients who underwent circumcision from March 2018 until August 2018. The result was found that the presence of phimosis was sign...
Effect of circumcision status on periurethral bacterial flora during the first year of life
The Journal of Pediatrics, 1988
To determine whether bacterial colonization is a factor in the pathogenesls of urinary tract infection, we compared the periurethral bacterial flora of uncircumcised versus circumcised boys during the first year of life. Intraurethral and circumferential glans cultures were obtained from 25 circumcised and 25 uncircumcised infants at 2 days, 2 weeks, 2 months, 4 months, 6 months, and 12 months of age. Different children were used at each age (300 total). The types of bacteria and the total and specific colony counts were compared. The results of the glans cultures were similar to those from the urethra. Uncircumcised boys had significantly higher total colony counts (p <0.003) at all ages except 12 months. Eschirchia coliwas present significantly more often (p <0.01) in the urethras of uncircumcised boys at 2 weeks, 2 months, 4 months, and 6 months. Gram.negative uropathogenic organisms (Klebsiella-enterobacter, Proteus mirabilis, and Pseudomona$ aeruginosa) were cultured more frequently (p <0.0005) from the urethras of uncircumcised boys at 2 months, 4 months, and 6 months. The specific colony counts for E. coli and the other uropathogenlc organisms were significantly higher (p <0.05) at all ages except 12 months. We conclude that during the first 6 months of life, the presence of a foreskin is associated with a greater quantity of periurethral bacteria and a greater likelihood for the presence of, as well as higher concentrations of, potentially uropathogenic organisms.
Introduction: Preputioplasty have gained a new interest now days because the retained preputial skin with mucosa after preputioplasty gives good cosmetic appearance and it can be utilized in future for urethral stricture surgery. The aim of this study was to compare the post-operative complications and post-operative hospital stay in patients operated by circumcision and preputioplasty. Methodology: This prospective study included 50 patients (age less than 4 years) having phimosis, treated during July 2010 to July 2012. These patients were treated by two methods viz. circumcision and preputioplasty (25 cases by each method).The patients were assessed post-operatively at day 1, day 15, at 2 months and at 3 months. Results: The study revealed that the immediate post-operative complications like pain, bleeding, oedema, difficulty in micturition and fever were present after both the procedures. But post-operative pain (84%), bleeding (24%) and difficulty in micturition (16%) were higher after circumcision than after preputioplasty (40%, 4% and 4% cases respectively). Post-operative oedema was more prominent in preputioplastyoperated patients (84%). Post-operative hospital stay was longer in cases treated with circumcision. After three months, recurrent adhesions were more common after preputioplasty (32%). Cosmetic appearance was acceptable in patients operated with both the procedures. Conclusion: Preputioplastyis a faster, easier, relatively painless technique with excellent cosmetic results and lesser complications than circumcision, except post-operative edema and adhesions.
Circumcision requirement in children with phimosis: immediately or elective?
Medical Science and Discovery, 2020
Objective: Phimosis is define as unretractable prepuce and has two different clinical presentation; pathological (PaP) and physiological. Physiological phimosis (PhP) is a common condition in children that does not require treatment. In our study, we aimed to determine the actual requirement for circumcision in patients with phimosis who were recommended circumcision. Material and Methods: Children who were offered circumcision due to phimosis between July 2019 and January 2020 and applied to the pediatric surgery and pediatric urology outpatient clinic were included in the study. They were evaluated in terms of referring physicians, genital examination findings and requirement for circumcision. Results: Between the study dates, 199 patients applied for circumcision due to phimosis. 126 patients are under one year old, 73 patients are over one year old. PhP was present in 194 of the patients and PaP in 5 of them. While PaP is not detected in patients under one year of age, there ar...
Comparative periurethral bacteriology of uncircumcised and circumcised males
Genitourinary medicine, 1997
It has been established that lack of circumcision increases the risk of urinary tract infection in infants. During the first six months, the presence of foreskin is associated with a greater quantity and a higher concentration of uropathogens in the periurethral area. Very little is known about this association in older males. To compare the periurethral bacteriology of uncircumcised healthy males of more than one year of age. The periurethral area of 125 uncircumcised and 46 circumcised healthy males (mean age, 26.5 and 28.3 years, respectively) was swabbed and cultured for facultative and anaerobic bacteria, genital mycoplasmas and Chlamydia trachomatis. Facultative Gram positive cocci predominated in both groups (62% and 80%, respectively). Pure culture of facultative Gram negative rods was more common in uncircumcised males (17% v 4% in circumcised males, p = 0.01). Streptococci, strict anaerobes and genital mycoplasmas were found almost exclusively in uncircumcised males of mor...
Male Circumcision and Infection
Circumcision [Working Title]
Worldwide, male circumcision is done for religious or cultural reasons, and to a lesser degree for medical indications. Newborn male circumcision is associated with fewer genitourinary infections in younger males. In the current decade, a substantial body of research suggests that male circumcision is effective as a prophylactic measure against HIV and other sexually transmitted infections. The compelling HIV reductions in 3 African randomized control trials in circumcised men have prompted use of male circumcision as a key part of HIV prevention in developing nations. More recently, the use of male circumcision as a public health measure in developed nations is a topic of international discussion.
Modified partial circumcision for phimosis
Annals of Pediatric Surgery, 2018
Objectives In the last years, many surgical techniques of preputioplasty have aimed to preserve the foreskin in case of phimosis. These techniques are not reliable for patients affected by phimosis linked to balanitis xerotica obliterans (BXO) and scarred foreskin. We tried an original technique of resection of the pathological foreskin, removing the mucosal internal layer followed by reconstruction of the foreskin. The aim was to evaluate the outcome of paediatric patients who underwent modified partial circumcision for pathological phimosis. Patients and methods In all, 360 patients with phimosis underwent modified partial circumcision at our institution. The mean age of the boys was 8.9 years, range 5-15 years. In 145 (40.3%) cases, indication for surgery was clinical suspicion of BXO, in 215 (59.7%) cases it was chronic inflammation of the foreskin. Results In all cases, the postoperative period was uneventful. Cosmesis was considered by parents as excellent in 95.2% of patients. In these patients, the glans was almost completely covered by soft foreskin. Histopathological examination of the removed foreskin documented BXO in 162 (45%). Twelve (3.3%) patients complained of recurrences and five (1.4%) patients of smegmatic cysts. Conclusion The described surgical technique of modified partial circumcision for the correction of pathological phimosis appears cosmetically well accepted, safe, and simple with low rate of late postoperative complications.
Effect of Circumcision on Incidence of Urinary Tract Infection. Authors' Reply
The Journal of Pediatrics, 1996
To determine whether circumcision decreases the risk of symptomatic urinary tract infection (UTI) in boys less than 5 years of age. Study design: A case-control study (1993 to 1995) in the setting of a large ambulatory pediatric service. Case subjects and control subjects were drawn from the same population. One hundred forty-four boys less than 5 years of age (median age, 5.8 months) who had a microbiologically proven symptomatic UTI (case subjects), were compared with 742 boys (median age, 21.0 months) who did not have a UTI (control subjects). The proportion of case and control subjects who were circumcised in each group was compared with the use of the chi-square test, with the strength of association between circumcision and UTI expressed in terms of an odds ratio. To determine whether age was a confounder or an effectmodifier, we stratified the groups by age (<I year;-> I year) and analyzed by the method of Mantel-Haenszel. Results: Of the 144 preschool boys with UTI, 2 (I .4%) were circumcised, compared with 47 (6.3%) of the 742 control subjects (chi-square value = 5.6; p = 0.02; odds ratio, 0.21; 95% confldence intervals, 0.06 to 0.76). There was no evidence that age was a confounder or modified the protective effect of circumcision on the development of UTI (Mantel-Haenszel chi-square value = 6.0; p = 0.01; combined odds ratio, 0.18; 95% confidence intervals, 0.05 to 0.71; Breslow-Day test of homogeneity chi-square value = 0.6; p = 0.4). Conclusions: Circumcision decreases the risk of symptomatic UTI in preschool boys. The protective effect is independent of age.
Urology journal, 2019
PURPOSE To discuss whether concealed penis after circumcision lowers perimeatal urethral and glanular sulcus uropathogenic bacterial colonization in healthy boys with no urinary tract problems and prevents attacks of febrile urinary tract infections in non-healthy boys with defined urinary tract abnormalities. Materials and Methods: This case-control study was conducted in Ibn-i Sina Hospital and retrospectively collected data of 471 boys were analyzed. All patients were scanned for any urinary tract abnormality and those with any defined abnormalities were classified as non-healthy group. (123 patients) Non-healthy patients were divided into two subgroups as concealed (n:31) and non-concealed (n:92) penis after circumcision. Healthy patients with no urinary problems were divided into three groups as circumcised without concealed penis (n:144), with concealed penis aft...