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Search Results: 1 - 10 of 28 matches for " phimosis "
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Corticosteróides tópicos no tratamento da fimose primária em idade pediátrica: revis?o baseada na evidência
Pires,Paulo; Teixeira,Hermínia; Lopes,Irene; Santos,José Agostinho;
Revista Portuguesa de Clínica Geral , 2011,
Abstract: goals: phimosis is defined as the presence of a non-retractable foreskin by a narrow preputial ring. it can be classified as primary or secondary. primary phimosis is present in 96% of newborns, and tends to resolve spontaneously in the first 3 years of life. after this age treatment may be considered. circumcision is the classic treatment, but is associated with morbidity and costs. recently, several authors have reported the use of topical steroids as an alternative treatment for phimosis with good results. the aim of this review is to evaluate the available evidence on the efficacy and safety of topical steroids in the treatment of primary phimosis in children aged 3 to 18 years. data sources: medline, evidence-based medicine web sites, the index of portuguese medical journals and references of selected articles. review methods: practice guidelines, systematic reviews, meta-analyses and randomized controlled trials (rct) were searched using the keywords phimosis and steroids. the strength of recommendation taxonomy (sort) of the american family physician was used to classify the articles. results: forty four articles were found and four met the inclusion criteria for this review. one guideline proposes treatment with a topical steroid, 0,05% to 0,1%, twice a day for 20 to 30 days (sor a). three randomized controlled trials found that the use of topical steroids in the treatment of primary phimosis is effective, with a resolution rate of 65,8% to 90% and no reported adverse effects (evidence level 1). conclusions: the available evidence suggests that the use of topical steroids for the treatment of primary phimosis in pediatric patients is effective and without adverse effects (sor a). the application of the drug requires retraction of the foreskin, which must be repeated for maintaining hygiene. topical steroids are safe and effective for the treatment of phimosis and can be recommended by the family physician.
Safety and Efficacy of Circumcision Stapler in the Treatment for Children with Phimosis and Redundant Prepuce  [PDF]
Zhuocheng Jiang, Hui Chen, Mingli Wu, ing Li, Hong Li, Mantao Jiang, Xingtao Cai
Open Journal of Urology (OJU) , 2018, DOI: 10.4236/oju.2018.89029
Abstract: Objective: To observe the clinical effect and safety of circumcision stapler in children with phimosis and redundant prepuce. Methods: From July 2013 to July 2017, 40 children were prospectively randomized and assigned to experiment group (circumcision stapler n = 20) or control group (conventional circumcision, n = 20). Outcomes were operation time, intraoperative blood loss and postoperative complications. Results: There was significant difference between the two groups for operation time (5.35 min vs 30.30 min, P < 0.05) and intraoperative blood loss (2.56 ml vs 10.40 ml, P < 0.05) respectively. Conclusion: Circumcision staplers are superior to conventional circumcision for the advantages of shorter operation time and fewer blood losses.
Epidemiologic study on penile cancer in Brazil
Favorito, Luciano A.;Nardi, Aguinaldo C.;Ronalsa, Mario;Zequi, Stenio C.;Sampaio, Francisco J. B.;Glina, Sidney;
International braz j urol , 2008, DOI: 10.1590/S1677-55382008000500007
Abstract: objectives: to assess epidemiologic characteristics of penile cancer in brazil. materials and methods: from may 2006 to june 2007, a questionnaire was distributed to all brazilian urologists. their patients' clinical and epidemiological data was analyzed (age, race, place of residence, history of sexually transmitted diseases, tobacco smoking, performance of circumcision, type of hospital service), as well as the time between the appearance of the symptoms and the diagnosis, the pathological characteristics of the tumor (histological type, degree, localization and size of lesion, stage of disease), the type of treatment performed and the present state of the patient. results: 283 new cases of penile cancer in brazil were recorded. the majority of these cases occurred in the north and northeast (53.02%) and southeast (45.54%) regions. the majority of patients (224, or 78.96%) were more than 46 years of age while only 21 patients (7.41%) were less than 35 years of age. of the 283 patients presenting penile cancer, 171 (60.42%) had phimosis with the consequent impossibility to expose the glans. a prior medical history positive for hpv infection was reported in 18 of the 283 cases (6.36%). in 101 patients (35.68%) tobacco smoking was reported. the vast majority of the cases (n = 207; 73.14%) presented with tumors localized in the glans and prepuce. in 48 cases (16.96%) the tumor affected the glans, the prepuce and the corpus penis; in 28 cases (9.89%) the tumor affected the entire penis. the majority of the patients (n = 123; 75.26%) presented with t1 or t2; only 9 patients (3.18%) presented with t4 disease. conclusion: penile cancer is a very frequent pathology in brazil, predominantly affecting low income, white, uncircumcised patients, living in the north and northeast regions of the country.
Estudo retrospectivo de fimose traumática em equinos e tratamento utilizando a técnica de circuncis?o com encurtamento de pênis (1982-2007)
Silva, Luiz Antonio Franco da;Rabelo, Rogério Elias;Godoy, Roberta Ferro de;Silva, Olízio Claudino da;Franco, Leandro Guimar?es;Coelho, Cássia Maria Molinaro;Cardoso, Leonardo Lamaro;
Ciência Rural , 2010, DOI: 10.1590/S0103-84782009005000231
Abstract: penis and prepuce injuries of stallions are common causes of infertility in horses and among them, paraphimosis is featured. this retrospective study was conducted in 367 rural properties and 49 cases were found; 43 of them were traumatic with 12 deaths. the technique of circumcision with shortening of the penis was used for the correction of the disease in 20 animals. they were divided into two groups according to the anesthetic protocol used. all horses had post-operative complications such as edema in various degrees, which decreased significantly in 95% of animals after the seventh day. thus, it was concluded that the technique of circumcision with penis shortening is an effective alternative in the treatment of traumatic paraphimosis in horses.
Fimosis y Circuncisión
CASTRO S,FELIPE; CASTRO A,FELIPE; RABY B,TRINIDAD;
Revista chilena de pediatría , 2010, DOI: 10.4067/S0370-41062010000200009
Abstract: the term phimosis is used when the prepuce cannot be reytracted behind the glans. this condition is oresent in almost all newborns, fulfilling mostly a protective function. in childhood, a gradual separation occurs, which is completed in adolescence. through this process, complications may happen such as urinary tract infections, balanitis, or paraphimosis. circumcision has been considered the treatment of choice, although some factors must be weighed: degree of narrowing, complications, opinión and religious beliefs of the parents. in the past 15 years, publications have suggested topical steroids as an alternative treatment, with variable success. treatment of phimosis will continue to be controversial.
Concealed Male Epispadias: A Rare Form of Penile Epispadias Presenting As Phimosis
Alireza Sina,Farshid Alizadeh
Urology Journal , 2011,
Abstract:
Preputial retraction in children
Agarwal Abhinav,Mohta Anup,Anand Ritesh
Journal of Indian Association of Pediatric Surgeons , 2005,
Abstract: OBJECTIVE: The aim of the study was to assess preputial retractability in children at various ages. MATERIALS AND METHODS: Nine hundred and sixty boys attending the hospital were included in the study. Children with hypospadias or history of preputial manipulation were excluded. Preputial anatomy was studied and subjects were classified into five groups as described by Kayaba et al . RESULTS: The prepuce could not be retracted at all so as to make even the external urethral meatus visible in 61.4% children aged 0-6 months while this decreased to only 0.9% in children aged 10-12 years. At the other end of the spectrum, while prepuce could not be fully retracted in any child below 6 months, it could be done in about 60% in the age group of 10-12 years. CONCLUSION Preputial nonseparation is the major cause of preputial nonretraction in the pediatric age group. Prepuce spontaneously separates from the glans as age increases and true phimosis is rare in children. Surgical intervention should be avoided for nonseparation of prepuce.
To circ or not to circ: clinical and pharmacoeconomic outcomes of a prospective trial of topical steroid versus primary circumcision
Nobre, Yuri D.;Freitas, Ricardo G.;Felizardo, Maria J.;Ortiz, Valdemar;Macedo Jr., Antonio;
International braz j urol , 2010, DOI: 10.1590/S1677-55382010000100012
Abstract: purpose: to compare the efficacy and costs of circumcision versus topical treatment using a prospective pharmacoeconomic protocol. materials and methods: we treated 59 patients (3-10 years of age) randomized into two groups: 29 underwent an 8-week course of topical treatment with 0.2% betamethasone-hyaluronidase cream twice a day; and 30 underwent circumcision. topical treatment success was defined as complete exposure of the glans. in cases of treatment failure, circumcision was performed and its cost imputed to that of the initial treatment. the pharmacoeconomic aspects were defined according to the brazilian national public health system database and the brazilian community pharmacies index. results: the two groups were statistically similar for all clinical parameters evaluated. topical treatment resulted in complete exposure of the glans in 52% of the patients. topical treatment was associated with preputial pain and hyperemia. however, treatment suspension was unnecessary. minor complications were observed in 16.6% of the surgical group patients. the mean cost per patient was us$ 53.70 and us$ 125.20, respectively, for topical steroid treatment (including the costs related to treatment failure) and circumcision. the total costs were us$ 2,825.32 and us$ 3,885.73 for topical treatment and circumcision, respectively. conclusions: topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery.
Treatment of phimosis with topical steroids and foreskin anatomy
Marques, Tatiana C.;Sampaio, Francisco J.B.;Favorito, Luciano A.;
International braz j urol , 2005, DOI: 10.1590/S1677-55382005000400012
Abstract: 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.
Necesidad de circuncisión o dilatación del prepucio: Estudio de 1.200 ni?os
Morales Concepción,Julio C.; González Fernández,Pedro; Morales Aránegui,Aymée; Guerra Rodríguez,Marlen; Mora Casacó,Bárbara;
Archivos Espa?oles de Urología (Ed. impresa) , 2008, DOI: 10.4321/S0004-06142008000600006
Abstract: objectives: to demonstrate the increase of preputial retractability with age. to point out the small usefulness of circumcision and preputial forced dilation during childhood. methods: the development of the prepuce and its retractability were evaluated in 1200 boys between 0 and 16 years. the prepuce was classified as type i to v depending on its lower or higher retractability in all cases having been dilated previously or not. results: prepuce retractability in boys under one year was type i (not retractile} in 63.4%, whereas it was type v (completely retractile) in only 3.7%. the contrary was observed in adolescents (11 to 16 years), in which type i was 0.9% and type v was observed in 80.9%. it was also observed that 309 boys (43.1%) among the 717 with previous prepuce forced dilation, had types i to iv prepuces, so, they had acquired new balanopreputial adherences by the time of examination for our study. seventeen boys (0.4%) required circumcision. no children suffered upper urinary tract infections. conclusions: all boys are born with the prepuce covering the glans penis, keeping adherences between both structures, which disappear with age, being the detachment complete at the time of puberty in most boys. so, we consider circumcision or forced dilation of the prepuce unnecessary in most boys.
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