Knowledge of and attitude towards circumcision of adult Korean males by age

AIM: Circumcision is widely practised in Korea, but little is known regarding the public's attitude towards circumcision. This study was designed to evaluate the knowledge and the general opinion of Korean adult males towards circumcision. METHODS: Fifteen hundred self-completion questionnaires were distributed to adult males in five decadal age groups ranging from 10 to 59 y old. Questions concerning opinions regarding the necessity, reasons, potential benefits and disadvantages of circumcision, as well as the role of peer pressure upon the decision to circumcise were included. Completed questionnaires were collected and analysed statistically. RESULTS: The achieved response rate was 62.7%. 73.1% believed that circumcision is necessary, while 7.1% believed it is not necessary. The principal reason for circumcision was to improve penile hygiene (77.9%). 68.7% did not prefer neonatal circumcision regardless of the respondent's age. The major reason was fear of pain (36.9%). Peer pressure was one of the most influential factors when deciding upon circumcision: 60.8% believed that they might be ridiculed by their peer group unless circumcised, and the younger the age of the respondent, the more frequently this opinion was held (p < 0.05). 62.7% thought that circumcision would prevent genital tract infection of the sexual partner. Respondents with older age tended to emphasize improved sexual potency (p < 0.05). CONCLUSIONS: This study indicates that common beliefs of adult males about circumcision in Korea are relatively homogeneous. Tailored education about circumcision is needed.     

Treatment of phimosis with topical steroids in 194 children

PURPOSE: Topical steroids have been advocated as an effective economical alternative to circumcision in boys with phimosis. We evaluated the effectiveness of topical steroid therapy as primary treatment in 194 patients with phimosis. METHODS: Between January 1996 and November 2000, 228 boys 16 years old or younger were referred for consideration of circumcision. When intervention was determined to be necessary, a 6-week course of topical steroids was used as primary treatment. Efficacy of treatment was evaluated at 3 months from initiation of therapy. RESULTS: Of the 228 patients 15 had such a mild degree of phimosis that no intervention was believed to be necessary, 19 were scheduled directly for circumcision due to cosmetic reasons, parent wishes, or severe phimosis with associated voiding problems and the remaining 194 received topical steroids as primary treatment. Of these 194 patients 25 had coexisting balanitis and 4 had a history of urinary tract infection. Conservative treatment was successful in 87%, 88% and 75% of patients with phimosis alone, coexisting balanitis and history of urinary tract infection, respectively. Overall, circumcision was avoided in 87% of patients treated with topical steroids. CONCLUSION: Topical steroids are becoming the standard conservative measure for treating phimosis. Our study supports this trend, with an overall efficacy of 87%.     

Penile paraffinoma

A 40-year-old Caucasian man, originating from Ukraine, but living for the last year and a half in Portugal, presented to our department with a one year history of an irregular penile mass and phimosis. He reluctantly admitted that 8 years previously he had multiple mineral oil injections in the penis, for the purpose of penile enlargement. A diagnosis of penile paraffinoma was made and surgical excision was performed at the urology department. Paraffinoma results from mineral-oil injections: such practice is very rare in the western world nowadays, however, it still is performed in many Eastern European Countries.     

一次性包皮自动切除环在包皮环切术中的应用研究

目的探讨一次性包皮自动切除环在包皮环切术中的应用价值及安全性。方法收集行传统包皮环切术患者40例和应用一次性包皮自动切除环行包皮环切术患者40ff0，比较二者的手术效果。结果观察组患者在手术时间、术中出血量、术后疼痛持续时间和并发症方面，均优于对照组，差异有统计学意义（P〈0．05）。观察组患者对术后包皮外观满意率为97．50％，对照组为80．00％，二者差异存在显著性（P〈0．05）。结论一次性包皮环切器应用于包皮环切术，节省手术时间，降低出血量和并发症发生率，操作简单，安全微创，值得临床推广应用。     

新型一次性包皮环切吻合器治疗包皮过长和包茎2O例临床分析

目的：探讨新型一次性包皮环切吻合器治疗包皮过长和包茎的治疗效果。方法：应用一次性包皮环切吻合器,对20例包皮过长或包茎的患者,给予包皮环切术。结果：手术均采用包皮环切吻合器完成。手术时间平均约3～8min。术后未出现切口大片裂开,血肿形成或迟发大量出血。其中2例患者有少量渗血,行加压包扎两天后出血完全停止,1例有钛钉松动伴有约1．5cm切口裂开,予换药包扎5天后切缘对合平整,余下患者3天后拆除纱布无明显水肿、出血。术后1个月复诊,20例患者切口愈合良好,术后阴茎外观美观。结论：新型一次性包皮环切吻合器切割吻合一次完成,微创、手术时间短,患者痛苦小,美观、治疗效果好,值得推广。     

3种包皮环切术的临床疗效分析

目的:比较传统包皮环切术、袖套状包皮切除术和包皮环切吻合术治疗包皮过长或包茎患者的临床疗效。方法:回顾性分析我院泌尿外科门诊采用传统包皮环切术(n=279)、袖套状包皮切除术(n=354)和包皮环切吻合术(n=285)治疗包茎或包皮过长918例患者的临床资料,比较3种术式手术时间、术中出血量、手术者对手术的满意度、术后4 h和7 d视觉模拟疼痛评分、术后并发症、创口完全愈合时间、包皮水肿程度、患者对术后外观的满意程度及围手术期费用等指标。结果:包皮环切吻合术在手术时间和术中出血量等方面要优于袖套状包皮切除术和传统包皮环切术(P<0.05)。传统包皮环切术、袖套状包皮切除术和包皮环切吻合术的创口完全愈合时间分别为(18.6±5.2)d、(11.4±3.7)d、(20.3±5.7)d,表明袖套状包皮切除术创口完全愈合时间明显优于传统包皮环切术和包皮环切吻合术(P<0.05)。袖套状包皮切除术在手术者对手术的满意度、术后水肿程度、术后并发症以及患者对外观的满意度等方面与包皮环切吻合术相似,但要优于传统包皮环切术(P<0.05)。传统包皮环切术和袖套状包皮切除术在术后7 d视觉疼痛模拟评分和围手术期费用上明显低于包皮环切吻合术(P<0.05)。结论:3种术式各有优缺点,最终的术式选择需根据患者的年龄、经济承受能力和手术者对不同术式的手术技巧差异和熟悉程度等多方面来考虑。     

包茎局部狭窄环超微结构研究

目的：了解包茎局部狭窄环组织在类固醇外用治疗前后超微结构的变化。方法异常狭窄环手术标本组织3例（包茎组）,正常对照组手术标本组织3例（正常对照组）,局部类固醇外用治疗后痊愈手术标本组织3例（用药后痊愈组）。于门诊手术过程中选取环切的包皮组织,包茎组取狭窄环处组织1～2 g,正常对照组和用药后痊愈组取相应的包皮外环口组织1～2 g,按电镜取材要求处理包埋并制片后,电镜观察局部组织超微结构。结果电镜观察发现包茎组狭窄环组织中存在异常堆积成束的胶原纤维。正常对照组和用药后痊愈组中未发现此类成纤维细胞和异常胶原堆积现象。结论包茎狭窄环内存在异常堆积的胶原纤维。包茎狭窄环处呈现高张力而缺乏足够的弹性与胶原纤维异常堆积有关。本研究也提示局部类固醇可能通过降解异常堆积的胶原纤维使包茎局部狭窄环松解而达到治愈包茎的目的。     

门诊小儿包皮环套术应用的临床观察

目的：为了减少传统包皮环切术并发症，探索新的手术方法和途径。方法：回顾分析了2003年5月至2005年2月应用一次性小儿包皮环套手术包，选择年龄在5岁左右，诊断为包茎或包皮过长的儿童120例．在门诊局麻下，应用环套术。术后随访。结果：116例环套术治愈，4例中途改传统环切术治愈。近期总的并发症为6．8％。结论：门诊一次性小儿包皮环套扎术宜选择5岁左右患儿。该手术方法创伤小、简单、快捷，切口外观整齐、漂亮，适合于门诊外科一日门诊开展。     

湿润烧伤膏应用于包茎术后伤口的临床疗效观察

目的：探讨美宝湿润烧伤膏应用于包茎术后伤口的治疗效果。方法：选取2009年1月-2013年4月在我科行包皮环切术治疗包茎的患者,共69例,根据患者及家属意愿,分为两组,治疗组39例,采用美宝湿润烧伤膏处理术后伤口,对照组30例,采用传统方法处理术后伤口。对治疗效果进行对比分析。结果：治疗组在消肿时间、疼痛情况、愈合时间及患者满意度等方面均优于对照组。结论：美宝湿润烧伤膏应用于包茎术后伤口,可取的良好的治疗效果,值得推广。