Balanitis xerotica obliterans in children and its incidence under the age of 5 years.

Objective: To analyse the incidence of BXO among paediatric circumcisions for preputial pathology, in particular in children under the age of 5 years.

Methods: Retrospective review revealed 1769 paediatric circumcisions performed between 1997 and 2008 at our institution. Data were collected on patient's age, date when sample received by pathology department and histological findings for all the foreskin samples received and examined during the study period.

[Treatment of urethral meatus stenosis due to Balanitis xerotic obliterans. Long term results using the meatoplasty of Malone].

Objective: To present our experience in the treatment of severe stenosis of the external urinary meatus in male children and adults with balanitis xerotic obliterans.

Materials And Methods: A total of 21 patients were operated on in a 5-year period, using the meatoplasty technique of Malone. Mean patient age was 41.

The Cleveland Clinic experience with adult hypospadias patients undergoing repair: their presentation and a new classification system.

Objective: • To characterize and categorize adults with hypospadias who presented to our clinic with urethral stricture and fistula to better clarify the presentation, history and intraoperative findings in this heterogeneous group and to better describe the natural history of this anomaly in adulthood.

Patient And Methods: • A retrospective chart review was performed on adults with hypospadias who underwent urethroplasty for urethral stricture, urethrocutaneous fistula, and/or hypospadias repair at Cleveland Clinic between 1993 and 2009. All procedures were performed by a single staff surgeon (K.

Lichen sclerosus in boys.

Background: Lichen sclerosus (LS) is a sclerosing skin disease. When it appears in boys, it nearly always affects the penis and usually causes phimosis requiring surgical treatment. The clinical significance of this disease in boys is inadequately recognized.

Critical outcome analysis of staged buccal mucosa graft urethroplasty for prior failed hypospadias repair in children.

Purpose: Although staged buccal mucosa graft urethroplasty is a well accepted technique for salvage urethroplasty, there are few reports on this procedure for redo hypospadias repair in children.

Materials And Methods: We reviewed patients who underwent staged buccal mucosa graft urethroplasty for redo hypospadias repair. Age, quality of graft before tubularization, meatal position, presence of balanitis xerotica obliterans and complications were recorded.

The surgical management of lichen sclerosus of the glans penis: our experience and review of the literature.

Introduction: Lichen sclerosus (LS) of the glans penis is a chronic, progressive, scleroatrophic inflammatory process of unknown etiology affecting the glans penis, prepuce, and urethra and may lead to severe impairment of sexual and urinary function.

Aims: To report our experience of surgical management of LS of the glans penis.

Main Outcome Measures: Complications, patients' satisfaction, cosmesis, resolution of pain and puritus, and postoperative sexual function and were recorded retrospectively.

Lichen sclerosus: epidemiological distribution in an equal access health care system.

Purpose: The incidence and demographics of lichen sclerosus range from 1/300 (0.3%) to 1/1,000 individuals (0.1%).

Oral mucosa graft for repair of hypospadias: outcomes at puberty.

Purpose: Oral mucosa graft has been used in the treatment of hypospadias for the last 15 years. We assessed the long-term outcome of oral mucosa grafts for urethral substitution in hypospadias surgery at our institution.

Materials And Methods: We retrospectively reviewed patients who underwent oral mucosa graft for hypospadias between 1994 and 2002.

Penile cancer--prevention and premalignant conditions.

Objectives: Relatively little evidence is available in the published studies on the prevention of penile cancer and premalignant conditions of the penis. The present review examined the current evidence available in preventing penile cancer and pathologic subtypes of premalignant conditions and their treatment. The recommendations made in the present review formulate the basis of the recent 2009 International Consultation on Urologic Disease Consensus Publishing Group.

Foreskin management: Survey of Canadian pediatric urologists.

Objective: To study the approaches to foreskin management of pediatric urologists in Canada.

Design: An online questionnaire comprising several survey questions and clinical vignettes.

Setting: Canada.

[Perineal urethrostomy in complex anterior urethral stricture].

Staged urethroplasty is a well-known procedure for urethral reconstruction that had already been described by Russell in 1914 and was later popularized by Johanson, Turner-Warwick, Blandy, and Schreiter. It lends itself to the treatment of complex anterior urethral stricture in combination with lichen sclerosus, failed correction of hypospadias, fistula, via falsa, abscess, carcinoma, or previously unsuccessful urethroplasty. Perineal urethrostomy can be performed as a temporary or definitive measure.

Case of a congenital urethral duplication being unmasked following circumcision for balanitis xerotica obliterans.

We present the case of an 11-year-old boy diagnosed with an Effmann Type II A1 urethral duplication after routine circumcision for balanitis xerotica obliterans (BXO). We discuss the pathophysiology, investigation and management both of BXO and urethral duplication.

The high rate of familial lichen sclerosus suggests a genetic contribution: an observational cohort study.

Background: Familial lichen sclerosus (LS) has been described in only 37 families. We feel that the association is under-reported.

Objectives: To determine the percentage of patients with LS who have a positive family history.

Extensive balanitis xerotica obliterans of urethrocutaneous fistula presenting as mass in scrotum.

A rare case of extensive lichen sclerosis (balanitis xerotica obliterans) involving the anterior urethra, urethrocutaneous fistula, and scrotum is described in a middle-aged man who presented with a history of obstructive voiding symptoms. He was managed by excision of mass along with the fistulae and staged buccal mucosal urethroplasty.

Tubularized incised plate hypospadias repair for distal hypospadias.

Purpose: We report surgical technique and outcomes in consecutive patients with primary distal hypospadias.

Materials And Methods: A prospectively maintained database of all patients operated by WS in 2000-2008 was reviewed for pertinent data in consecutive patients.

Results: A total of 551 consecutive patients of mean age 17 months underwent distal tubularized incised plate hypospadias repair by urethral plate tubularization with (459) or without (92) midline incision.

[Urethoplasty in balanitis xerotica obliterans. Technical variation].

Objective: We propose a modification to urethroplasty for stricture due to lichen sclerosus (balanitis xerotica obliterans).

Methods: We combine two-stage bucal mucosa graft and onlay ventral island flap. RESULTADOS/CONCLUSIONES: This technique offers enlargement of the graft with the island flap and removal of the pathological skin.

Two-stage repair in hypospadias.

We provide the reader with a nonsystematic review concerning the use of the two-stage approach in hypospadias repairs. A one-stage approach using the tubularized incised plate urethroplasty is a well-standardized approach for the most cases of hypospadias. Nevertheless, in some primary severe cases, in most hypospadias failures and in selected patients with balanitis xerotica obliterans a two-stage approach is preferable.

The role of two-stage repair in modern hypospadiology.

Hypospadias surgery continues to evolve. The enthusiasm for flap-based urethroplasty is waning and instead there is an increasing preference for urethroplasty that uses either the urethral plate alone or in combination with grafts. From the vast armamentarium of hypospadias repairs that are still in use, the author suggests a simple protocol of just three closely related procedures with which we can now repair almost all hypospadias.

Long-term efficiency of skin stretching and a topical corticoid cream application for unretractable foreskin and phimosis in prepubertal boys.

Objectives: To evaluate the long-term efficacy of topical application of a potent corticoid cream and skin stretching in the treatment of unretractable foreskin, pinpoint phimosis, balanopreputial adhesions and lichen sclerosus in prepubertal boys.

Methods: 462 prepubertal boys (mean age 4.7 years) with unretractable foreskin applied a topical potent corticoid cream together with skin stretching twice daily for 6 weeks.

Routine biopsies in pediatric circumcision: (non) sense?

Objective: At our institute we usually send the foreskin after circumcision for pathological examination. Does this make sense or is it merely medical overconsumption?

Material And Methods: A retrospective analysis was carried out of all pediatric patients who underwent a circumcision, from August 2005 to January 2008, for persisting pathological phimosis after treatment with topical steroids. Religious circumcisions were excluded.

Conservative treatment of phimosis with fluticasone proprionate 0.05%: a clinical study in 1185 boys.

Objective: Circumcision has been the traditional method of choice in the treatment of boys with phimosis. Recently, several published studies worldwide have focused their interest on more conservative approaches in management of this condition. These studies advocate the use of topical steroids in the phimotic foreskin.