A randomized clinical trial of on-demand oral pre-exposure prophylaxis does not modulate lymphoid/myeloid HIV target cell density in the foreskin.

Objectives: As topical pre-exposure prophylaxis (PrEP) has been shown to cause immune modulation in rectal or cervical tissue, our aim was to examine the impact of oral PrEP on lymphoid and myeloid changes in the foreskin in response to dosing and timing of drug administration.

Design: HIV-negative male individuals ( n  = 144) were recruited in South Africa and Uganda into an open-label randomized controlled trial in a 1 : 1 : 1 : 1 : 1 : 1 : 1 : 1 : 1 ratio to control arm (with no PrEP) or one of eight arms receiving emtricitabine-tenofovir disoproxil fumarate (F/TDF) or emtricitabine-tenofovir alafenamide (F/TAF) at one of two different doses, 5 or 21 h before undergoing voluntary medical male circumcision (VMMC).

Methods: After dorsal-slit circumcision, foreskin tissue sections were embedded into Optimal Cutting Temperature media and analysed, blinded to trial allocation, to determine numbers of CD4 + CCR5 + , CD1a + cells and claudin-1 expression.

Multiple preputial stones: A case report and literature review.

Introduction: Preputial stones are a very rare form of urinary tract stone, and only small number cases have been reported in the literature, and tend to occur in uncircumcised males with poor genital hygiene, low socioeconomic status, and phimosis.

Presentation Of Case: Here, we report a case in a male who presented with more than 100 preputial stones. The stones were evident on clinical examination by palpation on the preputial.

Limited Dorsal Slit Preputialplasty for Management of Phimosis in Children.

Objective: To evaluate the functional and cosmetic result of limited dorsal slit preputialplasty for surgical management of phimosis in children.

Methods: This is a prospective cohort study (Jan 2010 to Dec 2019) of 246 children (age >5 y) who were unable to retract the foreskin and were symptomatic.

Results: No intraoperative complications were encountered.

Subcutaneous tissue-sparing dorsal slit with new marking technique: A novel circumcision method.

Circumcision is a very common surgical procedure that is performed for medical and traditional purposes in the world. However, many technical of circumcision is needed to improve. Thus, this study introduced a novel method of circumcision that is a refined version of the sleeve technique, termed subcutaneous tissue sparing dorsal slit with new marking, and evaluated the safety and efficacy of this novel method of circumcision.

Can lichen sclerosus be diagnosed by preputial appearance or symptoms?

Introduction: Lichen sclerosus (LS), or balanitis xerotica obliterans, is a chronic, inflammatory disease accompanied by cicatrizing skin conditions resulting in pathologic phimosis. LS can be detected clinically by the whitish appearance of the glans or the foreskin, thickened, nonretractable foreskin, dysuria, and spraying. However, diagnosis is confirmed histopathologically.

Choosing the appropriate ShangRing size for paediatric circumcision using the no-flip technique.

Aim: To determine the correct ShangRing size for paediatric circumcision using the no-flip technique.

Methods: A cohort of 104 boys (from 6 to 14 years) underwent ShangRing circumcision at Ningbo First Hospital, China. The patients were randomly divided into three groups according to the different methods used for choosing the ring size.

Frenulum Sparing Circumcision: Step-By-Step Approach of a Novel Technique.

Objective: Circumcision, by most conventional methodologies, involves division of the frenulum and excision of the entire foreskin covering the glans. This seemingly simple procedure is occasionally associated with dreadful and devastating complications. We describe a new frenulum-sparing technique that circumvents some of the potential complications of conventional techniques and could also potentially help preserve preputial role in sexual function.

Voluntary medical male circumcision in resource-constrained settings.

Throughout East and Southern Africa, the WHO recommends voluntary medical male circumcision (VMMC) to reduce heterosexual HIV acquisition. Evidence has informed policy and the implementation of VMMC programmes in these countries. VMMC has been incorporated into the HIV prevention portfolio and more than 9 million VMMCs have been performed.

Is combined inner preputial inlay graft with tubularized incised plate in hypospadias repair worth doing?

Background: It has been noted that after tubularized incised plate urethroplasty (TIP) repair, the final meatal position is glanular but not at the optimum position. Inner preputial inlay graft combined with tubularized incised plate (G-TIP) has been proposed for redo urethroplasty. We extended this indication to be the standard technique for primary hypospadias repair.

Dorsal inlay inner preputial graft for primary hypospadias repair.

Background: The most commonly performed operation to repair distal hypospadias is the Tubularised incised plate (TIP) repair. The key step is midline incision of the urethral plate, which widens a narrow plate and converts a flat into a deep plate groove, ensuring a vertical, slit neomeatus and a normal-calibre neourethra. At times in cases of proximal hypospadias, the urethral plate is very narrow and needs to be augmented or substituted for further tubularisation.

High prevalence and incidence of HIV, sexually transmissible infections and penile foreskin cutting among sexual health clinic attendees in Papua New Guinea.

Unlabelled: Background Papua New Guinea (PNG) has one of the highest prevalences of HIV and sexually transmissible infections (STIs) in the Asia-Pacific region, and one of the highest burdens of maternal syphilis and cervical cancer globally. Despite this disease burden, only limited clinical research in sexual and reproductive health has been conducted in PNG.

Methods: A longitudinal clinical cohort study was conducted at two sexual health clinics.

[Prepuce in boys and adolescents: what when, and how?].

Introduction: The prepuce envelops the glans as a variant of a mucocutaneous tissue presenting with a lot offunctions, the most important of them being to protect the infant's glans from feces and ammonia in diapers, to protect the glans from abrasions and trauma throughout life, and to provide sufficient skin in erection. Circumcision was recognized as a method of solving foreskin problems a long time before Christ. Practicing male circumcision in history was customary several thousand years ago and has spread worldwide.

A typology of penile cutting in Papua New Guinea: results of a modified Delphi study among sexual health specialists.

Male circumcision (MC) significantly reduces the risk of HIV acquisition in men. The geographical, linguistic and cultural diversity of Papua New Guinea (PNG) makes issues of acceptability and implementation complex, and culturally appropriate HIV and Sexually Transmissible Infection (STI) prevention strategies are crucial in this setting. A modified Delphi approach was conducted with sexual health specialists to document and classify variants of penile cutting as part of a programme of research being carried out to investigate the acceptability and potential epidemiological impact of MC for HIV prevention in PNG, and options for future roll-out.

Prepuce: phimosis, paraphimosis, and circumcision.

Phimosis is a condition in which the prepuce cannot be retracted over the glans penis. Actually, physiologic phimosis is common in male patients up to 3 years of age, but often extends into older age groups. Balanoposthitisis a common inflammation occurring in 4-11% of uncircumcised boys.

[Phimosis: dorsal slit or circumcision?].

Introduction: Phimosis is perhaps one of the most frequent consultation on pediatric surgery clinics throught the world. The aim of this study is to compare the two procedures more frequently performed in our hospital: dorsal slit and circumcision. PATIENTS Y METHODS: Retrospective study of 1698 patients who were admitted for elective surgical treatment of phimosis between 2003 and 2009.

[A case of urinary retention caused by true phimosis].

We report a case of urinary retention caused by true phimosis in a 67-year-old man with untreated diabetes mellitus. The patient could not void in a stream, and urine dropped out of the external urethral orifice with manual compression of the penis. Subsequently, he visited our hospital due to urinary retention.

Current concepts in hypospadias surgery.

Anatomical anomalies in hypospadias are an abnormal ventral opening of the urethral meatus, abnormal ventral curvature of the penis and abnormal distribution of the foreskin around the glans with a ventrally deficient hooded foreskin. The techniques of hypospadias surgery continue to evolve. The current standard of care for hypospadias repair includes not only a functional penis adequate for sexual intercourse and urethral reconstruction offering the ability to stand to urinate, but also a satisfactory cosmetic result.

Dorsal inlay graft urethroplasty for primary hypospadiac repair.

Objective: Tubularized incised plate urethroplasty has become a popular technique for repairing distal and proximal hypospadias in many institutions. Dorsal inlay graft urethroplasty has been used in our institution since 2003 to reduce the risk of meatal stenosis. In the present study, we evaluated the results of the dorsal inlay graft procedure.

Paraphimosis: current treatment options.

Paraphimosis is a urologic emergency, occurring in uncircumcised males, in which the foreskin becomes trapped behind the corona and forms a tight band of constricting tissue. Often iatrogenically induced, paraphimosis can be prevented by returning the prepuce to cover the glans following penile manipulation. Treatment often begins with reduction of edema, followed by a variety of options, including mechanical compression, pharmacologic therapy, puncture technique and dorsal slit.

La Vega slit procedure for the treatment of phimosis.

Objectives: The surgical treatment of phimosis is usually circumcision. In countries in which circumcision is not widely practiced, this approach results in a phallus that is cosmetically unacceptable. We applied a ventral slit procedure to boys with severe phimosis and achieved outstanding results.

Use of the Mogen clamp for neonatal circumcision.

Most newborn circumcisions performed in the United States are done with either a Gomco clamp or a Plastibell device. The Mogen clamp, devised by a jewish mohel, provides a quick and simple surgical alternative. The foreskin is freed from the glans by blunt dissection, but no dorsal slit is made.

Paraphimosis in elderly men.

Paraphimosis occurs when the foreskin of the penis is retracted over the glans and cannot be replaced in its normal position. The tight ring of preputial skin constricts the distal penis causing vascular occlusion, much like a tourniquet. The condition is painful and, if not dealt with quickly, can lead to necrosis of the glans.

Emergency reduction of paraphimosis.

Paraphimosis in uncircumcised or incompletely circumcised children is a serious and painful condition requiring prompt reduction to prevent possible necrosis of the glans or urinary obstruction. Techniques described to reduce oedema distal to the constricting ring include application of ice packs, compressive elastic bandages, and making a dorsal slit which necessitates later circumcision. We have used a simple "puncture" technique to treat successfully an uncircumcised 12-year-old boy with severe paraphimosis.