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Zhao J, Dong Y, Clark E, Garcia JM, White DL, Kramer JR, Mazul AL, Hartman C, Chiao EY. Risk and predictors of penile cancer in US Veterans with HIV. AIDS 2024; 38:1395-1401. [PMID: 38652491 DOI: 10.1097/qad.0000000000003914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
OBJECTIVES People with HIV (PWH) may have an increased burden of penile cancer. We aimed to evaluate the risk of penile cancer in PWH compared with that of the general population. DESIGN We conducted a nationwide retrospective matched cohort study of penile cancer incidence among veterans with HIV (VWH) compared with veterans without HIV. METHODS We compared penile cancer incidence rates in 44 173 VWH to those of veterans without HIV ( N = 159 443; 4 : 1 matched in age). We used Cox regression models to estimate hazard ratios and 95% confidence intervals (CIs) for associations with HIV infection and for penile cancer risk factors. RESULTS HIV positivity was associated with an increased risk of penile cancer, with adjusted hazard ratios of 2.63 (95% CI 1.64-4.23) when adjusting for age, race/ethnicity, baseline BMI, smoking and alcohol use, economic means test, and history of condyloma. The risk increased to hazard ratio = 4.25 (95% CI 2.75-6.57) when adjusting for all factors except history of condyloma. Risk factors for penile cancer in VWH included lower nadir CD4 + count, less than 50% of follow-up time with undetectable HIV viral load, and history of condyloma. CONCLUSION VWH - particularly those with low CD4 + counts, detectable HIV viral loads, or history of condyloma - are at increased risk of penile cancer, suggesting the penile cancer prevention activities are needed in this population.
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Affiliation(s)
- Jing Zhao
- Section of Epidemiology and Population Sciences, Department of Medicine, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine
| | - Yongquan Dong
- Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt)
- Section of Health Services Research, Department of Medicine
| | - Eva Clark
- Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt)
- Section of Infectious Diseases, Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Jose M Garcia
- Geriatric Research, Education and Clinical Center (GRECC), VA Puget Sound Healthcare System and Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, Washington
| | - Donna L White
- Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt)
- Section of Health Services Research, Department of Medicine
- Dan L. Duncan Cancer Center, Baylor College of Medicine
- Texas Medical Center Digestive Disease Center, Baylor College of Medicine, Houston, TX
| | - Jennifer R Kramer
- Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt)
- Section of Health Services Research, Department of Medicine
- Dan L. Duncan Cancer Center, Baylor College of Medicine
- Section of Gastroenterology and Hepatology, Department of Medicine, Baylor College of Medicine
| | - Angela L Mazul
- Department of Otolaryngology-Head and Neck Surgery, Washington University
- Division of Public Health Science, Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Christine Hartman
- Health Services Research, Michael E. DeBakey Center for Innovations in Quality, Effectiveness, and Safety (IQuESt)
| | - Elizabeth Y Chiao
- Division of Cancer Prevention and Population Sciences, Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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Şimşek A, Başer A. An examination of erroneous medical practices in circumcision surgery in light of supreme court decisions. Pediatr Surg Int 2024; 40:157. [PMID: 38888660 DOI: 10.1007/s00383-024-05737-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE Global interest in circumcision, one of the oldest and most frequently performed surgical procedures worldwide, continues. There is a significant increase in cases regarding medical malpractice claims in the world and in our country. It is aimed to identify situations that lead to malpractice claims in circumcision surgery, which has question marks regarding its psychological and ethical aspects, to identify situations that are considered errors and professionally risky, and to contribute to eliminating these deficiencies. METHODS We examined the Supreme Court appeal decisions related to circumcision malpractice cases resolved between 2012 and 2022, using the keyword "circumcision" on the official website of the Republic of Turkiye Supreme Court. RESULTS We examined 30 Supreme Court decisions that met our criteria. It was determined that the most common lawsuit was filed due to negligence (43.3%), followed by carelessness (20%) and faulty action (20%). CONCLUSION Physical conditions must be appropriate and healthcare personnel must be adequately trained for circumcision, which is frequently performed especially in pediatric patients and is more frequently subject to malpractice lawsuits than other pediatric operations.
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Affiliation(s)
- Alper Şimşek
- Department of Urology, Siverek State Hospital, Karakoyun, Ediz Şanlıurfa Diyarbakır Yolu 8. Km Siverek, 63600, Şanlıurfa, Türkiye.
| | - Aykut Başer
- Department of Urology, Medical Faculty, Bandırma Onyedi Eylül University, Balikesir, Türkiye
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García-Perdomo HA, Granados-Duque V, Spiess PE. What is the relationship between penile cancer and the microbiome? A scoping review. Actas Urol Esp 2024:S2173-5786(24)00061-1. [PMID: 38734067 DOI: 10.1016/j.acuroe.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/17/2024] [Indexed: 05/13/2024]
Abstract
INTRODUCTION The microbiota is defined as the microorganisms in a particular environment. Conversely, the term microbiome is less firmly defined and is used to reference the habitat. OBJECTIVE To identify the association between the microbiome and the penile cancer EVIDENCE ACQUISITION: We performed this scoping review according to the recommendations of the Joanna Briggs Institute. We found five articles that fulfilled the inclusion criteria. We focused on oncogenesis and factors that alter the penile microbiome. We were not limited to language or setting. We searched MEDLINE (Ovid), Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and LILACS from inception to the present day. EVIDENCE SYNTHESIS We found nine studies describing multiple factors that could disturb the microbiome, such as sexual behavior, anatomic alterations including circumcision, and inflammatory factors: lichen sclerosus, poor genital hygiene, compromised immune system, smoking, and HPV infection. CONCLUSION Overall, knowledge of the composition of the penile microbiota and its role in penile cancer oncogenesis is minimal. PATIENT SUMMARY Future studies should focus on the relationship between the microbiome and penile cancer to broaden this field of knowledge.
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Affiliation(s)
- H A García-Perdomo
- UROGIV Research Group, Universidad del Valle, Cali, Colombia; Division of Urology/Urooncology, Department of Surgery, School of Medicine, Universidad del Valle, Cali, Colombia.
| | - V Granados-Duque
- UROGIV Research Group, Universidad del Valle, Cali, Colombia; Hospital Universitario del Valle, Cali, Colombia
| | - P E Spiess
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, Estados Unidos; Department of Genitourinary Oncology and Cancer Biology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, United States; Urology and Oncology, University of South Florida, Tampa, FL, United States
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4
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Ntshiqa T, Musekiwa A, Manesen R, Mdose H, Ngoma N, Kuonza L, Dlamini T, Reddy C, Williams S. Knowledge, Attitudes, Practices, and Acceptability of Medical Male Circumcision among Males in Traditionally Circumcising Rural Communities of Alfred Nzo District, Eastern Cape, South Africa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7091. [PMID: 38063521 PMCID: PMC10706319 DOI: 10.3390/ijerph20237091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 12/18/2023]
Abstract
Male circumcision (MC) reduces HIV transmission risk by up to 60% in heterosexual men. However, uptake of medical male circumcision (MMC) is low in traditionally circumcising communities of South Africa. We assessed knowledge, attitudes, and practices to identify factors predicting acceptability of MMC among males in the Alfred Nzo District. A cross-sectional study was conducted among males aged 15-49 years in this district. Logistic regression was used to identify factors predicting acceptability of MMC. We interviewed 343 males who had a median age of 19 years (interquartile range (IQR): 16-25 years). Of these, 77% (95% confidence interval (CI): 72-82) were circumcised: 77% (95% CI: 71-82) were circumcised in a traditional setting and 21% (95% CI: 16-26) in a medical setting. The median score of knowledge about the benefits of MMC was 62.5% (IQR: 37.5-75.0), with 59% (95% CI: 53-64) demonstrating a positive attitude towards MMC and 68% (95% CI: 63-73) accepting involvement of health workers in MC. Excellent knowledge (adjusted odds ratio (aOR): 3.07, 95% CI: 0.99-9.58, p = 0.053), awareness (aOR: 3.26, 95% CI: 1.08-9.86, p = 0.037), and positive attitude towards MMC (aOR: 2.35, 95% CI: 1.30-4.25, p = 0.005) were associated with acceptability of MMC. Participants demonstrated good knowledge and acceptance of the MMC programme. Knowledge, attitude, and awareness were significant predictors of MMC acceptability.
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Affiliation(s)
- Thobani Ntshiqa
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- South African National Aids Council, Pretoria 0002, South Africa
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
- The Aurum Institute, Johannesburg 2193, South Africa;
| | - Alfred Musekiwa
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Riyadh Manesen
- The Aurum Institute, Johannesburg 2193, South Africa;
- GERMS-SA, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa
- Epidemiology Unit, Eastern Cape Department of Health, Bisho 5605, South Africa;
| | - Hetani Mdose
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Nqobile Ngoma
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Lazarus Kuonza
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
| | - Thomas Dlamini
- Epidemiology Unit, Eastern Cape Department of Health, Bisho 5605, South Africa;
| | - Carl Reddy
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- School of Health Systems and Public Health, University of Pretoria, Pretoria 0002, South Africa
- TEPHINET Secretariat, The Task Force for Global Health, Decatur, GA 30030, USA
| | - Seymour Williams
- South African Field Epidemiology Training Programme, National Institute for Communicable Disease, Sandringham, Johannesburg 2131, South Africa; (A.M.); (H.M.); (N.N.); (L.K.); (C.R.); (S.W.)
- Centers for Disease Control and Prevention, Atlanta, GA 30328, USA
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Dar L, Baarimah A, Alshehrani S, Alasiri A, Alassiri M, Al-Ghamdi S. Male Genital Mutilation in the Name of Ritual Circumcision: A Case Report and Literature Review. Case Rep Urol 2023; 2023:9935247. [PMID: 37841831 PMCID: PMC10576645 DOI: 10.1155/2023/9935247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/17/2023] Open
Abstract
Unlike female genital mutilation, the alteration of male genitals has not received much attention. Circumcision is the most common and oldest surgical procedure being performed. When performed by surgeons or well-trained personal the procedure is safe, but most of the times it is being performed by untrained people with no or little medical background. This has led to many complications. Total skin loss is an uncommon but serious complication. There is an ongoing debate regarding the management of this complication. Here, we present a case of total penile skin loss which had resulted from penile mutilation in the name of ritual circumcision.
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Affiliation(s)
- Latif Dar
- Department of Pediatric Urology, Abha Maternity and Child hospital (AMCH), Abha, Saudi Arabia
| | - Alhareth Baarimah
- Department of Pediatric Urology, Khamis Mushayt Maternity and Children Hospital (KMMCH), Khamis Mushayt, Saudi Arabia
| | - Saeed Alshehrani
- Department of Pediatric Urology, Abha Maternity and Child hospital (AMCH), Abha, Saudi Arabia
| | - Alhassan Alasiri
- Department of Pediatric Urology, Abha Maternity and Child hospital (AMCH), Abha, Saudi Arabia
| | - Mohammad Alassiri
- Department of Pediatric Urology, Abha Maternity and Child hospital (AMCH), Abha, Saudi Arabia
| | - Saleh Al-Ghamdi
- Department of Pediatric Urology, Abha Maternity and Child hospital (AMCH), Abha, Saudi Arabia
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Peck ME, Bronson M, Djomand G, Basile I, Collins K, Kankindi I, Kayirangwa E, Malamba SS, Mugisha V, Nsanzimana S, Remera E, Kazaura KJ, Amuri M, Mmbando S, Mgomella GS, Simbeye D, Colletar Awor A, Biraro S, Kabuye G, Kirungi W, Chituwo O, Hanunka B, Kamboyi R, Mulenga L, Musonda B, Muyunda B, Nkumbula T, Malaba R, Mandisarisa J, Musuka G, Peterson AE, Toledo C. HIV, syphilis, and hepatitis B virus infection and male circumcision in five Sub-Saharan African countries: Findings from the Population-based HIV Impact Assessment surveys, 2015-2019. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0002326. [PMID: 37721926 PMCID: PMC10506706 DOI: 10.1371/journal.pgph.0002326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 08/06/2023] [Indexed: 09/20/2023]
Abstract
Voluntary medical male circumcision (VMMC) has primarily been promoted for HIV prevention. Evidence also supports that male circumcision offers protection against other sexually transmitted infections. This analysis assessed the effect of circumcision on syphilis, hepatitis B virus (HBV) infection and HIV. Data from the 2015 to 2019 Population-based HIV Impact Assessments (PHIAs) surveys from Rwanda, Tanzania, Uganda, Zambia, and Zimbabwe were used for the analysis. The PHIA surveys are cross-sectional, nationally representative household surveys that include biomarking testing for HIV, syphilis and HBV infection. This is a secondary data analysis using publicly available PHIA data. Univariate and multivariable logistic regression models were created using pooled PHIA data across the five countries to assess the effect of male circumcision on HIV, active and ever syphilis, and HBV infection among sexually active males aged 15-59 years. Circumcised men had lower odds of syphilis infection, ever or active infection, and HIV, compared to uncircumcised men, after adjusting for covariates (active syphilis infection = 0.67 adjusted odds ratio (aOR), 95% confidence interval (CI), 0.52-0.87, ever having had a syphilis infection = 0.85 aOR, 95% CI, 0.73-0.98, and HIV = 0.53 aOR, 95% CI, 0.47-0.61). No difference between circumcised and uncircumcised men was identified for HBV infection (P = 0.75). Circumcised men have a reduced likelihood for syphilis and HIV compared to uncircumcised men. However, we found no statistically significant difference between circumcised and uncircumcised men for HBV infection.
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Affiliation(s)
- Megan E. Peck
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Megan Bronson
- Division of Global HIV & TB, Epidemiology and Surveillance Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Gaston Djomand
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
| | - Ikuzo Basile
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | | | - Ida Kankindi
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | - Eugenie Kayirangwa
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | - Samuel S. Malamba
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Kigali, Rwanda
| | | | - Sabin Nsanzimana
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | - Eric Remera
- Ministry of Health, Rwanda Biomedical Center, Kigali City, Rwanda
| | - Kokuhumbya J. Kazaura
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Mbaraka Amuri
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Susan Mmbando
- National AIDS Control Program, Ministry of Health, Dar-es-Salaam, Tanzania
| | - George S. Mgomella
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Daimon Simbeye
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Dar-es-Salaam, Tanzania
| | - Anna Colletar Awor
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda
| | | | - Geoffrey Kabuye
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Kampala, Uganda
| | | | - Omega Chituwo
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Brave Hanunka
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Royd Kamboyi
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Lloyd Mulenga
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Bupe Musonda
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Brian Muyunda
- Division of Global HIV & TB, Centers for Global Health, Centers for Disease Control and Prevention, Lusaka, Zambia
| | | | - Rickie Malaba
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - John Mandisarisa
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | | | - Amy E. Peterson
- Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - Carlos Toledo
- Division of Global HIV & TB, HIV Prevention Branch, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, United States of America
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Ouattara A, Paré AK, Yé D, Sherazi A, Simporé M, Rouamba M, Kaboré AF, Kambou T. Complications of non-medical assisted circumcision in Burkina Faso. Clinical presentation, management, and outcomes - about 23 cases and literature review. Arch Ital Urol Androl 2023; 95:11494. [PMID: 37491935 DOI: 10.4081/aiua.2023.11494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 06/18/2023] [Indexed: 07/27/2023] Open
Abstract
OBJECTIVE To report the clinical presentation of circumcision complications encountered at our center and evaluate their management and outcomes. PATIENTS AND METHODS A retrospective and descriptive study was conducted at Souro Sanou University Hospital between January 1, 2014, and December 31, 2018. All patients presenting with circumcision complications were included. Parameters related to clinical aspects of circumcision complication, their management and outcomes were studied. RESULTS During the study period, 23 cases of circumcision complications were reported. The average age of patients with circumcision complications was 8.3 years ± 3.5 years, with ages ranging from 18 months to 65 years old. Circumcision was performed by nurses in 12 cases and traditional practitioners in 11 cases. Observed complications included post-circumcision bleeding and hematoma (n = 8), leading to surgical exploration and hemostasis; total or partial amputation of the glans (n = 4), requiring regularization and meatoplasty; infectious complications (n = 3), managed with combined resuscitation, antibiotic administration, and penile debridement; penile urethra-cutaneous fistulas (n = 2), which were repaired; and stenosis of the external urethral meatus (n = 2), treated by meatoplasty. No deaths were reported. CONCLUSIONS Circumcision complications presented various clinical manifestations, including hemorrhagic complications, glans amputation, infection, penile fistulas, and meatal stenosis. These complications were effectively managed from a functional perspective; however, aesthetic issues may persist. Emphasis should be placed on preventing these complications by ensuring circumcisions are performed by appropriately trained medical professionals.
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Affiliation(s)
- Adama Ouattara
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Abdoul-Karim Paré
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Delphine Yé
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Ali Sherazi
- Department of Medicine, Dalhousie Medicine New Brunswick, Saint John, New Brunswick.
| | - Mohamed Simporé
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Mickael Rouamba
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
| | - Aristide F Kaboré
- Urology Division, Yalgado Ouedraogo University Teaching Hospital, Ouagadougou.
| | - Timothée Kambou
- Urology Division, Souro Sanou University Teaching Hospital, Bobo-Dioulasso.
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8
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Mehta KS, Marfatia YS, Jain AP, Shah DJ, Baxi DS. Male circumcision and Sexually transmitted Infections - An update. Indian J Sex Transm Dis AIDS 2021; 42:1-6. [PMID: 34765930 PMCID: PMC8579597 DOI: 10.4103/ijstd.ijstd_20_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/13/2021] [Accepted: 03/18/2021] [Indexed: 11/04/2022] Open
Abstract
Role of male circumcision (MC) as a tool to prevent sexually transmitted infections (STIs)/human immunodeficiency virus (HIV) was assessed. An attempt was made to search articles related to association between MC and STIs/HIV. A thorough search was carried out to find out quality articles published in indexed specialty journals. Centers for Disease Control and Prevention and World Health Organization (WHO) sites were also referred. Warm and moist environment of area under foreskin facilitates some pathogens to persist and replicate. Further, the thinness of foreskin predisposes it to minor trauma and abrasions that facilitate the entry of pathogens. MC reduces HIV infection risk by 50%–60% over time and reduces the risk of men acquiring herpes simplex virus-2 and human papillomavirus (HPV) that can cause penile and other anogenital cancers, by 30%. There is no significant reduction in risk of acquiring syphilis, but reduced risk of acquisition of Haemophilus ducreyi is reported. MC is reported to be beneficial in conditions such as traumatic injury, Balanitis Xerotica Obliterans, refractory balanoposthitis, and chronic, recurrent urinary tract infections. MC also reduces the chances of penile carcinoma by facilitating improved penile hygiene, lowering HPV/HIV transmission rates, and reducing chronic inflammatory conditions such as phimosis and balanitis. MC has been recommended by the WHO and UNAIDS in 2007 as an additional HIV prevention intervention in settings of high HIV prevalence. MC is an important adjunct to safe sex education, condom use, and vaccination (HPV) in reducing the global burden of HIV/STIs-related morbidity and mortality.
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Affiliation(s)
- Kajal S Mehta
- Consultant Dermatologist, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
| | - Yogesh S Marfatia
- Department of Skin and VD, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
| | - Apexa P Jain
- Department of Skin and VD, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
| | - Dhiral J Shah
- Department of Skin and VD, Baroda Medical College, Vadodara, Gujarat, India
| | - Disha S Baxi
- Department of Skin and VD, SBKS Medical Institute and Research Centre, Vadodara, Gujarat, India
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9
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Nxumalo CT, Mchunu GG. Healthcare providers' perceptions and understanding of voluntary medical male circumcision in KwaZulu-Natal, South Africa: A qualitative study. S Afr Fam Pract (2004) 2021; 63:e1-e6. [PMID: 34476965 PMCID: PMC8424757 DOI: 10.4102/safp.v63i1.5318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/13/2021] [Accepted: 07/07/2021] [Indexed: 11/30/2022] Open
Abstract
Background There is compelling evidence that voluntary medical male circumcision (VMMC) reduces the chances of heterosexual transmission of HIV infection. Healthcare workers are among the key influencers in terms of the scale-up of VMMC as they are often involved in mobilisation for uptake. There is a paucity of qualitative research on healthcare workers’ experiences, understanding and perceptions of VMMC; particularly in the South African rural primary healthcare context. This study was conducted to examine healthcare workers perceptions and understanding of VMMC in KwaZulu-Natal, South Africa. Methods The study employed a qualitative approach using a phenomenographic design. A purposive sample of 15 doctors, nurses and clinical associates working in 6 different rural clinics in KwaZulu-Natal, South Africa, were interviewed in English in-depth using a semi-structured interview schedule. The interviews were audio-recorded, and transcribed. The results were analysed thematically using phenomenographic data analysis procedures. Results Categories of description in participants’ perceptions and understanding of VMMC emerged. The findings of this study revealed that healthcare workers perceptions and understanding of VMMC were predominantly influenced by the hegemonic religious and cultural norms associated with male circumcision in KwaZulu-Natal, South Africa. Conclusion The findings of this study suggest that tailored training to address healthcare workers misperceptions and poor understanding of VMMC is necessary to ensure that they become effective custodians for VMMC implementation.
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Affiliation(s)
- Celenkosini T Nxumalo
- KwaZulu-Natal Department of Health, Ndwedwe Community Health Centre, Verulam, South Africa; and, School of Nursing and Public Health, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
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Punjani N, Basourakos SP, Nang QG, Lee RK, Goldstein M, Alukal JP, Li PS. Genitourinary Infections Related to Circumcision and the Potential Impact on Male Infertility. World J Mens Health 2021; 40:179-190. [PMID: 34169676 PMCID: PMC8987143 DOI: 10.5534/wjmh.210043] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/08/2021] [Accepted: 04/12/2021] [Indexed: 11/30/2022] Open
Abstract
Male circumcision (MC) is one of the oldest surgical procedures still completed today. Medical indications for MC include phimosis, recurrent balanitis, cosmesis, and infection prevention. In this review, we mainly focus on the role of MC in the prevention of human immunodeficiency virus, human papillomavirus, herpes simplex virus, gonorrhea, chlamydia, chancroid, and syphilis, and the subsequent impact of these genitourinary infections on male fertility. Overall, many compelling data support that MC may play an essential role in both genitourinary infection prevention and male fertility.
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Affiliation(s)
- Nahid Punjani
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Spyridon P Basourakos
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Quincy G Nang
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Richard K Lee
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Marc Goldstein
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Joseph P Alukal
- Department of Urology, Columbia University, New York, NY, USA
| | - Philip S Li
- Department of Urology, Center for Male Reproductive Medicine and Microsurgery, Weill Cornell Medicine, Cornell University, New York, NY, USA.
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Palmer E, Rau A, Engelbrecht M. Changing Cultural Practices: A Case Study of Male Circumcision in South Africa. Am J Mens Health 2020; 14:1557988320927285. [PMID: 32715892 PMCID: PMC7385840 DOI: 10.1177/1557988320927285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article presents a case study of Simon, a 25-year old Black South African male. According to his Pedi customs, Simon underwent traditional male circumcision (TMC) as a 12-year-old adolescent. He tells of his fears relative to this experience and how, over time, he transitioned from a belief in TMC to a strong preference for medical male circumcision (MMC). Using a single-case study design, the aim of the research was to explore the value of the exercise of choice in TMC, which may influence cultural perceptions of gender and masculinity. The study unpacks the way in which the meaning and experience of TMC is shaped by the social and cultural contexts of South Africa. This qualitative exploration complements conventional medical accounts of circumcision, which are often focused on the medical procedure while ignoring cultural and social factors. Issues of gender, particularly the construction of hegemonic masculinity and how it positions men, women, and young boys in relation to each other and their communities, are discussed. Simon’s case study provides new insights and perspectives on personally and culturally sensitive issues which are not easily accessed nor commonly understood. Data collected via in-depth interviews were transcribed and analyzed thematically. Analysis applied information from the literature and key concepts from the theoretical standpoint of social constructivism. Case study analysis allowed space for unexpected, emergent themes to arise from the data. Four main themes were identified, notably language, silence, patriarchy, and masculinity.
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Affiliation(s)
- Eurica Palmer
- Centre for Development Support, Faculty of Economic and Management Sciences, University of the Free State, Bloemfontein, South Africa
| | - Asta Rau
- Centre for Health Systems Research & Development, Faculty of the Humanities, University of the Free State, Bloemfontein, South Africa
| | - Michelle Engelbrecht
- Centre for Health Systems Research & Development, Faculty of the Humanities, University of the Free State, Bloemfontein, South Africa
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Tasci AI, Danacioglu YO, Arikan Y, Colakoglu Y, Yapar B, Buyuk Y. Management of post-circumcision necrosis of the penis: the medicolegal aspect. Pediatr Surg Int 2020; 36:523-528. [PMID: 32088740 DOI: 10.1007/s00383-020-04630-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE To perform a medical evaluation of penile necrosis causes and treatment approaches by examining patients who had penile necrosis after circumcision surgery. METHODS A total of 24 patients with penile necrosis after circumcision surgery, who presented at various hospitals in Turkey between September 2003 and April 2013 and whose cases were being reviewed at the Institution of Forensic Medicine with regard to malpractice, were evaluated retrospectively. RESULTS The mean age of the patients was 5 ± 3.7 years, and the mean time of the necrosis diagnosis after circumcision was 5.2 ± 6.3 days. In etiologic terms, the predictive factors were monopolar cautery use in ten (41.6%) patients, post-circumcision infection in eight (33.3%), compartment syndrome due to post-circumcision dressing in three (12.5%), local anesthetic agent used for dorsal nerve blockage in two (8.3%), and methemoglobinemia in one (4.1%) patient. The first approaches to necrosis treatment were surgical intervention in 15 (62.5%) patients, hyperbaric oxygen treatment (HBOT) in 6 (25%), the conservative approach in 2 (8.3%), and HBOT plus surgical intervention in 1 (4.1%) patient. CONCLUSION Penile necrosis is a preventable complication that requires early intervention. The current study will be helpful in preventing penile necrosis and in guiding surgeons in approaches following its occurrence.
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Affiliation(s)
- A I Tasci
- Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Y O Danacioglu
- Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Y Arikan
- Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey.
| | - Y Colakoglu
- Department of Urology, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - B Yapar
- The Council of Forensic Medicine, Istanbul, Turkey
| | - Y Buyuk
- The Council of Forensic Medicine, Istanbul, Turkey
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A rare presentation of penile keloids after traditional circumcision: Case report. Int J Surg Case Rep 2019; 60:261-264. [PMID: 31261043 PMCID: PMC6610228 DOI: 10.1016/j.ijscr.2019.05.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Revised: 04/28/2019] [Accepted: 05/28/2019] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Only few cases of penile keloids have been reported in the literature. There have been no published reports on penile keloids following traditional circumcision in Africa. CASE REPORT We present a case of a 13-year-old boy with penile keloids following traditional circumcision. The patient was successfully treated with complete excision of the keloid followed by a course of adjuvant treatment with corticosteroid injection. DISCUSSION Penile keloids are a rare complication despite penile surgery being common. Male circumcision is a standard operation performed worldwide for medical, religious as well as cultural reasons. Traditional circumcision continues to be practised in many African countries. Keloids are a benign hyperproliferative growth of scar tissue that can complicate wound healing. Successful treatment is classically multimodal. CONCLUSION This case highlights one of the more serious complications of circumcision. Although penile keloids are rare, the techniques involved in traditional circumcision potentially predispose to keloid formation in a genetically prone population.
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Circumcision, Buried Penis and Obesity in a Contemporary Cohort of Patients with Penile Cancer. UROLOGY PRACTICE 2019. [DOI: 10.1097/upj.0000000000000002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Morris BJ, Hankins CA, Lumbers ER, Mindel A, Klausner JD, Krieger JN, Cox G. Sex and Male Circumcision: Women's Preferences Across Different Cultures and Countries: A Systematic Review. Sex Med 2019; 7:145-161. [PMID: 31031121 PMCID: PMC6523040 DOI: 10.1016/j.esxm.2019.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 02/26/2019] [Accepted: 03/14/2019] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Women's choices for a sexual partner are influenced by numerous personal, cultural, social, political and religious factors, and may also include aspects of penile anatomy such as male circumcision (MC) status. AIM To perform a systematic review examining (i) whether MC status influences women's preference for sexual activity and the reasons for this, and (ii) whether women prefer MC for their sons. METHODS PRISMA-compliant searches were conducted of PubMed, Google Scholar, Embase, and the Cochrane Database of Systematic Reviews. Articles that met the inclusion criteria were rated for quality using the SIGN system. RESULTS Database searches identified 29 publications with original data for inclusion, including 22 for aim (i) and 4 of these and 7 others pertaining to aim (ii). In the overwhelming majority of studies, women expressed a preference for the circumcised penis. The main reasons given for this preference were better appearance, better hygiene, reduced risk of infection, and enhanced sexual activity, including vaginal intercourse, manual stimulation, and fellatio. In studies that assessed mothers' preference for MC of sons, health, disease prevention, and hygiene were cited as major reasons for this preference. Cultural differences in preference were evident among some of the studies examined. Nevertheless, a preference for a circumcised penis was seen in most populations regardless of the frequency of MC in the study setting. CONCLUSION Women's preferences generally favor the circumcised penis for sexual activity, hygiene, and lower risk of infection. The findings add to the already well-established health benefits favoring MC and provide important sociosexual information on an issue of widespread interest. Morris BJ, Hankins CA, Lumbers ER, et al. Sex and Male Circumcision: Women's Preferences Across Different Cultures and Countries: A Systematic Review. Sex Med 2019;7:145-161.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW, Australia.
| | - Catherine A Hankins
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada; London School of Hygiene and Tropical Medicine, London, UK
| | - Eugenie R Lumbers
- School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine and Priority Research Centre for Reproductive Science, University of Newcastle, Callaghan, NSW, Australia; Mothers and Babies Research Centre, Hunter Medical Research Institute, New Lambton, NSW, Australia
| | - Adrian Mindel
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW, Australia
| | - Jeffrey D Klausner
- Division of Infectious Diseases and the Program in Global Health, Fielding School of Public Health, University of California Los Angeles Care Center, Los Angeles, CA, USA
| | - John N Krieger
- Department of Urology, University of Washington School of Medicine, Seattle, WA, USA
| | - Guy Cox
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, NSW, Australia
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Karami H, Abedinzadeh M, Moslemi MK. Assessment of meatal stenosis in neonates undergoing circumcision using Plastibell Device with two different techniques. Res Rep Urol 2018; 10:113-115. [PMID: 30310773 PMCID: PMC6166766 DOI: 10.2147/rru.s171292] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose It was intended to compare meatal stenosis (MS) as a late complication of neonatal circumcision by using two different methods of Plastibell Device circumcision. Materials and methods A total of 2,307 healthy term newborns (6–36 hours) who were born between 2007 and 2009 in Niknafs Medical Center of Rafsanjan, Iran, were simply randomized into two groups in a controlled, nonblinded clinical trial. In group A (1,102 neonates), the frenulum was maintained intact without any manipulation, and in group B (1,205 neonates) frenular hemostasis was performed in all cases by thermal cautery. MS was assessed by follow-up visits that were made for all cases at the 24–72 hours, 60th day, 12th month, and 16th month after circumcision. Results At 2 months follow-up visit, the rate of MS in group A was 4.9% (54) and in group B was 5.9% (71), which was not statistically significant. After 12 months, MS in group A was 8.5% (94) and in group B was 13.7% (165), which was statistically significant (P<0.001). At 16 months after circumcision, in the frenulum intact group, MS was 13.8% (152) and in the cautery group, it was 18.9% (228), which was compatible with significant difference (P=0.001). Conclusion Our experience with large group of cases revealed that neonatal circumcision by using Plastibell Device with intact frenulum technique decreases the rate of delayed MS.
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Affiliation(s)
- Hormoz Karami
- Department of Urology, Shahid Rahnemoon Hospital, School of Medicine, Yazd University of Medical Sciences, Yazd, Iran,
| | - Mehdi Abedinzadeh
- Department of Urology, Shahid Rahnemoon Hospital, School of Medicine, Yazd University of Medical Sciences, Yazd, Iran,
| | - Mohammad Kazem Moslemi
- Department of Urology, Shahid Rahnemoon Hospital, School of Medicine, Yazd University of Medical Sciences, Yazd, Iran,
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夏 慧, 吴 荷, 薛 康, 杨 诚, 杨 建. [Clinical effectiveness of disposable circumcision suture in children: a prospective randomized controlled trial]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2018; 38:884-887. [PMID: 33168504 PMCID: PMC6765532 DOI: 10.3969/j.issn.1673-4254.2018.07.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To assess the clinical efficacy of disposable circumcision suture device (DCSD) in children receiving circumcision. METHODS Children with phimosis and redundant prepuce undergoing circumcision in our hospital were prospectively enrolled in this study hospital and randomized into DCSD group and conventional circumcision (CC) group. A total of 236 boys were enrolled, including 132 in DCSD group and 104 in CC group. The use of local anesthesia, operation time, intraoperative blood loss, intraoperative and postoperative pain scores, penile appearance satisfaction rates, postoperative complications, healing time of the incision, and the overall satisfaction rate were compared between the two groups. RESULTS Compared with CC group, DCSD group had a significantly higher proportion of local anesthesia (P < 0.01), shorter operative time (P < 0.001), less intraoperative blood loss (P < 0.001), lower intraoperative and postoperative pain scores (P < 0.001), higher penile appearance satisfaction rates (P=0.03), less postoperative complications (P=0.04), shorter healing time (P < 0.001), and a higher overall satisfaction rate (P < 0.005). CONCLUSIONS The use of DCSD can shorten the operative time and is associated with good tolerance of local anesthesia, less pain, quick recovery, and higher penile appearance satisfaction rates in children receiving circumcision.
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Affiliation(s)
- 慧 夏
- />南方医科大学第三附属医院泌尿外科,广东 广州 510630Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 荷花 吴
- />南方医科大学第三附属医院泌尿外科,广东 广州 510630Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 康颐 薛
- />南方医科大学第三附属医院泌尿外科,广东 广州 510630Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 诚 杨
- />南方医科大学第三附属医院泌尿外科,广东 广州 510630Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
| | - 建昆 杨
- />南方医科大学第三附属医院泌尿外科,广东 广州 510630Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China
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Tshimanga M, Makunike-Chikwinya B, Mangwiro T, Tapiwa Gundidza P, Chatikobo P, Murenje V, Herman-Roloff A, Kilmarx PH, Holec M, Gwinji G, Mugurungi O, Murwira M, Xaba S, Barnhart S, Feldacker C. Safety and efficacy of the PrePex device in HIV-positive men: A single-arm study in Zimbabwe. PLoS One 2017; 12:e0189146. [PMID: 29220392 PMCID: PMC5722373 DOI: 10.1371/journal.pone.0189146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 11/17/2017] [Indexed: 11/21/2022] Open
Abstract
Male circumcision (MC) for sexually active, HIV-negative men reduces HIV transmission and averts HIV infections. Excluding HIV-positive men from MC decreases access to additional health and hygiene benefits. In settings where HIV-testing is, or is perceived to be, required for MC, testing may reduce MC uptake. Reducing promotion of HIV testing within MC settings and promoting device-based MC may speed MC scale-up. To assess safety and efficacy of PrePex MC device among HIV-positive men, we conducted a one-arm, open-label, prospective study in otherwise healthy HIV-positive men in Zimbabwe.
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Affiliation(s)
- Mufuta Tshimanga
- Zimbabwe Community Health Intervention Project (ZiCHIRe), Harare, Zimbabwe
| | | | | | | | - Pesanai Chatikobo
- Zimbabwe Community Health Intervention Project (ZiCHIRe), Harare, Zimbabwe
| | - Vernon Murenje
- International Training and Education Center for Health (I-TECH), Harare, Zimbabwe
| | | | - Peter H. Kilmarx
- U.S. Centers for Disease Control and Prevention, Harare, Zimbabwe
| | - Marrianne Holec
- International Training and Education Center for Health (I-TECH), Seattle, Washington, United States of America
| | | | | | | | | | - Scott Barnhart
- International Training and Education Center for Health (I-TECH), Seattle, Washington, United States of America
- Department of Medicine, University of Washington, Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
| | - Caryl Feldacker
- International Training and Education Center for Health (I-TECH), Seattle, Washington, United States of America
- Department of Global Health, University of Washington, Seattle, Washington, United States of America
- * E-mail:
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Morris BJ, Krieger JN, Klausner JD. CDC's Male Circumcision Recommendations Represent a Key Public Health Measure. GLOBAL HEALTH, SCIENCE AND PRACTICE 2017; 5:15-27. [PMID: 28351877 PMCID: PMC5478224 DOI: 10.9745/ghsp-d-16-00390] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 01/31/2017] [Indexed: 12/20/2022]
Abstract
Frisch and Earp, opponents of male circumcision, have criticized draft recommendations from the CDC that advocate counseling men and parents of newborn boys in the United States about the benefits and risks of male circumcision. We provide a rebuttal to Frisch and Earp's criticisms and contend that the recommendations are entirely appropriate and merit consideration for policy development.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences and Bosch Institute, University of Sydney, Sydney, New South Wales, Australia.
| | - John N Krieger
- University of Washington School of Medicine and VA Puget Sound Health Care System, Section of Urology, Seattle, WA, USA
| | - Jeffrey D Klausner
- Department of Epidemiology, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, CA, USA
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‘I have made children, so what's the problem?’ Retrospective self-circumcision and the sexual and urological health needs of some Somali men in Sweden. SEXUAL & REPRODUCTIVE HEALTHCARE 2017; 11:36-40. [DOI: 10.1016/j.srhc.2016.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2016] [Revised: 08/29/2016] [Accepted: 09/14/2016] [Indexed: 11/21/2022]
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Bio-behavioral Interventions to Prevent HIV Transmission. Infect Dis (Lond) 2017. [DOI: 10.1016/b978-0-7020-6285-8.00090-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Circumcision Status and Time to Sexual Debut Among Youth in Sub-Saharan Africa: Evidence from Six Demographic and Health Surveys. AIDS Behav 2016; 20:2514-2528. [PMID: 26350790 DOI: 10.1007/s10461-015-1141-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
This paper examines the relationship between circumcision status and timing of sexual debut among unmarried youth in Sub-Saharan Africa using Demographic and Health Surveys. Results from survival analysis indicate that the association between circumcision and timing of first sex is place and context specific. Compared to uncircumcised, circumcised men in Rwanda, Uganda and Namibia hasten sexual initiation, whilst circumcised youth in Ethiopia and Mali delayed sex initiation. In Togo however, we found parity in timing to sexual debut. Our multivariate results reveal that, knowledge of HIV/AIDS risk and educational level also feed into the association between circumcision and timing of sex initiation- implying that efforts to prevent new HIV infection through circumcision could benefit from a proper understanding of how diverse set of factors interact in specific contexts to shape youth's decisions to initiate early sex.
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Van Howe RS, Svoboda JS, Hodges FM. HIV infection and circumcision: cutting through the hyperbole. ACTA ACUST UNITED AC 2016; 125:259-65. [PMID: 16353456 DOI: 10.1177/146642400512500607] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to determine whether the justifications given for promoting mass circumcision as a preventive measure for HIV infection are reasonable and whether mass circumcision is a feasible preventive measure for HIV infection in developing countries. The medical literature concerning the practice of circumcision in the absence of medical indication was reviewed regarding its impact on HIV infection and related issues. The literature was analysed with careful attention to historical perspective. Our results show that the medical literature supporting mass circumcision for the prevention of HIV infection is inconsistent and based on observation studies. Even if the two ongoing randomised controlled trials in Africa show a protective benefit of circumcision, factors such as the unknown complication rate of the procedure, the permanent injury to the penis, human rights violations and the potential for veiled colonialism need to be taken into account. Based on the best estimates, mass circumcision would not be as cost-effective as other interventions that have been demonstrated to be effective. Even if effective, mass circumcision as a preventive measure for HIV in developed countries is difficult to justify.
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Brady MT. Newborn Male Circumcision with Parental Consent, as Stated in the AAP Circumcision Policy Statement, Is Both Legal and Ethical. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2016; 44:256-262. [PMID: 27338601 DOI: 10.1177/1073110516654119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Newborn male circumcision is a minor surgical procedure that has generated significant controversy. Accumulating evidence supports significant health benefits, most notably reductions in urinary tract infections, acquisition of HIV and a number of other sexually transmitted infections, penile cancer, phimosis, paraphimosis, balanitis and lichen sclerosis. While circumcision, like any surgical procedure, has risks for complications, they occur in less than 1 in 500 infants circumcised and most are minor and require minimal intervention. The CDC and the American Academy of Pediatrics (AAP) believe that health benefits of circumcision outweigh the risks. For this reason, the AAP believes that parents should be allowed to make the decision concerning circumcision of their male infants after receiving non-biased information on health risks and health benefits.
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Affiliation(s)
- Michael T Brady
- Michael T. Brady, M.D., is a Professor of Pediatrics at The Ohio State University. He is Associate Medical Director at Nationwide Children's Hospital. He was a member of the American Academy of Pediatrics Task Force on Circumcision
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Comparing the length of penile mucosa in men with and without premature ejaculation. Urologia 2016; 83:36-9. [PMID: 26812606 DOI: 10.5301/uro.5000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2015] [Indexed: 11/20/2022]
Abstract
BACKGROUND Premature ejaculation is one of the prevalent disorders in men; almost one out of three men between 18 and 59 years old have this disorder with its leading sequel such as lack of self-confidence, anxiety, depression and unsatisfactory intercourse in men and their partners. This study aimed to compare the length of penile mucosa in men with and without premature ejaculation. METHOD Three hundred and eighty patients referring to our hospital from March 2009 to March 2010 were enrolled in the study. First group comprised 190 men with premature ejaculation and second group included 190 men without premature ejaculation as control group that were chosen randomly. A questionnaire was designed to collect data and was completed for both groups. Height, weight, body mass index (BMI), length of penile mucosa, length of penis and intravaginal ejaculation latency time (IELT) were measured. RESULTS The mean IELT in premature ejaculation group and control group were 47.58 ± 29.55 and 410.38 ± 190.2 s, respectively (p = 0.001). The mean penis length in premature ejaculation group and control group were 127.25 ± 16.23 and 127.03 ± 17.42 mm, respectively (p = 0.901, with nonsignificant difference); the mean penile mucosa in premature ejaculation group was 33.83 ± 11.54 mm and in control group was 31.40 ± 11.97 mm (p = 0.014, with significant difference). CONCLUSION Longer penile mucosa can be one of the factors in causing premature ejaculation.
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Kakaire O, Byamugisha JK, Tumwesigye NM, Gamzell-Danielsson K. Prevalence and factors associated with sexually transmitted infections among HIV positive women opting for intrauterine contraception. PLoS One 2015; 10:e0122400. [PMID: 25859659 PMCID: PMC4393084 DOI: 10.1371/journal.pone.0122400] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 02/20/2015] [Indexed: 11/25/2022] Open
Abstract
Background Women living with HIV/AIDS (WLHA) are a high risk group for sexually transmitted infections (STIs). However, the majority of women with STIs are asymptomatic. Data on prevalence of STIs among WLHA in Uganda are limited. The objective of the study was to determine prevalence and factors associated with STIs among WLHA opting for intrauterine contraceptive device (IUD). Methods Three hundred fifty one WLHA deemed free of STIs using a syndromic logarithm were enrolled into the study. Endo-cervical swabs were taken before IUD insertion and PCR test for Nisseria gonorrhea (NG), Trichomonas vaginalis (TV) and Chlamydia trachomatis (CT) infections conducted. Results Participants’ mean age was 29.4 ± 6.2 years, 83% were under 35years, 50% had secondary education and 73% were married. The majority (69%) had disclosed their HIV sero status to their spouses, 82% used Cotrimoxazole prophylaxis, 70% were on antiretroviral therapy, 90% had CD4 count greater than 350, about 60% reported condoms use and 70% were of parity 2-4. Over 50% of the participants’ spouses were older than 35 years and 72% had attained secondary education. STIs prevalence was 11.1%, (95% CI 7.8-14.4) and individual prevalence for TV, NG, and CT was 5.9%, 5.4% and 0.9% respectively. Factors independently associated with STI were having primary or less education (OR= 2.3, 95% CI: 1.09 - 4.85) having a spouse of primary or less education (OR= 3.3, 95% CI: 1.6 - 6.78) and muslim faith (OR= 0.2, 95% CI: 0.04 - 0.78). Conclusion STI prevalence was 11.1%. TV and NG were the commonest STIs in this population. Having primary or less education for both participant and spouse was associated with increased risk while being of muslim faith was associated with reduced risk of STI.
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Affiliation(s)
- Othman Kakaire
- Department of Obstetrics and Gynecology, Makerere University College of Health Sciences, Mulago Hospital Complex, Old Mulago Hill, Kampala, Uganda
- * E-mail:
| | - Josaphat Kayogoza Byamugisha
- Department of Obstetrics and Gynecology, Makerere University College of Health Sciences, Mulago Hospital Complex, Old Mulago Hill, Kampala, Uganda
| | - Nazarius Mbona Tumwesigye
- School of Public Health, Makerere University College of Health Sciences, Mulago Hospital Complex, Old Mulago Hill, Kampala Uganda
| | - Kristina Gamzell-Danielsson
- Department of Women’s and Children’s Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
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Christodoulidou M, Sahdev V, Houssein S, Muneer A. Epidemiology of penile cancer. Curr Probl Cancer 2015; 39:126-36. [PMID: 26076979 DOI: 10.1016/j.currproblcancer.2015.03.010] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Moyo S, Mhloyi M, Chevo T, Rusinga O. Men's attitudes: A hindrance to the demand for voluntary medical male circumcision--a qualitative study in rural Mhondoro-Ngezi, Zimbabwe. Glob Public Health 2015; 10:708-20. [PMID: 25648951 DOI: 10.1080/17441692.2015.1006241] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Male circumcision has witnessed a paradigm shift from being regarded as a religious and cultural practice to a global intervention strategy meant to curb transmission of HIV. This is particularly evident in sub-Saharan African countries where the HIV prevalence is greater than 15%. Zimbabwe adopted the voluntary medical male circumcision (VMMC) strategy in 2009; however, since then the uptake of the intervention has only 10% of the adult male population has reported having been circumcised. To better understand this limited uptake of VMMC, we conducted a qualitative study with uncircumcised men aged 15-79 years in Mhondoro-Ngezi, Zimbabwe. Through assessing men's attitudes towards VMMC in seven focus group discussions, conducted between July and August 2012, this article seeks to provide improved strategies for delivering this intervention in Zimbabwe. These data reveal that, in general, men have a negative attitude towards VMMC. Specific barriers to the uptake of VMMC included the perceived challenge to masculinity, post-circumcision stigma, lack of reliable and adequate information and perceptions about the appropriateness of VMMC. These results suggest that structural interventions aimed at reducing stigma related to circumcision, in addition to increased efforts to disseminate accurate information about VMMC, are required in order to dispel men's attitudes that hinder demand for VMMC.
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Affiliation(s)
- Stanzia Moyo
- a Centre for Population Studies , University of Zimbabwe , Harare , Zimbabwe
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Promm M, Rösch WH. [Circumcision and orchiopexy: management of complications]. Urologe A 2014; 53:663-70. [PMID: 24733101 DOI: 10.1007/s00120-014-3485-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Circumcision and orchidopexy are among the most frequently performed pediatric urological procedures. Although they may be classified as surgical interventions suitable for junior surgeons, either procedure can lead to serious consequences including the loss of the respective organ. In this paper, the general aspects of pediatric urological surgery (e.g., distinctive features of informing underage patients, the handling of children in the operating room, and relevant pediatric anesthesiological aspects) are described first. Then, the most important sources of error will be highlighted and potential complications and their management during all stages of the procedure will be illustrated. Apart from the so-called freehand circumcision, this paper also deals with potential complications when using the Plastibell® device. In regard to orchidopexy, laparoscopic procedure shall be discussed in addition to the standard procedure.
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Affiliation(s)
- M Promm
- Klinik für Kinderurologie in Kooperation mit der Universität Regensburg, Klinik St. Hedwig, Krankenhaus Barmherzige Brüder Regensburg, Steinmetzstraße 1-3, 93049, Regensburg, Deutschland,
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Wilson NL, Xiong W, Mattson CL. Is Sex Like Driving? HIV Prevention and Risk Compensation. JOURNAL OF DEVELOPMENT ECONOMICS 2014; 106:78-91. [PMID: 26997745 PMCID: PMC4794434 DOI: 10.1016/j.jdeveco.2013.08.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Risk compensation has been called the "Achilles' heel" of HIV prevention policies (Cassell et al 2006). This paper examines the behavioral response to male circumcision, a major HIV prevention policy currently being implemented throughout much of Sub-Saharan Africa. Contrary to the presumption of risk compensation, we find that the response due to the perceived reduction in HIV transmission appears to have been a reduction in risky sexual behavior. We suggest a mechanism for this finding: circumcision may reduce fatalism about acquiring HIV/AIDS and increase the salience of the tradeoff between engaging in additional risky behavior and avoiding acquiring HIV. We also find what appears to be a competing effect that does not operate through the circumcision recipient's belief about the reduction in the risk of acquiring HIV.
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Dauendorffer JN, Cavelier-Balloy B, Renaud-Vilmer C. [Circumcision and dermatology]. Ann Dermatol Venereol 2013; 140:816-20. [PMID: 24315231 DOI: 10.1016/j.annder.2013.06.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Revised: 06/21/2013] [Accepted: 06/28/2013] [Indexed: 11/27/2022]
Affiliation(s)
- J-N Dauendorffer
- Service de dermatologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France.
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Manganiello M, Hughes CD, Hagander L, Bayne D, Pierre JH, Buckley JC, Meara JG. Urologic disease in a resource-poor country. World J Surg 2013; 37:344-8. [PMID: 23052811 DOI: 10.1007/s00268-012-1818-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Understanding the role that urologic disease plays within central Haiti could lead to the development of sustainable and regionally appropriate urologic care. We aim to document the prevalence of urologic surgical disease presenting for treatment in central Haiti. METHODS The present study is based on a retrospective review of surgical case logs at five Partners in Health and Zanmi Lasante hospitals in central Haiti. Data were collected from June 30, 2009, through July 29, 2010, and included patient demographics, disease processes, interventions required, surgeon name, and surgeon training (urologic trained versus non-urologic trained). RESULTS Urologic surgical disease comprised 498/5,539 (9.0 %) of all surgical cases in central Haiti from July 2009-July 2010. A total of 492 diagnoses and 498 urologic procedures on 469 patients were recorded. Most common diagnoses included hydrocele (33.3 %), phimosis (23.0 %), benign prostatic hyperplasia (10.8 %), and cryptorchidism (7.3 %). Hydrocelectomy was the most commonly performed procedure (160/498, 32.1 %), followed by circumcision (117/498, 23.4 %) and open prostatectomy (38/498, 7.6 %). Surgeon training (urologic versus non-urologic) was determined for 360/498 (72.3 %) of surgical cases. Urologic trained surgeons performed 55/360 (15.3 %) of all surgical procedures. Among patients who underwent prostatectomy, urology surgeons performed 14/31 (45.2 %) of open prostatectomies, and non-urology surgeons performed 17/31 (54.8 %). Urologists performed all transurethral resections of the prostate (9 vs. 0; p = 0.0051). CONCLUSIONS Urologic surgical diseases comprise a substantial source of morbidity for patients in central Haiti. Understanding the scale and scope of urologic disease is important in developing health systems to adequately address the regional burden of surgical disease in limited-resource settings.
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Affiliation(s)
- Marc Manganiello
- Institute of Urology, Lahey Clinic, 41 Mall Road, Burlington, MA 01805, USA.
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Mohammadi AA, Seyed Jafari SM, Abdollahi A. Risk of burn trauma during circumcision with radiofrequency scalpel: case report and review of literature. INTERNATIONAL JOURNAL OF BURNS AND TRAUMA 2013; 3:169-172. [PMID: 23875124 PMCID: PMC3712405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/19/2013] [Indexed: 06/02/2023]
Abstract
Male circumcision, one of the oldest and most frequent operations performed all over the world, removes 33-50% of the penile skin. Like each surgical procedure, circumcision can leads to complications ranging from the insignificant to the tragic. Circumcision methods can be done with different ways. The radiofrequency (RF) scalpel, an innovative instrument, can be used in circumcision. Here, we present three boys who sustained sever burn injuries during circumcision with RF method. In sum, interesting characteristics made RF procedures so popular in different fields of surgery. Although having low incidence, the important complications of this technology such as burns should raise our attentions. Performing radiofrequency circumcision by an experienced operator, selection of proper size of ground pads, and elimination of any interface between the skin and ground pad are the factors that can prevent such tragedies.
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Affiliation(s)
- Ali Akbar Mohammadi
- Shiraz Burn Research Centre, Division of Plastic and Reconstructive Surgery, General Surgery Department, Shiraz University of Medical SciencesShiraz, Iran
| | - Seyed Morteza Seyed Jafari
- Shiraz Burn Research Centre, Division of Plastic and Reconstructive Surgery, General Surgery Department, Shiraz University of Medical SciencesShiraz, Iran
| | - Ahmad Abdollahi
- General Surgery Department, Shiraz University of Medical SciencesShiraz, Iran
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Shabbir M, Barod R, Hegarty PK, Minhas S. Primary prevention and vaccination for penile cancer. Ther Adv Urol 2013; 5:161-9. [PMID: 23730331 DOI: 10.1177/1756287212465456] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The outcome of penile cancer is proportional to the stage at presentation. Strategies aimed at primary prevention would have a clear advantage, both for the individual and in terms of health economics. A number of preventative measures could be employed, including circumcision, smoking cessation, education on hygiene and human papillomavirus (HPV) prevention. There is a high prevalence of HPV infection associated with penile cancer worldwide. The recent development of HPV vaccines has facilitated interest in their use for the prevention of penile cancer. In this article we review the literature surrounding penile cancer prevention and HPV vaccination in men.
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Affiliation(s)
- Majid Shabbir
- Department of Urology, Guy's Hospital, Great Maze Pond, London SE1 9RT, UK
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Sexually transmitted infections and male circumcision: a systematic review and meta-analysis. ISRN UROLOGY 2013; 2013:109846. [PMID: 23710368 PMCID: PMC3654279 DOI: 10.1155/2013/109846] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 01/22/2013] [Indexed: 01/19/2023]
Abstract
The claim that circumcision reduces the risk of sexually transmitted infections has been repeated so frequently that many believe it is true. A systematic review and meta-analyses were performed on studies of genital discharge syndrome versus genital ulcerative disease, genital discharge syndrome, nonspecific urethritis, gonorrhea, chlamydia, genital ulcerative disease, chancroid, syphilis, herpes simplex virus, human papillomavirus, and contracting a sexually transmitted infection of any type. Chlamydia, gonorrhea, genital herpes, and human papillomavirus are not significantly impacted by circumcision. Syphilis showed mixed results with studies of prevalence suggesting intact men were at great risk and studies of incidence suggesting the opposite. Intact men appear to be of greater risk for genital ulcerative disease while at lower risk for genital discharge syndrome, nonspecific urethritis, genital warts, and the overall risk of any sexually transmitted infection. In studies of general populations, there is no clear or consistent positive impact of circumcision on the risk of individual sexually transmitted infections. Consequently, the prevention of sexually transmitted infections cannot rationally be interpreted as a benefit of circumcision, and any policy of circumcision for the general population to prevent sexually transmitted infections is not supported by the evidence in the medical literature.
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Hayashi Y, Kohri K. Circumcision related to urinary tract infections, sexually transmitted infections, human immunodeficiency virus infections, and penile and cervical cancer. Int J Urol 2013; 20:769-75. [DOI: 10.1111/iju.12154] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Accepted: 03/06/2013] [Indexed: 11/26/2022]
Affiliation(s)
- Yutaro Hayashi
- Department of Nephro-Urology; Nagoya City University Graduate School of Medical Sciences; Nagoya; Japan
| | - Kenjiro Kohri
- Department of Nephro-Urology; Nagoya City University Graduate School of Medical Sciences; Nagoya; Japan
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Abstract
OBJECTIVES To review the risk factors, prevention, treatment, and management of the patient with penile cancer. DATA SOURCES Publications; clinical experience. CONCLUSION Penile cancer is a rare malignancy in the United States, but is more common in developing countries. The disease is so uncommon in the United States that there are oncology nurses who have never cared for a patient with this diagnosis. IMPLICATIONS FOR NURSING PRACTICE With significant psychosocial implications for the patient with penile cancer and partner, it is important that the nurse have an understanding of the diagnosis, treatment, and care of these patients.
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Affiliation(s)
- Jeanne Held-Warmkessel
- Department of Nursing, 333 Cottman Ave., Fox Chase Cancer Center, Philadelphia, PA 19111, USA.
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Abdulla A, Daya D, Pinthus J, Davies T. Buried penis: An unrecognized risk factor in the development of invasive penile cancer. Can Urol Assoc J 2012; 6:E199-202. [PMID: 23093645 DOI: 10.5489/cuaj.11226] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
One of the documented benefits of neonatal circumcision is protection against invasive penile cancer. To date there have been a handful of published cases of invasive penile cancer in men circumcised as neonates. We report a case of a 73-year-old man, with a history of neonatal circumcision with no evidence of previous human papillomavirus exposure, who developed a buried penis secondary to obesity. He was diagnosed with Grade 2, pT3N0 squamous cell carcinoma of the penis. This report suggests that buried penis may pose a risk factor for the development of penile cancer despite the protective effects of neonatal circumcision. Thus periodic examination of a buried penis is warranted even in patients with no risk factors for penile cancer. A review of the literature is provided.
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Affiliation(s)
- Alym Abdulla
- McMaster Institute of Urology, Division of Urology, Department of Surgery McMaster University, Hamilton, ON
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Pan F, Pan L, Zhang A, Liu Y, Zhang F, Dai Y. Circumcision with a novel disposable device in Chinese children: a randomized controlled trial. Int J Urol 2012; 20:220-6. [PMID: 22974480 DOI: 10.1111/j.1442-2042.2012.03132.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 07/26/2012] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To compare the outcomes and complications of three methods of circumcision in a Chinese pediatric population. METHODS A total of 120 children were randomly assigned to three groups. Group I was submitted to circumcision using the Shenghuan disposable device according to Yan's method; group II was submitted to circumcision using the same device, but according to Peng's methods; group III was operated on by using the conventional scalpel/suture technique. The three groups were compared mainly by the following outcomes: duration of surgery, intraoperative bleeding, postoperative pain, cosmetic effect, and the rates of edema, dehiscence, scarring, adhesion and infection. RESULTS Groups I and II had less intraoperative bleeding. In terms of the duration of surgery, group I was the quickest. Pain scores in using the Shenghuan disposable device were higher at 6 h after surgery compared with the conventional scalpel/suture technique. The percentage of patients using paracetamol in group II was higher than that in group III at 12 h after surgery. Other complications were similar, and all three groups had successful outcomes. CONCLUSIONS Circumcision using the Shenghuan disposable device represents a safer and time-saving option compared with the conventional scalpel/suture technique, with better cosmetic outcomes. Yan's method seems to be better than Peng's method when using the Shenghuan disposable device for circumcision in children.
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Affiliation(s)
- Feng Pan
- Department of Urology, Affiliated Drum Tower Hospital, Nanjing University, School of Medicine, Nanjing, China
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Morris BJ, Bailey RC, Klausner JD, Leibowitz A, Wamai RG, Waskett JH, Banerjee J, Halperin DT, Zoloth L, Weiss HA, Hankins CA. Review: a critical evaluation of arguments opposing male circumcision for HIV prevention in developed countries. AIDS Care 2012; 24:1565-75. [PMID: 22452415 PMCID: PMC3663581 DOI: 10.1080/09540121.2012.661836] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A potential impediment to evidence-based policy development on medical male circumcision (MC) for HIV prevention in all countries worldwide is the uncritical acceptance by some of arguments used by opponents of this procedure. Here we evaluate recent opinion-pieces of 13 individuals opposed to MC. We find that these statements misrepresent good studies, selectively cite references, some containing fallacious information, and draw erroneous conclusions. In marked contrast, the scientific evidence shows MC to be a simple, low-risk procedure with very little or no adverse long-term effect on sexual function, sensitivity, sensation during arousal or overall satisfaction. Unscientific arguments have been recently used to drive ballot measures aimed at banning MC of minors in the USA, eliminate insurance coverage for medical MC for low-income families, and threaten large fines and incarceration for health care providers. Medical MC is a preventative health measure akin to immunisation, given its protective effect against HIV infection, genital cancers and various other conditions. Protection afforded by neonatal MC against a diversity of common medical conditions starts in infancy with urinary tract infections and extends throughout life. Besides protection in adulthood against acquiring HIV, MC also reduces morbidity and mortality from multiple other sexually transmitted infections (STIs) and genital cancers in men and their female sexual partners. It is estimated that over their lifetime one-third of uncircumcised males will suffer at least one foreskin-related medical condition. The scientific evidence indicates that medical MC is safe and effective. Its favourable risk/benefit ratio and cost/benefit support the advantages of medical MC.
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Affiliation(s)
- Brian J Morris
- School of Medical Sciences and Bosch Institute, University of Sydney, NSW, Australia.
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Abstract
BACKGROUND/PURPOSE To understand whether information from the African clinical trials about the partially protective effect of male circumcision against human immunodeficiency virus (HIV) infection could influence adults to circumcise a newborn son. METHODS Using the 2008 ConsumerStyles panel survey data, multiple regression analysis was performed to identify correlates of (1) inclination toward circumcising a newborn son and (2) being influenced to have a newborn son circumcised if it would reduce the chance of becoming HIV infected later in life. RESULTS Response rate was 50.6% (10,108/19,996). Approximately 12% reported not being inclined to circumcise a newborn son. Higher odds of not being inclined to circumcise a newborn son were associated with Hispanic and "other" race/ethnicity, being an uncircumcised man and a man not reporting circumcision status, postgraduate education, region, and negative health-related attitudes. Lower odds were associated with black race and less number of household members. Fifty-three percent of respondents reported that information about the protective effect of circumcision would make them more likely to have a newborn son circumcised. Higher odds of being influenced to have a newborn son circumcised were associated with being ≥45 years of age, black race, living in a household with fewer than 5 members, having high school or some college education, region, and positive health-related attitudes; lower odds were associated with being an uncircumcised man and lower income. CONCLUSIONS Our findings suggest that providing educational information about the HIV prevention and benefit of circumcision may increase the inclination to circumcise a newborn son for some people.
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Kalkan M, Şahin C, Toraman AR. Complications of Circumcision: Our Experiences Over The Last 15 Years. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2011. [DOI: 10.29333/ejgm/82727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Male circumcision and penile cancer: a systematic review and meta-analysis. Cancer Causes Control 2011; 22:1097-110. [PMID: 21695385 PMCID: PMC3139859 DOI: 10.1007/s10552-011-9785-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2011] [Accepted: 05/23/2011] [Indexed: 02/06/2023]
Abstract
Objective We systematically reviewed the evidence of an association between male circumcision and penile cancer. Methods Databases were searched using keywords and text terms for the epidemiology of penile cancer. Random effects meta-analyses were used to calculate summary odds ratios (ORs) and 95% confidence intervals (CI). Results We identified eight papers which evaluated the association of circumcision with penile cancer, of which seven were case–control studies. There was a strong protective effect of childhood/adolescent circumcision on invasive penile cancer (OR = 0.33; 95% CI 0.13–0.83; 3 studies). In two studies, the protective effect of childhood/adolescent circumcision on invasive cancer no longer persisted when analyses were restricted to boys with no history of phimosis. In contrast, there was some evidence that circumcision in adulthood was associated with an increased risk of invasive penile cancer (summary OR = 2.71; 95% CI 0.93–7.94; 3 studies). There was little evidence for an association of penile intra-epithelial neoplasia and in situ penile cancer with circumcision performed at any age. Conclusions Men circumcised in childhood/adolescence are at substantially reduced risk of invasive penile cancer, and this effect could be mediated partly through an effect on phimosis. Expansion of circumcision services in sub-Saharan Africa as an HIV prevention strategy may additionally reduce penile cancer risk. Electronic supplementary material The online version of this article (doi:10.1007/s10552-011-9785-9) contains supplementary material, which is available to authorized users.
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Wambura M, Mwanga JR, Mosha JF, Mshana G, Mosha F, Changalucha J. Acceptability of medical male circumcision in the traditionally circumcising communities in Northern Tanzania. BMC Public Health 2011; 11:373. [PMID: 21605433 PMCID: PMC3112418 DOI: 10.1186/1471-2458-11-373] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Accepted: 05/23/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Data from traditionally circumcising communities show that non-circumcised males and those circumcised in the medical settings are stigmatised. This is because traditional circumcision embodies local notions of bravery as anaesthetics are not used. This study was conducted to assess the acceptability of safe medical circumcision before the onset of sexual activity for HIV infection risk reduction in a traditionally circumcising community in Tanzania. METHODS A cross-sectional study was conducted among males and females aged 18-44 years in traditionally circumcising communities of Tarime District in Mara Region, North-eastern Tanzania. A face-to-face questionnaire was administered to females to collect information on the attitudes of women towards circumcision and the preferred age for circumcision. A similar questionnaire was administered to males to collect information on socio-demographic, preferred age for circumcision, factors influencing circumcision, client satisfaction, complications and beliefs surrounding the practice. RESULTS Results were available for 170 males and 189 females. Of the males, 168 (98.8%) were circumcised and 61 (36.3%) of those circumcised had the procedure done in the medical setting. Of those interviewed, 165 (97.1%) males and 179 (94.7%) females supported medical male circumcision for their sons. Of these, 107 (64.8%) males and 130 (72.6%) females preferred prepubertal medical male circumcision (12 years or less). Preference for prepubertal circumcision was significantly associated with non-Kurya ethnic group, circumcision in the medical setting and residence in urban areas for males in the adjusted analysis. For females, preference for prepubertal circumcision was significantly associated non-Kurya ethnic group and being born in urban areas in the adjusted analysis. CONCLUSIONS There is a shift of preference from traditional male circumcision to medical male circumcision in this traditionally circumcising population. However, this preference has not changed the circumcision practices in the communities because of the community social pressure. Male circumcision national program should take advantage of this preference of medical male circumcision by introducing safe and affordable circumcision services and mobilising communities in a culturally sensitive manner to take up circumcision services.
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Affiliation(s)
- Mwita Wambura
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Joseph R Mwanga
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Jacklin F Mosha
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Gerry Mshana
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - Frank Mosha
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
| | - John Changalucha
- National Institute for Medical Research, P.O. Box 1462, Mwanza, Tanzania
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Morris BJ, Gray RH, Castellsague X, Bosch FX, Halperin DT, Waskett JH, Hankins CA. The Strong Protective Effect of Circumcision against Cancer of the Penis. Adv Urol 2011; 2011:812368. [PMID: 21687572 PMCID: PMC3113366 DOI: 10.1155/2011/812368] [Citation(s) in RCA: 85] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2010] [Accepted: 03/09/2011] [Indexed: 01/30/2023] Open
Abstract
Male circumcision protects against cancer of the penis, the invasive form of which is a devastating disease confined almost exclusively to uncircumcised men. Major etiological factors are phimosis, balanitis, and high-risk types of human papillomavirus (HPV), which are more prevalent in the glans penis and coronal sulcus covered by the foreskin, as well as on the penile shaft, of uncircumcised men. Circumcised men clear HPV infections more quickly. Phimosis (a constricted foreskin opening impeding the passage of urine) is confined to uncircumcised men, in whom balanitis (affecting 10%) is more common than in circumcised men. Each is strongly associated with risk of penile cancer. These findings have led to calls for promotion of male circumcision, especially in infancy, to help reduce the global burden of penile cancer. Even more relevant globally is protection from cervical cancer, which is 10-times more common, being much higher in women with uncircumcised male partners. Male circumcision also provides indirect protection against various other infections in women, along with direct protection for men from a number of genital tract infections, including HIV. Given that adverse consequences of medical male circumcision, especially when performed in infancy, are rare, this simple prophylactic procedure should be promoted.
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Affiliation(s)
- Brian J. Morris
- School of Medical Sciences and Bosch Institute, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ronald H. Gray
- Population and Family Planning, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Xavier Castellsague
- Institut Català d'Oncologia (ICO), IDIBELL, CIBERESP, RTICC, 08908 L'Hospitalet de Llobregat, Catalonia, Spain
| | - F. Xavier Bosch
- Institut Català d'Oncologia (ICO), IDIBELL, CIBERESP, RTICC, 08908 L'Hospitalet de Llobregat, Catalonia, Spain
| | - Daniel T. Halperin
- Department of Global Health and Population, Harvard School of Public Health, Boston, MA 02115, USA
| | - Jake H. Waskett
- Circumcision Independent Reference and Commentary Service, Radcliffe, Manchester M261JR, UK
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Minhas S, Manseck A, Watya S, Hegarty PK. Penile cancer--prevention and premalignant conditions. Urology 2010; 76:S24-35. [PMID: 20691883 DOI: 10.1016/j.urology.2010.04.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 04/09/2010] [Accepted: 04/09/2010] [Indexed: 12/26/2022]
Abstract
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. METHODS The association of human papillomavirus subtypes and penile cancer is well-established, although the etiology, natural history, and treatment of premalignant lesions have mainly been reported in retrospective case series with short-term follow-up. The exact pathologic role of chronic inflammatory conditions, such as balanitis xerotica obliterans in the etiology of penile cancer remains largely unknown. RESULTS Some of the potential strategies for the prevention of penile cancer could include circumcision, reducing the risk of transmission of penile human papillomavirus infection with male vaccination, early treatment of phimosis, smoking cessation, and hygienic measures. Implementing some of these measures would require extensive cost/benefit analysis, with significant changes in the global health policy. CONCLUSIONS Owing to the current levels of evidence from published studies, firm guidelines cannot be formulated for the treatment of premalignant conditions, although preventative measures, such as reducing human papillomavirus transmission, could become strategic health targets.
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Affiliation(s)
- Suks Minhas
- Institute of Urology, Division of Surgical and Interventional Sciences, University College London, 25 Grafton Way, London, United Kingdom.
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