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PubMedDate not supplied

[Effect of nonsteroidal anti-inflammatory drugs and paracetamol on hemodynamic changes during postoperative analgesia in children].

The purpose of the present study was to comparatively assess the adequacy of postoperative analgesia using nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol in children undergone "minor" surgical interventions. For postoperative analgesia in children, the authors used paracetamol in a single dose of 25-30 mg/kg, diclofenac in a dose of 1.5-2.0 mg/kg, which were rectally administered as suppositories, as well as diclofenac in the same dose as intramuscular injections (Group 1). A comparison was made with postoperative analgesia using analgin and promedole (Group 2 (control)). Group 1 comprised 63 patients and Group 2 included 26 patients with identical diseases (inguinal hernias, varicocele, phimosis). Functional parameters were recorded in patients in the lying position before, 30 min, 1, 2, and 3 hours after surgery. The efficiency of postoperative analgesia was evaluated, by using central hemodynamic parameters that many investigators consider to be one of the major criteria for the adequacy of anesthesia. Comparison of postoperative data has revealed a difference between the groups, which suggests that the use of NSAIDs and paracetamol for preventive and postoperative analgesia in children substantially improves the postoperative period and promotes a rapid rehabilitation in patients. Comparative analysis of the efficiency of postoperative analgesia of the above agents has indicated that diclofenac and paracetamol have a sufficient analgesic activity and at the same time do not show the adverse reactions unique to narcotic analgesics.

Acetaminophen↗
PubMed2005

Complications of circumcision in Israel: a one year multicenter survey.

BACKGROUND: In Israel, virtually all children undergo circumcision in the neonatal period. Traditionally, it is commonly performed by a "Mohel" (ritual circumciser) but lately there is an increasing tendency among the educated secular population to prefer a medical procedure performed by a physician and with local anesthetic injection. OBJECTIVES: To evaluate the outcome of this procedure and to compare the complication rate following circumcisions performed by ritual circumcisers and by physicians. METHODS: In 2001, of the 19,478 males born in four major medical centers in Israel 66 had circumcision-related complications. All the children were circumcised in non-medical settings within the community. The patients were medically evaluated either urgently due to immediate complications or electively in outpatient clinics later on. Upon the initial assessment a detailed questionnaire was filled to obtain data regarding the procedure, the performer, and the subsequent complications. RESULTS: All the circumcisions were performed during the early neonatal period, usually on day 8 of life (according to Jewish law). in 55 cases (83%) it was part of a ritual ceremony conducted by a ritual circumciser (Mohel), while in 11 babies (17%) physicians were involved. Acute bleeding after circumcision was encountered in 16 cases (24%), which required suturing in 8. In addition, we found two cases of wound infection and one case of partial amputation of glans penis in which the circumcision was performed by a ritual circumciser. Among the late complications, the most common was excess of skin in 38 cases (57%); 5 children (7.5%) had penile torsion and 4 children (6%) had shortages of skin, phimosis and inclusion cyst. The overall estimated complication rate of circumcision was 0.34%. CONCLUSIONS: Complications of circumcision are rare in Israel and in most cases are mild and correctable. There appears to be no significant difference in the type of complications between medical and ritual circumcisions.

Ceremonial Behavior↗
PubMed2005

The riddle of the sands: circumcision, history, and myth.

Although many nineteenth century misconceptions about the foreskin have been dispelled since Douglas Gairdner showed that infantile phimosis was not a congenital defect, other old ideas have proved more persistent. Among the most ubiquitous are the proposition that ritual or religious circumcision arose as a hygiene or sanitary measure; and the related idea that allied troops serving in the Middle East during the Second World War were subject to such severe epidemics of balanitis that mass circumcision was necessary. Both these claims are medical urban myths which should be firmly laid to rest.

Balanitis↗
PubMed2005

Pediatric genitourinary examination: a clinician's reference.

The importance of a genitourinary (GU) examination and how to evaluate common GU complaints are discussed. Diagnoses covered include inguinal hernia, hydrocele, varicocele, undescended testis, phimosis, hypospadias, meatal stenosis, penile adhesions, labial adhesions, and vaginal voiding. Developmental considerations and examination tips are addressed.

Child↗
PubMed1992

[A preliminary report on penile cancer in the Instituto Oncológico Nacional from 1982 to 1990].

Cancer of the penis is not to common disease and its incidence varies between 0.5 and 5%. In Panama, 70 cases were registered from 1982 to 1990 and it is considered an important social problem in the rural population. Phimosis and poor hygiene are important factors in its etiology. Of 70 cases seen at the National Institute of Oncology from 1982 to 1990, 51 cases were analyzed comparing two approaches in regard to lymph node metastasis: (1) an expectant approach in those without clinically suspected lymph node metastasis, and (2) lymph node biopsy using the Cabañas technique in those clinically suspected followed by lymphadenectomy if the biopsy was positive. The high percentage biopsies (Cabañas technique) as well as the significant morbidity (31.6%) in these patients, compared with no morbidity and the high accuracy of the expectant approach (90%) lead the authors to recommend the Cabañas biopsy technique only for patients of low educational level and difficult follow-up as outpatients. Others patients should be followed clinically for signs of tumor activity.

Age Factors↗
PubMed2005

[Clinical experience of streptococcal balanoposthitis in 47 healthy adult males].

Between January 2001 and December 2003, 189 adult patients with balanoposthitis were treated in my clinic. Swab culture from the affected lesion detected Streptococcus pyogens in 47 cases (PYO group), other bacterial species including Candida albicans in 93 (B group), no bacterial growth in 27 (NB group) and swab culture was not done because clinical symptom was trivial in 22 (N group). The PYO group had a significantly higher prevalence of purulent discharge (68.1%) and local pain (38.3%), compared to the B group (25.8% and 21.5%, respectively) or the NB group (33.3% and 11.1%, respectively). Phimosis was absent in 7 cases in the PYO group. The route of infection in the PYO group was considered to be predominantly via sexual contact (PYO group 78.7%, B group 52.7%, NB group 59.3%), especially through fellatio by commercial sex worker for the majority of the PYO patients. The latent period (from sexual contact to the onset of symptoms) was 3 days or less in 40.5% and 4 to 7 days in 35.1% in the PYO group, whereas it was more than a week or not remembered in the majority of the B and NB groups, disapproving the causal relationship with sexual contact in such cases. Treatment with tosufloxacin tosilate or amoxicillin was effective in most cases of streptococcal balanoposthitis. Our results suggest that Streptococcus pyogens is one of the causative organisms of sexually transmitted balanoposthitis.

Administration, Oral↗
PubMedDate not supplied

[Outpatient care for urological patients].

The presence of adequately equipped surgical unit in outpatient clinics provides surgical aid to more patients with urological diseases. Preoperative preparation, aseptic and antiseptic measures, local anesthesia were routine. 64 operations for phimosis, condylomatous growth of the foreskin, hydrocele, cyst of the epididymis and spermatic cord, chronic epididymitis, short frenulum of the prepuce were performed in outpatient setting. Recovery lasted as usual.

Ambulatory Care↗
PubMed1990

[Penile cancer].

We review the literature on penis cancer. The disease is rare and most of the cumulative experience is reported in retrospective series. Multi-institutional international collaboration will be needed for prospective studies of certain facets of this disease which are at present controversial. Suggested areas of research are how to treat early invasive tumours, the diagnosis and treatment of inguinal metastases, the improvement of radiotherapy techniques, the development of effective chemotherapy and effective combinations of therapies. This will potentially lead to a more sparing of organs. It is also necessary to study palliation, and aspects of quality of life. The incidence may be further reduced by educating the public about the condition and about genital hygiene, including the necessity for the early treatment of phimosis.

Carcinoma↗
PubMed1990

[Clinical analysis of penile cancers among Chinese in Taiwan].

From 1972 to 1984, 34 patients with the histologic diagnosis of penile carcinoma were treated at Kaohsiung Medical College Hospital. Of the 34 patients 1 (3%) had transitional cell carcinoma, the others had epidermoid carcinoma. Their ages ranged from 19 to 73 years with a mean of 54 years; the majority of the patients were in the fifth and sixth decades of life. The most common clinical symptom of the tumor was a mass or ulcer over the penis. Phimosis, Bowen's disease and venereal diseases seemed to bear a close etiologic relationship to the penile carcinoma. The prognosis of penile cancer depends upon the stage of the disease. The 5-year survival rates were: 60% for Stage A, 38% for Stage C, and 0% for Stage D patients. Cumulative survival rate was 39%. Circumcision in the neonatal stage is the most effective method in preventing such a disease.

Adult↗
PubMed1990

Squamous cell carcinoma of the penis.

Squamous cell carcinoma of the penis (CA Penis) is not a rare disease in P.R. We have reviewed all cases of CA penis diagnosed in our institution from Jan. 79-Jan. 89. Pathology and hospital records were audited. The survival data on all patients was updated via telephone or record review up to May 89. A total of 18 pts were seen in the last decade. Of these 11. (61%) were seen in the last four years. Four of 18 patients were excluded from analysis due to lack of staging and therapy data. The median age 54.9 y (range 23-82y). The following risk factors were identified: phimosis 12/14 (86%) p = .05, leukoplakia 8/14 (57%); prior venereal disease 1/14 (7%). The primary lesion appeared in the prepuce 8/14 (57%) and glans 6/14 (43%). TNM staging was done in all pts. Most pts presented with T3 or T4 disease 10/14 (71%) and palpable regional adenopathy (N1-N3) 9/14 (64%). Of the nine pts with palpable adenopathy, in 5 (56%) microscopic malignant disease was confirmed. A correlation between T3 or T4 disease and the presence of palpable adenopathy was seen (80%). The Stage at diagnosis of the 14 pts: I: 0/14 (29%), II: 5/14 (7%), III: 3/14 (21%), IV: 6/14; (43%). All pts were treated with partial penectomy and 7/14 had unilateral or bilateral inguinal lymphadenectomy. Long term survivors (LTS), greater than 12 mo., were seen 3/4 pts with Stage II disease, 1/3 Stage III, and 2/5 in Stage IV. The most important prognostic factor for LTS was malignant involvement of regional lymph nodes with 0/5 in this group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Microsurgical therapy in tubal sterility].

In spite of the advances in the field of in vitro-fertilization, microsurgery still offers the best chances for treatment of tubal infertility. Because of the irreversible tubal wall pathology the results following microsurgical repair of the postinfectious tubal disease are limited to approximately 30%. No further improvement of the surgical technique is to be expected. According to the birth rate and the rate of extrauterine gestation, microsurgery gives the best results in the correction of filmy adhesions, fimbrial phimosis and proximal tubal occlusion. Distal tubal occlusion with development of hydrosalpinx and extremely thickness of the wall should be treated by IVF-ET. If higher rates of pregnancy are to be achieved in the future in tubal sterility, the treatment of methods (microsurgery, endoscopy and extracorporeal fertilization) must be combined.

Anastomosis, Surgical↗
PubMed1987

[Clinical statistics on outpatients at the Urological Clinic of Higashi Sapporo Sanjukai Hospital in 1985].

A statistical study was performed on new outpatients, the total number of which was 7,786 (male: 4,953, female: 2,833) in 1985. The male to female ratio was 1.75:1. They had urogenital diseases definitely diagnosed (6,786), tentatively diagnosed (600), normal (260), and diseases other than urogenital (140), and 36.2% of them had been referred to us by other sources. On these outpatients 206 operations had been performed circumcision, resection of condyloma and vasectomy were representative. The peak of the age distribution was in the thirties for males and in the twenties for females. For the first time in Japan, we treated renal and upper ureteral stones using extracorporeal shock wave lithotripsy (ESWL) on September 1, 1984. The results of ESWL at out hospital have been satisfactory. A statistical study was made on new outpatients according to the international disease classification. There were 152 malignant (urogenital) tumors (2.1%). The major diseases of the new outpatients were cystitis (acute or chronic: 20.6%), upper urinary tract stones (19.4%), prostatitis (13.5%), benign prostatic hypertrophy (10.7%). In males the major diseases were prostatitis, upper urinary tract stones, benign prostatic hypertrophy, balanoposthitis, and phimosis, and in females they were cystitis, upper urinary tract stone, pyelonephritis, and renoptosis. We conclude that our hospital plays a major role as a private urological hospital.

Adolescent↗
PubMedDate not supplied

[Evaluation of results of school health examination in the Murcia region. 1986/87].

In the present study, we have carried out an evaluation of school examinations in 47,943 children in the past course. We have compared our results with those from similar previous studies in other parts of Spain. Our findings were comparable in visual acuity and scoliosis, and not so much about cryptorchidism and phimosis. We think that examinations are necessary, but it is needed to increase the quality and the effectiveness, to get closer to the knowledge of usefulness and to the correct evaluation of school health programs.

Age Factors↗
PubMed1989

American Academy of Pediatrics: Report of the Task Force on Circumcision.

Properly performed newborn circumcision prevents phimosis, paraphimosis, and balanoposthitis and has been shown to decrease the incidence of cancer of the penis among US men. It may result in a decreased incidence of urinary tract infection. However, in the absence of well-designed prospective studies, conclusions regarding the relationship of urinary tract infection to circumcision are tentative. An increased incidence of cancer of the cervix has been found in sexual partners of uncircumcised men infected with human papillomavirus. Evidence concerning the association of sexually transmitted diseases and circumcision is conflicting. Newborn circumcision is a rapid and generally safe procedure when performed by an experienced operator. It is an elective procedure to be performed only if an infant is stable and healthy. Infants respond to the procedure with transient behavioral and physiologic changes. Local anesthesia (dorsal penile nerve block) may reduce the observed physiologic response to newborn circumcision. It also has its own inherent risks. However, reports of extensive experience or follow-up with the technique in newborns are lacking. Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained.

Circumcision, Male↗
PubMed1989

[Hypervascularization syndrome of the penis following arterialization of the dorsal penile vein for erectile impotence].

A hypervascularization syndrome following arterialization of the deep dorsal vein of the penis to amend venous erectile impotence is a rare cause of penile ulcers that has not previously been described in the dermatological literature. Arterialization is performed by installing a shunt from the inferior epigastric artery or a venous bypass from the femoral artery to the deep dorsal vein of the penis, resulting in a blockage of venous outflow and in retrograde inflow into the corpora cavernosa. Complications arise as a result of persistently elevated blood pressure in the deep venous system and the erectile tissue in 10-20% of cases and are most often linked to dilatation of the shunt: the consequences are enlargement and induration of the glans, hazard of phimosis and paraphimosis, pulsation of the penis, micturation difficulties and, ultimately, ulceration of the glans. Surgical reduction of the arterial inflow ("banding" of the shunt) is the only therapeutic procedure that reduces hypervascularization without compromising the newly gained erectile function.

Arteriovenous Shunt, Surgical↗
PubMed1989

[Clinical statistics on outpatients at the urological clinic of Sanjukai Hospital in 1988].

A statistical study was performed on new outpatients. The total number of new outpatients in 1988 was 8,389 (male: 5,284, female: 3,105) and the male to female ratio was 1.70:1. They had urogenital diseases definitely diagnosed (7,486), urogenital diseases indefinitely diagnosed (576), no diseases (260), and diseases other than urogenital (67). Thirty-five percent of the outpatients were referred to us by other sources. The number of operations on new outpatients was 139, circumcision, vasectomy and resection of condyloma were representative. The peak of the age distribution was in the thirties for males and in the fifties for females. A statistical study was made on new outpatients according to the international classification of disease. There were 146 malignant (urogenital) tumors (1.8%). The major diseases of the new outpatients were cystitis (acute or chronic: 20.7%), upper urinary tract stone (18.5%), prostatitis (13.0%), and benign prostatic hypertrophy (11.2%). In males the major diseases were prostatitis, upper urinary tract stone, benign prostatic hypertrophy, balanoposthitis, phimosis and in females they were cystitis, upper urinary tract stone, pyelonephritis, renoptosis, and neurogenic bladder. We conclude that our hospital plays a major role as a private urological hospital.

Adult↗
PubMed1988

[Pediatric surgical one-day hospital].

670 sick children were operated upon under conditions of a one-day surgical hospital. Selection of the patients and preoperative preparing was fulfilled at the polyclinic. The selected children had the following diseases: inguinal (119) and umbilical (87) hernias, hernias of the linea alba (14), hydrocele (68), cryptorchidism (81), benign tumours of soft tissues (43), phimosis (258). Complications in the nearest postoperative period made up 0.3%. The economic effect of the treatment of 670 children with surgical diseases at the surgical one-day hospital was more than 50,000 rubles.

Child↗
PubMedDate not supplied

Complementary use of hysterosalpingography, hysteroscopy and laparoscopy in 100 infertile patients: results and comparison of their diagnostic accuracy.

While there is no disputing the invaluable role of laparoscopy in the study of the infertile woman, the function of hysterosalpingography (HSG) and hysteroscopy is still left open to debate. Our research concerns 100 infertile women undergoing HSG, hysteroscopy and laparoscopy; the aim of the study was to check the diagnostic accuracy of the three tests. The sensitivity and specificity of HSG vs hysteroscopy were 74.2% and 91.3% respectively. The sensitivity and specificity of HSG vs laparoscopy were 64.5% and 63.3% as regards tubal patency and 6.9% and 92.8% in the diagnosis of tubal phimosis and pelvic pathology. Despite the limits HSG revealed, our results show that a correct study of the infertile woman can only be accomplished by a combination of all three tests; we therefore recommend a combined approach using all three procedures in all infertile patients.

Adult↗