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PubMedDate not supplied

[Modification of meatoglanuloplasty (MAGPI-Duckett) for treatment of balanic and coronal forms of hypospadia in children].

14 boys with balanic hypospadia (BH) and 23 boys with coronal hypospadia (CH) aged 9 months to 15 years were operated in 1997-2000. For 13 boys this operation was meatoglanuloplasty (MAGPI) by J. Duckett. Complications occurred in 4 boys: retraction (downwards) of the meatus (n = 2), urethral stenosis and urinary fistula (n = 2). 24 boys have undergone modified MAGPI operation. The modification consists in extended mobilization of the lateral parts of the head with longitudinal consecutive incisions along the head margin into the spongy bodies. The head is closed by suturing its mobilized margins with two rows of interrupted monofilamentous (PDS, prolene) sutures above the urethra. A variant of saving foreskin is possible when partial separation of the internal and external layers is made bilaterally with consecutive circular closure of the preputial sac. Phimosis is prevented by a relief longitudinal incision along the internal foreskin and transverse suturing. The patients were followed up for 2 months to 1.5 years. The original operation MAGPI provided good cosmetic and functional results in 9 boys(69.2%), satisfactory in 2 boys(15.4%), unsatisfactory also in 2 boys(15.4%). The modified MAGPI operation provided only good cosmetic and functional results. Thus, the proposed modification (MAGPI-Duckett) ensures a more reliable variant of meatoglanuloplasty in balanic and coronal hypospadia irrespective of the size and shape of the head, presence of the scaphoid fossa or meatostenosis. These additional procedures helped to reduce the number of postoperative complications and improved cosmetic and functional results.

Adolescent↗
PubMed2002

Zoon's balanitis treated with Erbium:YAG laser ablation.

BACKGROUND AND OBJECTIVE: Zoon's balanitis (ZB) is an uncommon, benign, idiopathic inflammatory condition affecting uncircumcised males. Definitive treatments include circumcision and carbon dioxide (CO2) laser ablation. We describe an alternative laser modality showing efficacy in the treatment of ZB. STUDY DESIGN/MATERIALS AND METHODS: We report the first case of ZB effectively treated with Erbium:YAG (Er:YAG) laser ablation. We review the pathogenesis and medical, surgical, and laser management of ZB. RESULTS: Our patient demonstrated a long-term clinical and histologic cure after Er:YAG laser ablation of ZB. CONCLUSIONS: As an alternative to circumcision or continuous wave CO2 laser, we propose a trial of Er:YAG laser ablation as a low risk, first line treatment of ZB.

Aged↗
PubMed2000

Balanitis xerotica obliterans--a review.

Balanitis xerotica obliterans (BXO) is a scarcely known disease, wrongly considered rare. With a high degree of suspicion and histologic examination, the condition will prove to be much more frequent than one generally believes. The etiology of the condition is unknown at present. Many cases of BXO occurring after circumcision may be cases of secondary phimosis due to BXO not being recognized at the time of surgery. Most of the cases of BXO are seen in the third to fifth decades of life, even though they may occur at the extremes of age. Biopsy of the lesions is not essential in all cases and is indicated to differentiate from penile cancer and in atypical cases. Early diagnosis and treatment of BXO are very important in preventing the urological complications of the diseases such as urethral stricture. Treatment of BXO depends on the anatomic location of the lesions and their extent and severity, together with the rapidity of progression of the disease process. The treatment may vary from topical corticosteroids, laser vaporization in early cases to meatoplasty and urethroplasty in extensive cases. Topical pharmacotherapy is useful in the early stages to reduce the initial symptoms and slow down the progression, but is not effective in all cases and is not the curative treatment of disease. Meatal stenosis, phimosis, scar adhesions, fissures, erosions of glans and prepuce and involvement of the urethra are indications for surgical treatment. Surgery seems to be the only treatment that can relieve the symptoms of advanced disease. Modified circumcision, with total removal of inner preputial layer, definitively relieves phimosis without any recurrence. Meatotomy will not prevent the recurrence of meatal stenosis. Excision of the scleroatrophic tract and grafting of the glans base, coronal sulcus, and the end of the shaft give a complete relief of pain during erection and intercourse in circumcised patients with balanopreputial adhesions and restore the elasticity of the skin of penile shaft. These procedures have been shown to yield excellent functional results during a follow-up period of up to 4 years. BXO involving anterior urethra can be treated by 2-stage urethroplasty or substitution urethroplasty. The complete excision of the stricture and flap urethroplasty seems to be better than a 2-stage procedure. However, at the present time, it is not possible to say that surgery can completely resolve this chronic and progressive disease. Despite many reports in the literature of cases of BXO associated with squamous cell carcinoma, the etiologic relationship between the two conditions is uncertain.

Administration, Topical↗
PubMed2000

Balanitis xerotica obliterans with urethral stricture after hypospadias repair.

Three cases of urethral stricture due to balanitis xerotica obliterans (BXO) after hypospadias repair are reported. The first patient showed white, dense scarring on the prepuce before the hypospadias repair and developed a stricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, and then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topical steroid ointment or sublesional triamcinolone injection is recommended for this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral problems.

Balanitis↗
PubMed2006

Extensive balanitis xerotica obliterans (BXO) involving the anterior urethra and scrotum.

We describe an unusual case of balanitis xerotica obliterans (BXO) involving the entire anterior urethra and the scrotum that had presented as a palpable nodular scrotal mass with obstructive voiding symptoms in middle aged man. He was managed by a staged urethroplasty. We report the first such case of BXO involving the scrotum resulting in a nodular mass that has not been described and reported till date.

Adult↗
PubMed1979

Balanitis xerotica obliterans involving anterior urethra.

Balanitis xerotica obliterans (BXO) is known to affect the urethral meatus, glans, and prepuce. We describe a case of biopsy-proved BXO that involves not only the usual areas but the anterior urethra as well. Of added interest is the subsequent development of squamous cell carcinoma in the fossa navicularis. The literature is reviewed.

Balanitis↗
PubMed1982

Continuous wave carbon dioxide treatment of balanitis xerotica obliterans.

Herein is presented the first case of balanitis xerotica obliterans treated successfully by carbon dioxide-continuous wave (CW-CO2) laser vaporization. This method appears to be a safe addition to other well-known treatment modalities, offering minimal postoperative discomfort, preservation of anatomic landmarks and function, and excellent cosmetic results.

Adult↗
PubMed2006

[Balanitis: diagnosis and treatment].

Balanitis refers to a variety of unrelated conditions. It results from infective, irritative, allergic, traumatic, or inflammatory causes; pre-malignant lesions have been also identified. All these causes are successively reviewed regarding their positive diagnosis and their treatment. Normal aspects of the balanopreputial area will be explained because they may cause some anxiety in certain patients. The difference between the circumcised and uncircumcised penile skin that cause differences in the incidence and appearance of dermatoses of the glans and corona will be studied. Pre-malignant lesions of the balanopreputial area, although not frequent, represent a difficult diagnosis and therapeutic challenge. The major problem is the earliness of the diagnosis that may avoid the occurrence of squamous cell carcinoma. Moreover, lichen sclerosus may develop into squamous cell carcinoma and therefore a lifelong follow-up must be implemented. Thus, any fixed, chronic or suspicious Lesion must be rapidly assessed by a biopsy.

Balanitis↗
PubMed2005

The response of clinical balanitis xerotica obliterans to the application of topical steroid-based creams.

OBJECTIVE: The aim of this study was to assess the effectiveness of using topical steroid-based creams in the management of clinically diagnosed balanitis xerotica obliterans (BXO) in boys. METHODS: The response in 56 boys to locally applied steroid-based creams was studied retrospectively. All had been referred by their general practitioners with symptoms of penile pathology and then subsequently had a clinical diagnosis of BXO made. The boys were initially assessed after 3 months of treatment and then at various intervals depending on their response. RESULTS: The mean age at presentation of the boys was 8.9 (4 to 15) years. After the initial 3-month assessment, 10 (17.9%) boys had complete resolution. When the treatment period was prolonged by an average of 14 months, the total number of boys showing resolution increased to 17 (30.4%). All boys showing resolution had clinically mild BXO limited to the prepuce only. Those patients with established scar formation on the foreskin showed no significant improvement. CONCLUSIONS: Topical steroids seem to offer a reliable option only in the management of mild BXO limited to the prepuce in boys with minimal scar formation. Steroid-based creams can be offered to such patients provided they and their families are realistic as to the likelihood of success. This treatment is ineffective in the face of established scarring.

Administration, Topical↗
PubMed2005

Plasma cell (Zoon's) balanitis with concomitant HIV infection.

We report a case of the development of Zoon's balanitis in an African-American man with human immunodeficiency virus. Photographs of the clinical and pathological lesion are presented. To our knowledge, this has not been recently reported in urologic studies. The clinicopathologic correlation is discussed.

Adult↗
PubMed1987

Chronic balanitis owing to pemphigus vegetans.

Pemphigus is an autoimmune bullous dermatosis in which intercellular antibodies are associated with loss of intercellular cohesion. Pemphigus vegetans, a rare variant of pemphigus, is manifested by vegetating plaques, usually in intertriginous areas of patients who probably have an increased resistance to the disease. We report a case of chronic balanitis owing to pemphigus vegetans, and discuss proposed pathogenic mechanisms and treatment.

Aged↗
PubMed1985

Balanitis as a fixed drug eruption to tetracycline.

Fixed drug eruptions are a rarely reported complication of tetracycline therapy. For poorly understood reasons, the epithelium of the glans penis seems unusually susceptible to this type of reaction. We report 3 additional cases of balanitis secondary to orally administered tetracycline and suggest that there may not be cross sensitivity to doxycycline.

Adult↗
PubMed1980

Balanitis circumscripta plasmacellularis.

A patient is presented with a recalcitrant penile lesion which demonstrated the clinical and histologic features of the balanitis originally described by Zoon. The status of this disease and its relationship to similar disorders are discussed.

Aged↗
PubMed1984

Carbon dioxide laser treatment of balanitis xerotica obliterans.

A case of balanitis xerotica obliterans unresponsive to topical therapy is presented. The condition was successfully corrected following epithelial vaporization with the carbon dioxide laser, the patient remaining free of recurrence for 21 months postoperatively.

Adult↗
PubMed1999

Long-term antibiotic therapy for balanitis xerotica obliterans.

In an open uncontrolled study of 3 patients with balanitis xerotica obliterans we have observed significant improvement after long-term systemic antibiotic therapy. Two of the patients noticed softening of the skin as well as disappearance of pruritus, tenderness, and inflammatory changes within 3 weeks of receiving oral and intramuscular penicillin. The third patient experienced the same degree of improvement after a regimen of dirithromycin, 500 mg/day. Stopping the antiobiotic for 1 month resulted in relapse, with improvement again on resumption.

Adult↗
PubMed1998

Balanitis.

Balanitis, inflammation of the glans penis, is a frequently presenting genital disorder. It may be infectious and sexually transmissible, or commonly represents a noninfectious dermatologic condition. Accurate diagnosis is essential for management.

Adult↗
PubMed2001

Urethral stone presenting as a stop valve--a rare complication of balanitis xerotica obliterans.

Balanitis xerotic obliterans (BXO) is the genital subcategory of lichen sclerosis et atrophicus. The association of BXO with urethral stone causing interruption of the urinary stream and voiding by manual displacement of the urethral stone has not been described before. We describe one such case of a young boy with BXO and urethral stone who voided by manually displacing the stone for over a year. The case is reported to emphasize the ingenuity of the patient in continuing to void for over a year despite the association of the impacted urethral stone with urethral stricture and BXO.

Adult↗