High-risk Oncogenic Human Papilloma Virus Infection of the Foreskin and Microbiology of Smegma in Prepubertal Boys

Balcı, Melih; Tuncel, Altuğ; Baran, İrmak; Güzel, Özer; Keten, Tanju; Aksu, Neriman; Atan, Ali

doi:10.1016/j.urology.2015.04.034

Cited by 11 publications

(7 citation statements)

References 24 publications

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“… 41 Recent studies have reported the occurrence of several subclinical high-risk HPV infections in the prepuce of boys, a region that is considered a large reservoir for viral diseases and has not received enough attention to date. 43 These results support the interest in the vaccination against HPV in male subjects. 44 Tetravalent and nonavalent vaccines are recommended to males starting at ages 11 to 12 years and may be administered until the age of 26, as in females.…”

Section: Resultssupporting

confidence: 67%

Anogenital warts in pediatric population

Costa‐Silva

Fernandes

Rodrigues

et al. 2017

An. Bras. Dermatol.

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The approach to children with anogenital warts in the context of sexual abuse is a challenge in clinical practice. This study aims to review the current knowledge of anogenital warts in children, the forms of transmission, and the association with sexual abuse and to propose a cross-sectional approach involving all medical specialties. A systematic review of the literature was conducted in Portuguese and English from January 2000 to June 2016 using the ISI Web of Knowledge and PubMed databases. Children aged 12 years or younger were included. The ethical and legal aspects were consulted in the Declaration and Convention on the Rights of Children and in the World Health Organization. Non-sexual and sexual transmission events of human papillomavirus in children have been well documented. The possibility of sexual transmission appears to be greater in children older than 4 years. In the case of anogenital warts in children younger than 4 years of age, the possibility of non-sexual transmission should be strongly considered in the absence of another sexually transmitted infection, clinical indicators, or history of sexual abuse. The importance of human papillomavirus genotyping in the evaluation of sexual abuse is controversial. A detailed medical history and physical examination of both the child and caregivers are critical during the course of the investigation. The likelihood of an association between human papillomavirus infection and sexual abuse increases directly with age. A multidisciplinary clinical approach improves the ability to identify sexual abuse in children with anogenital warts.

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Section: Resultssupporting

confidence: 67%

Anogenital warts in pediatric population

Costa‐Silva

Fernandes

Rodrigues

et al. 2017

An. Bras. Dermatol.

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“…[25] A Turkish study of 100 prepubertal boys swabbed before circumcision identified 72 organisms, 75% being Gram-positive bacteria, 24% Gram-negative bacteria, and 1% Candida spp. [26] Nine percent of boys had high-risk HPV genotypes. Most bacteria were multidrug resistant and included species capable of causing urinary tract infections.…”

Section: Resultsmentioning

confidence: 99%

Penile inflammatory skin disorders and the preventive role of circumcision

Morris

Krieger

2017

Int J Prev Med

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Penile inflammatory skin conditions such as balanitis and posthitis are common, especially in uncircumcised males, and feature prominently in medical consultations. We conducted a systematic review of the medical literature on PubMed, EMBASE, and Cohrane databases using keywords “balanitis,” “posthitis,” “balanoposthitis,” “lichen sclerosus,” “penile inflammation,” and “inflammation penis,” along with “circumcision,” “circumcised,” and “uncircumcised.” Balanitis is the most common inflammatory disease of the penis. The accumulation of yeasts and other microorganisms under the foreskin contributes to inflammation of the surrounding penile tissue. The clinical presentation of inflammatory penile conditions includes itching, tenderness, and pain. Penile inflammation is responsible for significant morbidity, including acquired phimosis, balanoposthitis, and lichen sclerosus. Medical treatment can be challenging and a cost burden to the health system. Reducing prevalence is therefore important. While topical antifungal creams can be used, usually accompanied by advice on hygiene, the definitive treatment is circumcision. Data from meta-analyses showed that circumcised males have a 68% lower prevalence of balanitis than uncircumcised males and that balanitis is accompanied by a 3.8-fold increase in risk of penile cancer. Because of the high prevalence and morbidity of penile inflammation, especially in immunocompromised and diabetic patients, circumcision should be more widely adopted globally and is best performed early in infancy.

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“…of samples Median age (Range) Phimosis Investigated HPV type general HPV HR-HPV LR-HPV HPV type 16/18 16 18 Balci et al . 15 Turkey 100 5.7 (0.2–9.0) 55 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68 9 9 0 3 3 0 Maarof et al . 14 Malaysia 51 9.0 (4.0–12.0) 2 NA 2 0 2 0 0 0 Klinglmair et al .…”

Section: Resultsmentioning

confidence: 99%

“… Author (year) Location Detailed reasons for selected population Detailed description of sampling and measurement method Risk of bias study participation outcome measurement Balci et al . 15 Turkey The reasons for circumcision were primary phimosis and religious. Yes Low Low Maarof et al .…”

Section: Resultsmentioning

confidence: 99%

“…of samples Prevalence (95% CI) a general HPV HR-HPV LR-HPV HPV16/18 HPV16 HPV18 Balci et al . 15 100 9.0 (4.2–16.4) 9.0 (4.2–16.4) 0.0 (0.0–3.6) 3.0 (0.6–8.5) 3.0 (0.6–8.5) 0.0 (0.0–3.6) Maarof et al . 14 51 3.9 (0.5–13.5) 0.0 (0.0–7.0) 3.9 (0.5–13.5) 0.0 (0.0–7.0) 0.0 (0.0–7) 0.0 (0.0–7.0) Klinglmair et al .…”

Section: Resultsmentioning

confidence: 99%

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HPV prevalence in the foreskins of asymptomatic healthy infants and children: Systematic review and meta-analysis

Lee

Kim

et al. 2017

Sci Rep

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The true HPV prevalence in the foreskins of infants and children has been little documented, but reporting on this prevalence is of great importance given its impact on the rationale for treating asymptomatic boys. We searched multiple databases from 1960 to 2016 for observational or prospective studies that reported on HPV prevalence in foreskins. We conducted a meta-analysis using a random-effects model to pool for HPV prevalence in the foreskins of infants and children. Eight studies, with a total of 556 infants and children with phimosis, were eligible for the meta-analysis. The pooled overall prevalence of general HPV, high-risk HPV, low-risk HPV, HPV 16/18, HPV 16, and HPV 18 were 17.3 (95%CI: 0.8–46.3), 12.1 (95% CI: 0.9–31.5), 2.4 (95% CI: 0.0–11.2), 4.8 (95% CI: 0.0–16.8), 1.7 (95% CI: 0.0–5.1), and 0 (95% CI: 0–0.5), respectively. The estimated HPV prevalence in foreskins was not zero among infants and children, which implies HPV transmission other than by sexual contact. Considering that high-risk HPV is detected in asymptomatic infants and children, future studies are warranted to determine whether preventive treatments in asymptomatic infants and children could be effective in preventing persistence or transmission of high-risk HPV.

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High-risk Oncogenic Human Papilloma Virus Infection of the Foreskin and Microbiology of Smegma in Prepubertal Boys

Cited by 11 publications

References 24 publications

Anogenital warts in pediatric population

Anogenital warts in pediatric population

Penile inflammatory skin disorders and the preventive role of circumcision

HPV prevalence in the foreskins of asymptomatic healthy infants and children: Systematic review and meta-analysis

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