Prevalence of Phimosis in Males of All Ages: Systematic Review

Morris, Brian J.; Matthews, Jim; Krieger, John N.

doi:10.1016/j.urology.2019.10.003

Cited by 31 publications

(25 citation statements)

References 54 publications

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“…Phimosis, inflammatory conditions (balanitis and lichen sclerosus) and poor genital hygiene are relevant risk factors for cancer of the penis. The prevalence of phimosis in males in adulthood is over 3.4% 28 . Between patients with cancer of the penis, this prevalence is over 25-75% 16,29 , and its contribution can be attributed to the accumulation of smegma, higher incidence of HPV or as an isolated carcinogenic factor 7,[30][31][32] .…”

Section: Discussionmentioning

confidence: 99%

Profile of patients with penile cancer in the region with the highest worldwide incidence

Vieira

Feitoza

Pinho

et al. 2020

Sci Rep

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To determine the epidemiological, histopathological, and clinical characteristics of patients diagnosed with penile cancer in the Brazilian state of Maranhão, the region with the highest incidence worldwide. One hundred and sixteen penile cancer patients were interviewed from July 2016 to October 2018. The majority of patients lived in a rural area (57%), worked in farming (58%), had a low level of schooling or no schooling (90%), and were married or in a stable relationship (74%). The mean age was 60.4 ± 16.51 years (range, 23-93 years). Phimosis (66%), poor/moderate genital hygiene (73%), history of sexually transmitted infections (55%), and zoophilia (60%) were found in the majority of patients. Most patients had their first sexual encounter at 16.2 ± 2.8 years (range, 10-25 years), and 75% had >6 sexual partners. The most common initial symptom was pruritus (37%), and most patients waited to seek treatment (average time to treatment, 18.9 months; range, 2-84 months). Human papillomavirus (HPV)-related histologies were observed in 62% of patients. Most patients had histological grades II or III (87%), stage ≥T2 disease (84%), and lymphadenopathy at admission (42%). Penectomy was performed in 96% of patients. The population with penile cancer in the region of highest incidence in the world is marked by low socioeconomic status, high prevalence of HPV infection, and phimosis. The delay in seeking treatment is related to a very high rate of advanced cancer and aggressive surgical treatment. The high prevalence of young patients was also a striking feature.Penile cancer is uncommon in developed countries, and its incidence varies according to the demographic region and the circumcision status 1,2 . In the US and Europe, the age-standardized incidence rate (ASR) for 100,000 inhabitants is between 0.1 and 1.0 3 . However, in less developed countries, including some countries in South America, Asia, and Africa, the incidence is alarmingly high 1 . In uncircumcised males, the cumulative lifetime risk for cancer of the penis is higher compared to the general population, corresponding to 1 in 600 men in the US 2 . Brazil has a high incidence, and the state of Maranhão, located in the northeastern region of the country, has the highest incidence of penile cancer in the world (ASR of 6.1 cases per 100,000 inhabitants) 4 .The etiology of penile carcinoma remains unknown, and its mechanisms of development have not been completely elucidated. Phimosis, balanitis, smegma, precarious genital hygiene, smoking, history of sexually transmitted infections (STIs), and human papilloma virus (HPV) infection (present in approximately 50% of cases) are the main risk factors, and circumcision is an important protective factor 5-8 . Its incidence is higher in regions History of STIs 55 (40/73) Sexual history Age of first sexual encounter [mean (range)] 16.2 years (10-25 years) Zoophilia 60 (43/72) No. female partners Less than 6 25 (19/75) Between 6 and 10 17 (13/75) More than 10 58 (43/75) Duration of symptom [mean (range)] 18.9 months ...

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Section: Discussionmentioning

confidence: 99%

Profile of patients with penile cancer in the region with the highest worldwide incidence

Vieira

Feitoza

Pinho

et al. 2020

Sci Rep

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“…La causa del carcinoma de células escamosas es desconocida (6) , y ha sido atribuida a varios factores, entre ellos se encuentra el VPH, habiéndose reportado su asociación hasta en el 40 % de los casos (9) ; asimismo, se encontró relación en el 66,3 % con el subtipo basaloide-verrugoso (9) . Otro factor es la fimosis, pudiendo ser de etiología primaria o secundaria; esta última puede ser, además, consecuencia de liquen escleroso, diabetes u obesidad (10) . Según Barnes et al, el riesgo de cáncer de pene invasivo se incrementa con el sobrepeso (OR = 2,64) y con la obesidad (OR = 3,24) (11) , lo cual podría estar relacionado con mecanismos secundarios a un autoexamen e higiene genital deficiente, pene enterrado con acumulación de esmegma y fimosis funcional (11) .…”

Section: Discussionunclassified

¿Podría ser la diabetes factor de riesgo para cáncer de pene?: a propósito de un caso

Diaz-Meyzan

Lazo

2021

revista de salud udh

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El cáncer de pene es raro y afecta con mayor frecuencia a hombres mayores de edad. Reportamos el caso de un paciente varón con antecedente de tuberculosis y que, asimismo, padece diabetes mellitus (DM), quien presento cáncer a células escamosas de pene, siendo sometido a tratamiento quirúrgico satisfactorio. El artículo tiene el propósito de mostrar la posible relación entre la diabetes y el cáncer de pene, siendo esta una neoplasia infrecuente en la zona. Sin embargo, es recomendable tenerlo presente para hacer un diagnóstico precoz y tratamiento oportuno.

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“…Phimosis is defined by a prepuce that cannot be retracted over the glans due to narrowing of the preputial orifice and/or adhesion between glans and the prepuce [1]. Physiologically most boys are born with phimosis, called primary phimosis, which spontaneously resolves over the years.…”

Section: Introductionmentioning

confidence: 99%

Penile intraepithelial neoplasia, penile cancer precursors and human papillomavirus prevalence in symptomatic preputium: a cross‐sectional study of 351 circumcised men in Sweden

Kristiansen¹,

Bjartling²,

Svensson³

et al. 2020

BJU International

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Objectives To investigate the prevalence of pathological disease and spectrum of human papillomavirus (HPV) types among symptomatic foreskin tissue. Patients and Methods Consecutively excised symptomatic foreskins from 351 men were sent for histopathological evaluation. During the surgical procedure, a fresh biopsy was taken for HPV analysis by modified general primer polymerase chain reaction. A medical questionnaire regarding medication, smoking habits, number of lifetime sexual partners, former diseases and surgery performed on penis was completed by all participants. Results The most common clinical diagnosis and cause for circumcision was phimosis, seen in 85.2%. Histopathologically inflammatory dermatological conditions were present in 87% of the men. The most common histopathological diagnosis was lichen sclerosus (LS) observed among 58.7%. Notably, penile intraepithelial neoplasia (PeIN) was present in 2% without former clinical suspicion. Overall, HPV was detected in 17.1% of the men and 28 different HPV types were found. High‐risk (HR) HPV types were identified in 9.1% and HPV16 was present in 2.3%. Current smoking increased the risk of HPV (crude odds ratio [OR] 2.8, confidence interval [CI] 1.4–5.6; P = 0.005). Having >15 lifetime sexual partners increased the risk of HPV (crude OR 2.6, 95% CI 1.4–5.1; P = 0.003) and when adjusted for current smoking the OR was substantially increased (OR 6.0, 95% CI CI 2.2–16.8; P < 0001). Conclusions Histopathological evaluation of circumcised symptomatic foreskin revealed PeIN in 2% of the men without any clinical suspicion of malignancy and that treatable dermatological conditions were present in 87%, LS being the most common. HR‐HPV types were present in 9%. Due to risk of malignant development both in PeIN and in inflammatory skin diseases we recommend sending all excised foreskins from patients with symptoms for histopathological evaluation as guidance for further clinical management.

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Prevalence of Phimosis in Males of All Ages: Systematic Review

Cited by 31 publications

References 54 publications

Profile of patients with penile cancer in the region with the highest worldwide incidence

Profile of patients with penile cancer in the region with the highest worldwide incidence

¿Podría ser la diabetes factor de riesgo para cáncer de pene?: a propósito de un caso

Penile intraepithelial neoplasia, penile cancer precursors and human papillomavirus prevalence in symptomatic preputium: a cross‐sectional study of 351 circumcised men in Sweden

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