A Novel Tool to Predict the Cosmetic Outcome after Circumcision: Penile Visibility Index
ABSTRACT
Objectives: We aimed to evaluate the circumcision status and complications, and the value of penile visibility index in predicting circumcision complications among elementary school children. Patients and Methods: Elementary school students were evaluated with physical exam in terms of circumcision complications. Visible penile length/stretched penile length ratio was calculated for each subject and recorded as penile visibility index (PVI). Data were assessed with SPSS 15.0 software. Results: Average age was 9.04 (5 - 14) years. Circumcision complications were detected in 84 of 361 circumcised subjects (23.2%). There was no relationship between age at circumcision and complications (p > 0.05). Concealed penis was detected in 3.6% of all subjects. Mean PVI was significantly different between cases with and without glanular adhesion, and between cases with and without residual prepuce. On the overall, mean PVI in complication and no complication groups were 0.52 and 0.59 respectively, and the difference was statistically significant (p < 0.001). Conclusion: PVI calculation before circumcision, might help predict the cosmetic outcome of circumcision beforehand.
Cite this paper
Akyol, I. , Soydan, H. , Kocoglu, H. , Ates, F. , Karademir, K. and Baykal, K. (2014) A Novel Tool to Predict the Cosmetic Outcome after Circumcision: Penile Visibility Index. International Journal of Clinical Medicine, 5, 605-610. doi: 10.4236/ijcm.2014.510082.
Akyol, I. , Soydan, H. , Kocoglu, H. , Ates, F. , Karademir, K. and Baykal, K. (2014) A Novel Tool to Predict the Cosmetic Outcome after Circumcision: Penile Visibility Index. International Journal of Clinical Medicine, 5, 605-610. doi: 10.4236/ijcm.2014.510082.
References
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http://dx.doi.org/10.1136/adc.86.2.76 [2] Yegane, R., Kheirollahi, A., Salehi, N., et al. (2006) Late Complications of Circumcision in Iran. Pediatric Surgery International, 22, 442-445.
http://dx.doi.org/10.1007/s00383-006-1672-1 [3] Klavs, I. and Hamers, F.F. (2008) Male Circumcision in Slovenia: Results from a National Probability Sample Survey. Sexually Transmitted Infections, 84, 49-50.
http://dx.doi.org/10.1136/sti.2007.027524 [4] Cathcart, P., Nuttall, M., van der Meulen, J., et al. (2006) Trends in Paediatric Circumcision and Its Complications in England between 1997 and 2003. British Journal of Surgery, 93, 885-890. http://dx.doi.org/10.1002/bjs.5369 [5] Edgar, J. and Schoen, M.D. (2006) Ignoring Evidence of Circumcision Benefits. Pediatrics, 118, 385-387.
http://dx.doi.org/10.1542/peds.2005-2881 [6] Drain, P.K., Halperin, D.T., Hughes, J.P., Klausner, J.D. and Bailey, R.C. (2006) Male Circumcision, Religion, and Infectious Diseases: An Ecologic Analysis of 118 Developing Countries. BMC Infectious Diseases, 6, 172.
http://dx.doi.org/10.1186/1471-2334-6-172 [7] Atikeler, M.K., Gecit, I., Yuzgec,V. and Yalcin, O. (2005) Complications of Circumcision Performed within and outside the Hospital. International Urology and Nephrology, 37, 97-99. http://dx.doi.org/10.1007/s11255-004-6077-2 [8] Sahin, F., Beyazova, U. and Akturk, A. (2003) Attitudes and Practices Regarding Circumcision in Turkey. Child: Care, Health and Development, 29, 275-280. http://dx.doi.org/10.1046/j.1365-2214.2003.00342.x [9] Sivasli, E., Bozkurt, A.I., Ceylan, H. and Coskun, Y. (2003) Gaziantep bölgesindeki sünnet ileilgili bilgi, tutum ve davranislari. Cocuk Sagligi ve Hastaliklari Dergisi, 46, 114-118. [10] Muula, A., Prozesky, H.W., Mataya, R.H. and Ikechebelu, J.I. 2007) Prevalence of Complications of Male Circumcision in Anglophone Africa: A Systematic Review. BMC Urology, 7, 4.
http://dx.doi.org/10.1186/1471-2490-7-4 [11] Williams, C.P., Richardson, B.G. and Bukowski, T.P. (2000) Importance of Identifying the Inconspicuous Penis: Prevention of Circumcision Complications. Urology, 56, 140-143.
http://dx.doi.org/10.1016/S0090-4295(00)00601-4 [12] Brisson, P.A., Patel, H.I. and Feins, N.R. (2002) Revision of Circumcision in Children: Report of 56 Cases. Journal of Pediatric Surgery, 37, 1343-1346.
http://dx.doi.org/10.1053/jpsu.2002.35005 [13] Sivakumar, B., Brown, A.A. and Kangesu, L. (2004) Circumcision in “Buried Penis”—A Cautionary Tale. Annals of the Royal College of Surgeons of England, 86, 35-37.
http://dx.doi.org/10.1308/003588404772614669 [14] Ahmed, A., Mbibu, N.H., Dawam, D. and Kalayi, G.D. (1999) Complications of Traditional Male Circumcision. Annals of Tropical Paediatrics, 19, 113-117.
http://dx.doi.org/10.1080/02724939992743 [15] Ceylan, K., Koseoglu, B., Yilmaz, Y., et al. (2007) Severe Complications of Circumcision: An Analysis of 48 Cases. Journal of Pediatric Urology, 3, 32-33. http://dx.doi.org/10.1016/j.jpurol.2006.02.009 [16] Ozdemir, E. (1997) Significantly Increased Complication Risks with Mass Circumcisions. British Journal of Urology, 80, 136-139.
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http://dx.doi.org/10.1097/01.PRS.0000107735.19836.60 [18] Akoz, T., Erdogan, B., Gorgu, M., Aslan, G. and Altintas, H. (1998) Unusual Complications of Circumcision. Plastic and Reconstructive Surgery, 101, 1915-1918.
http://dx.doi.org/10.1097/00006534-199806000-00021 [19] Williams, N. and Kapila, L. (1993) Complications of Circumcision. British Journal of Urology, 80, 1231-1236. [20] Okeke, L.I., Asinobi, A.A. and Ikuerowo, O.S. (2006) Epidemiology of Complications of Male Circumcision in Ibadan, Nigeria. BMC Urology, 6, 21.
http://dx.doi.org/10.1186/1471-2490-6-21 [21] Maizels, M., Zaontz, M. and Donovan, J. (1986) Surgical Correction of the Buried Penis: Description of a Classification System and a Technique to Correct the Disorder. The Journal of Urology, 136, 268-271. [22] Borsellino, A., Spagnoli, A., Vallasciani, S., Martini, L. and Ferro, F. (2007) Surgical Approach to Concealed Penis: Technical Refinements and Outcome. Urology, 69, 1195-1198.
http://dx.doi.org/10.1016/j.urology.2007.01.065 [23] Bergeson, P., Hopkin, R.J., Bailey Jr., R.B., McGill, L.C. and Piatt, J.P. (1993) The Inconspicuous Penis. Pediatrics, 92, 794-799. [24] Casale, A.J., Beck, S.D. and Cain, M.P. (1999) Concealed Penis in Childhood: A Spectrum of Etiology and Treatment. The Journal of Urology, 162, 1165-1168.
[1] Gatrad, A.R., Sheikh, A. and Jacks, H. (2002) Religious Circumcision and the Human Rights Act. Archives of Disease in Childhood, 86, 76-78.
http://dx.doi.org/10.1136/adc.86.2.76 [2] Yegane, R., Kheirollahi, A., Salehi, N., et al. (2006) Late Complications of Circumcision in Iran. Pediatric Surgery International, 22, 442-445.
http://dx.doi.org/10.1007/s00383-006-1672-1 [3] Klavs, I. and Hamers, F.F. (2008) Male Circumcision in Slovenia: Results from a National Probability Sample Survey. Sexually Transmitted Infections, 84, 49-50.
http://dx.doi.org/10.1136/sti.2007.027524 [4] Cathcart, P., Nuttall, M., van der Meulen, J., et al. (2006) Trends in Paediatric Circumcision and Its Complications in England between 1997 and 2003. British Journal of Surgery, 93, 885-890. http://dx.doi.org/10.1002/bjs.5369 [5] Edgar, J. and Schoen, M.D. (2006) Ignoring Evidence of Circumcision Benefits. Pediatrics, 118, 385-387.
http://dx.doi.org/10.1542/peds.2005-2881 [6] Drain, P.K., Halperin, D.T., Hughes, J.P., Klausner, J.D. and Bailey, R.C. (2006) Male Circumcision, Religion, and Infectious Diseases: An Ecologic Analysis of 118 Developing Countries. BMC Infectious Diseases, 6, 172.
http://dx.doi.org/10.1186/1471-2334-6-172 [7] Atikeler, M.K., Gecit, I., Yuzgec,V. and Yalcin, O. (2005) Complications of Circumcision Performed within and outside the Hospital. International Urology and Nephrology, 37, 97-99. http://dx.doi.org/10.1007/s11255-004-6077-2 [8] Sahin, F., Beyazova, U. and Akturk, A. (2003) Attitudes and Practices Regarding Circumcision in Turkey. Child: Care, Health and Development, 29, 275-280. http://dx.doi.org/10.1046/j.1365-2214.2003.00342.x [9] Sivasli, E., Bozkurt, A.I., Ceylan, H. and Coskun, Y. (2003) Gaziantep bölgesindeki sünnet ileilgili bilgi, tutum ve davranislari. Cocuk Sagligi ve Hastaliklari Dergisi, 46, 114-118. [10] Muula, A., Prozesky, H.W., Mataya, R.H. and Ikechebelu, J.I. 2007) Prevalence of Complications of Male Circumcision in Anglophone Africa: A Systematic Review. BMC Urology, 7, 4.
http://dx.doi.org/10.1186/1471-2490-7-4 [11] Williams, C.P., Richardson, B.G. and Bukowski, T.P. (2000) Importance of Identifying the Inconspicuous Penis: Prevention of Circumcision Complications. Urology, 56, 140-143.
http://dx.doi.org/10.1016/S0090-4295(00)00601-4 [12] Brisson, P.A., Patel, H.I. and Feins, N.R. (2002) Revision of Circumcision in Children: Report of 56 Cases. Journal of Pediatric Surgery, 37, 1343-1346.
http://dx.doi.org/10.1053/jpsu.2002.35005 [13] Sivakumar, B., Brown, A.A. and Kangesu, L. (2004) Circumcision in “Buried Penis”—A Cautionary Tale. Annals of the Royal College of Surgeons of England, 86, 35-37.
http://dx.doi.org/10.1308/003588404772614669 [14] Ahmed, A., Mbibu, N.H., Dawam, D. and Kalayi, G.D. (1999) Complications of Traditional Male Circumcision. Annals of Tropical Paediatrics, 19, 113-117.
http://dx.doi.org/10.1080/02724939992743 [15] Ceylan, K., Koseoglu, B., Yilmaz, Y., et al. (2007) Severe Complications of Circumcision: An Analysis of 48 Cases. Journal of Pediatric Urology, 3, 32-33. http://dx.doi.org/10.1016/j.jpurol.2006.02.009 [16] Ozdemir, E. (1997) Significantly Increased Complication Risks with Mass Circumcisions. British Journal of Urology, 80, 136-139.
http://dx.doi.org/10.1046/j.1464-410X.1997.00218.x [17] Demirseren, M.E. and Gokrem, S. (2004) Circumcision in Unqualified Hands: A Significant Risk of Complication. Plastic and Reconstructive Surgery, 113, 1090-1092.
http://dx.doi.org/10.1097/01.PRS.0000107735.19836.60 [18] Akoz, T., Erdogan, B., Gorgu, M., Aslan, G. and Altintas, H. (1998) Unusual Complications of Circumcision. Plastic and Reconstructive Surgery, 101, 1915-1918.
http://dx.doi.org/10.1097/00006534-199806000-00021 [19] Williams, N. and Kapila, L. (1993) Complications of Circumcision. British Journal of Urology, 80, 1231-1236. [20] Okeke, L.I., Asinobi, A.A. and Ikuerowo, O.S. (2006) Epidemiology of Complications of Male Circumcision in Ibadan, Nigeria. BMC Urology, 6, 21.
http://dx.doi.org/10.1186/1471-2490-6-21 [21] Maizels, M., Zaontz, M. and Donovan, J. (1986) Surgical Correction of the Buried Penis: Description of a Classification System and a Technique to Correct the Disorder. The Journal of Urology, 136, 268-271. [22] Borsellino, A., Spagnoli, A., Vallasciani, S., Martini, L. and Ferro, F. (2007) Surgical Approach to Concealed Penis: Technical Refinements and Outcome. Urology, 69, 1195-1198.
http://dx.doi.org/10.1016/j.urology.2007.01.065 [23] Bergeson, P., Hopkin, R.J., Bailey Jr., R.B., McGill, L.C. and Piatt, J.P. (1993) The Inconspicuous Penis. Pediatrics, 92, 794-799. [24] Casale, A.J., Beck, S.D. and Cain, M.P. (1999) Concealed Penis in Childhood: A Spectrum of Etiology and Treatment. The Journal of Urology, 162, 1165-1168.