br Symptoms Some patients with buried penis were circumcised

Symptoms Some patients with buried penis were circumcised when they presented at clinics. Casale et al reported that 56% of their patients had previously underwent penile surgery, and almost all of them underwent circumcision. In addition, Bergeson et al reported that 42% of their patients underwent circumcision. Because inadequate circumcision complicates further surgical correction in patients with buried penis, it is crucial for the primary care physician to diagnose this condition and avoid circumcision without careful consideration. Adults may present with painful erection, sexual embarrassment, and difficulty with vaginal penetration. Some may have difficulty voiding in a standing position and may soil themselves while urinating.
Management In general, procedures used to correct the buried penis anomaly include degloving the penis, dissecting the pteryxin and subcutaneous tissue from the corpora, releasing any band of dysplastic tissues tethering the penis, and reconstructing the penile skin. Several researchers have emphasized the importance of fixing the penile skin to the pubis or Buck\'s fascia. The removal of excess subcutaneous fat may be helpful in some obese patients; however, it has rarely been performed in children. Numerous surgical techniques have been developed to correct this condition. Glanz and Kubota et al have used multiple Z-plasties to correct the anomaly. Crawford described the release of tethering bands from the Dartos through an S-shaped skin incision on the dorsum of the penis. Wollin et al corrected the sparse ventral shaft skin by using an island pedicle flap from the inner prepuce. Donahoe and Keating described preputial unfurling to cover the shaft after releasing the penis from tethering. In addition, Chin et al reported a modified preputial unfurling technique with satisfactory results. Johnson anchored the suprapubic skin to the pubis to ensure the length of the exposed dorsal penile skin, whereas Horton et al suggested removing the excess suprapubic fat as an essential procedure in some obese patients. Although early surgery has been suggested, evidence regarding whether the buried penis anomaly resolves with age is unavailable. Maizels et al and Wollin et al emphasized the negative social and psychological effects of this anomaly during childhood and therefore recommended early surgical treatment. Casale et al suggested that the anomaly should be corrected immediately after the affected children start walking, when the children\'s abdominal fat has diminished. Philip and Nicholas corrected the anomaly immediately after the diagnosis to resolve both dysuria and cosmetic problems. Herndon et al reported that corrections were more successful in toddlers and less successful in adolescents. As the penile length increases, the prepubic fat accumulates, and more frequent erections and surgical corrections in adults are generally considered to be more difficult. Surgical management in young boys is essential for satisfactory treatment; therefore, an accurate diagnosis and early referral by primary care physicians are crucial.
Introduction Urolithiasis is a common urologic disease that is increasing in prevalence in many high-incidence nations. A national survey by Lee et al in Taiwan determined that 9.6% of the population suffered stones throughout their lifetime (male 14.5% vs. females 4.3%). Despite the complexity of the causes of urinary tract stones and the fact that some mechanisms remain unknown, studies have indicated age, sex, geography, season, climate, race, obesity, diabetes, and water intake to be risk factors. In recent years, the epidemiology of urolithiasis has changed in line with an improvement in social conditions, particularly in urban areas within more affluent developing countries. However, according to the scholar Bart, “… with the geographical distribution of urinary tract stones,” people in specific geographic areas globally are more prone to urinary tract stones compared with those in other areas. In this respect, Taiwan is located in a geographical belt where urolithiasis is more likely to occur throughout the lifetime of the population, with a prevalence between 4% and 20% at a male-to-female sex ratio of 2:1. The old Arabian proverb “prevention is better than treatment” is relevant to urolithiasis, and a patient\'s understanding of the disease helps to lower the prevalence and associated costs. Although statistical studies on urolithiasis have already been conducted, this study focused on specific epidemiological groups and their corresponding treatments.