Prevalence and risk factors for penile lesions/anomalies in a cohort of Brazilian men ≥ 40 years of age

Abstract

Purpose: To report the prevalence and risk factors of penile lesions/anomalies in a Metropolitan Brazilian city. Materials and Methods: All participants undergoing prostate cancer screening in the city of Curitiba were systematically examined to identify penile lesions including cutaneous mycosis, sexually transmitted diseases, penile cancer, meatal stenosis, hypospadias, and Peyronie's disease. Outcomes of interest included the prevalence and the relative risk and 95% confidence intervals of the lesions/anomalies according to age, school level, race, personal history of diabetes, arterial hypertension, nonspecific urethritis, and vasectomy. Results: Balanoposthitis occurred in 11.8% of all participants, with an increased risk in those with diabetes (RR = 1.73), or past history of nonspecific urethritis (RR = 1.58); tinea of the penis was present in 0.2%; condyloma acuminata in 0.5%; herpes virus infection in 0.4%; urethral discharge in 0.2%; genital vitiligo in 0.7%, with an increased prevalence in non-white men (RR = 4.43), and in subjects with lower school level (RR = 7.24); phimosis in 0.5%, with a nearly 7-fold increased risk in diabetics; lichen sclerosus in 0.3%; stenosis of the external urethral meatus in 0.7%, with a higher prevalence in subjects with lichen sclerosus (RR = 214.9), and in those older than 60 years of age (RR = 3.57); hypospadia in 0.6%; fibrosis suggestive of Peyronie's disease in 0.9%, especially in men older than 60 years (RR = 4.59) and with diabetes (RR = 3.91); and penile cancer in 0.06%. Conclusion: We estimated the prevalence and risk factors of commonly seen penile diseases in an adult cohort of Brazilian men.

Prevalence of Phimosis in Males of All Ages: Systematic Review

“…58 Phimosis was 6.7 times more common in men with a history of diabetes. 39 Phimosis may be a warning sign of diabetes, since 12% of the men with phimosis and who had no previous history of a disorder of glucose metabolism or diabetes were found to have diabetes (8%) or impaired fasting glycemia (4%), that is, diabetes prevalence was higher than the UK average for diabetes of 3.6% at the time of the study. 59 Balanitis is common in diabetes and recurrent infection and scarring is probably responsible for the phimosis that develops.…”

“…[2][3][4] These were sourced as follows. The PubMed search yielded 1455 "hits," of which 27 2,4,14,17,18,20,21,[23][24][25][27][28][29][30][33][34][35][37][38][39][41][42][43]45,46,48,49 fulfilled the inclusion criteria. Google Scholar yielded 4 further articles.…”

Penile inflammatory skin disorders and the preventive role of circumcision

“…[50] A Brazilian study of men presenting for prostate cancer screening identified balanoposthitis in 12%. [51] The prevalence was 58% higher in those with a history of nonspecific urethritis. [51] Balanoposthitis is especially common in uncircumcised diabetic men,[205152] a dysfunctional, shrunken penis likely a contributing factor.…”

“…[51] The prevalence was 58% higher in those with a history of nonspecific urethritis. [51] Balanoposthitis is especially common in uncircumcised diabetic men,[205152] a dysfunctional, shrunken penis likely a contributing factor. [20] Not surprisingly, balanoposthitis in diabetic men adds to their frequent diabetic neuropathy and peripheral vascular disease, so contributing to their sexual dysfunction.…”

Cost Analysis of Adult Male Circumcision with the PrePex™ Device versus Surgery in Rwanda

“…The prevalence in adult males appears to be low, but it is difficult to determine with accuracy due to differences in demographics and reporting criteria. Primary studies have reported rates of 0.5% among men over age 40 in Brazil (Romero, Romero, Almeida, Oliveira, & Filho, 2013) and 5% among men over age 18 in Rwanda (Bitega et al, 2011). A comprehensive review suggests that the prevalence in adult males is approximately 2% (Shahid, 2012).…”