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ABSTRACT The morphological characteristics of the external genitalia of the bull may contribute to the etiopathogenesis of preputial diseases that trigger the impotence coeundi and losses in farms. The goal of this study was to establish morphometric parameters of the preputial ostium, the internal preputial leaflet (IPL), the free part and glans of the penis; describe the histological characteristics of the IPL; perform a count of the preputial sebaceous glands and compare these variables between 24-month-old Aberdeen Angus and Nellore bulls. At the slaughterhouse, 20 preputial pieces were collected from each breed. A device composed of base, rod, ring, and funnel was designed to hold each suspended and distended part. The IPL, the free part of the penis and the glans were measured. The ostium diameter was measured, and the radius, perimeter, and area of the preputial ostium were calculated. Samples were collected from the dorsal and ventral regions and from the cranial, medial, and caudal portions of the IPL. By electronic and optical microscopy, IPL characterization and sebaceous gland counts were performed. Analysis of variance was performed using the F test at 5%. It was concluded that Nellore bulls have a more extensive IPL and free part of the penis and more preputial sebaceous glands than Aberdeen Angus bulls. In both breeds, there are more glands in the ventral region of the ostium.

The case is a 29-year-old male. He had a medical history of schizophrenia. He visited a local urologist with the chief complaint of itching of his penis. He was referred to our department because a hard mass at the glans was suspicious for penile cancer. At the time of our initial examination, we could not invert his foreskin. A yellowish-white mass lesion was observed through the slightly open foreskin. Ultrasonography showed no blood flow in the mass. Magnetic resonance imaging indicated no evidence of malignancy in the mass. Thus, we predicted the mass to be accumulation of smegma, not cancer. However, we were almost unable to remove the smegma because the irreversible phimosis covered it. The patient underwent phimosiotomy under general anesthesia. We removed the clustered smegma from all around the glans after a dorsal incision, while confirming that there were no findings of malignancy on the glans. The postoperative course was good. He was discharged two days after the surgery. We instructed him and his family to keep his penis clean. Two months after surgery, there was no reaccumulation of smegma on his glans. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to investigate the common bacteria found in the smegma in the subpreputial space of asymptomatic boys prospectively, and to determine the difference of those bacteria according to the presence of smegma. Materials and Methods: In our institution, 40 boys who performed penoplasty were recruited into the study. Swab was done using aseptic techniques on smegma and glans in the operation room. According to the presence of smegma in the subpreputial space, we classified glans as a group S (with smegma, n=20) and group C (without smegma, n=20). The swabs were immediately sent to microbiology laboratory for microscopy, culture, and sensitivity tests. Results: The mean age was 30.4±26.4 months. Thirty-one bacteria were isolated from smegma, comprising 15 gram-positive species (48.4%) and 16 gram-negative species (51.6%). The most commonly isolated gram-negative bacterium was Escherichia coli (25.8%), while the commonly isolated gram-positive bacteria were Enterococcus faecalis (19.4%) and Enterococcus avium (12.9%). Most of the bacterial isolates were multi-drug-resistant (61.3%). In group S, 12 boys had 22 bacterial isolates in the glans. The commonly isolated bacteria were E. coli (27.3%), E. avium (22.7%) and E. faecalis (18.2%). In group C, 13 boys had 21 bacterial isolates in the glans. The most commonly isolated bacterium was E. faecalis (28.6%). Conclusions: Smegma in the subpreputial space of children was colonized by many kinds of uropathogen.

Purpose: This study investigates the frequency of isolated microorganisms and the antimicrobial resistant pattern of inner foreskin and smegma in prepubertal children.Materials and Methods: This comparative cross-sectional study was conducted between March and November 2019, where 132 prepubertal boys, who were scheduled to receive religious circumcisions at our outpatient clinic, were examined. The patients were divided into the following groups based on the presence of smegma in their subpreputial space: Group I (with smegma, n=58) and Group II (without smegma, n=74). Sterile stuart transport swabs (Advanced Diagnostic Research, Mediko Kimya, Turkey) were taken from the smegma or the subpreputial space (glans surface and inner foreskin) using aseptic techniques and then the swab samples were immediately transported by sterile stuart transportation for microscopy, culture identification, and antibiographic resistance testing by conventional test methods and automated systems (VITEK II, Biomerieux, France) to the Microbiological Laboratory of our hospital.Results: 48 bacteria isolated from 39 boys in Group I comprised 28 gram-positive species (58.3%) and 20 gram-negative species (41.7%). The most commonly isolated gram-negative bacterium was Proteus mirabilis (45%) while most positive was Staphylococcus hominis (42.9%). In Group II, 68 boys had 103 bacterial isolates in the glans comprising 81 gram-positive species (78.6%) and 22 gram-negative species (21.4%). The most commonly isolated gram-negative bacterium was Proteus mirabilis (42.9%) while the most positive were Enterococcus faecalis (40.7%) and S. hominis (42.9%) Conclusion: The subpreputial space of uncircumcised boys is colonized by various types of uropathogens resistant to multidrug drugs. Smegma does not pose additional risks to microbiological colonization in children. [ABSTRACT FROM AUTHOR]

• Preputial stones are a very rare form of urinary tract stone. • Almost all the cases happen in a male in uncircumcised males, poor genital hygiene, low socioeconomic status, and phimosis. • The symptoms and signs are due to phimosis. • Neglected preputial stones can cause serious morbidities, such as hydronephrosis and renal failure. Preputial stones are a very rare form of urinary tract stone, and only small number cases have been reported in the literature, and tend to occur in uncircumcised males with poor genital hygiene, low socioeconomic status, and phimosis. Here, we report a case in a male who presented with more than 100 preputial stones. The stones were evident on clinical examination by palpation on the preputial. The patient was treated by dorsal slit circumcision. Preputial stones can occur at any age but are far more common in adult males. All cases of preputial stone are associated with severe phimosis in uncircumcised males. The symptoms and signs are due to phimosis, like in these patients, which causes urinary stasis beneath the foreskin. The stone is often palpable on examination of the prepuce, and a plain radiograph can confirm this. Neglected preputial stones can cause serious morbidities. Treatment involves the removal of stone and elimination of the predisposing cause. This case reminds us of the necessity of circumcision for adult uncircumcised males. [ABSTRACT FROM AUTHOR]

Abstract Bovine leukosis is a chronic lymphoproliferative disorder that leads to significant economic losses in the beef and dairy industries. The major route of virus transmission is believed to be iatrogenic through the transfer of blood containing infected lymphocytes. In addition, BLV proviral DNA has been identified in nasal secretions, saliva, milk, colostrum, semen and smegma; however, natural transmission of BLV through these secretions has not been clearly demonstrated. The use of bulls for natural breeding has been identified as a risk factor in BLV infected dairy herds. However, the risk of BLV-infected bulls transmitting the virus is unknown. The objective of this study was to evaluate the potential for BLV transmission during natural breeding between a BLV-infected bull and uninfected heifers. Forty healthy, BLV seronegative, and proviral-negative beef heifers were randomly assigned to one of two groups: control heifers (n = 20) exposed to a BLV seronegative and proviral negative bull and challenged heifers (n = 20) exposed to a BLV seropositive and proviral-positive bull. Each group was housed with the bull for a period of 38 days in a 5-acre pasture to replicate the housing of commercial beef cattle during the breeding season. Blood samples were collected from heifers at −60, −30 and 0 days prior to breeding and day 30, 60 and 90 after the breeding period ended. Blood samples were tested for BLV antibodies by ELISA and BLV proviral DNA by CoCoMo-qPCR. New infection was not detected by ELISA or CoCoMo-qPCR in any of the challenge or control heifers at any time point during the study. Based on these results, BLV infected bulls that are healthy and aleukemic may not be a significant risk of BLV transmission during a defined breeding season. Highlights • The BLV infected bull used for natural service had a PVL of 175.90 copies/105 cells in the smegma and 18,405.16 copies/105 cells in blood. • Seroconversion to BLV was observed in none of the cows exposed to BLV infected bull during breeding season. • BLV infected bulls that are healthy and aleukemic may not be a significant risk of BLV transmission during a defined breeding season. [ABSTRACT FROM AUTHOR]

Bovine trichomoniasis is a sexually transmitted disease that results in infertility, abortion, and calf age variability. To date, management strategies include testing for Tritrichomonas foetus and culling of infected males. Challenges associated with testing include cost of culture medium, time and labor burden of sample incubation and processing, and adverse effects of bacterial growth on detection sensitivity. To overcome these challenges, we developed a direct reverse-transcription quantitative real-time PCR (direct RT-qPCR) utilizing smegma, eliminating the use of culture medium. In an analysis of 166 field samples (56 positives and 110 negatives as determined using microscopic reading of cultures as the reference test), the direct RT-qPCR exhibited 100% diagnostic sensitivity and 100% specificity, whereas the currently employed qPCR (culture qPCR), which utilizes cultured samples, exhibited 95% diagnostic sensitivity and 100% specificity. Agreement between direct RT-qPCR and culture qPCR was 98%. Moreover, direct RT-qPCR identified 3 more positive samples and exhibited lower quantification cycle (Cq) values among positives by culture reading than did culture qPCR (direct RT-qPCR Cq range = 14.6–32.3 vs. culture qPCR Cq range = 18.7–37.4). The direct RT-qPCR enables simplified sample collection, elimination of culture medium, faster results, applicability in cows, and lower cost than culture qPCR. [ABSTRACT FROM AUTHOR]

The present study is a prospective study of examination of 109 cases of accused of sexual assault coming at Department of Forensic Medicine and toxicology, Indira Gandhi Medical College Nagpur. Period from October 2014 to September 2015. It was aimed to study the socio-demographic profile of accused of sexual assault, analysis of its findings in clinical examination and its co-relation with the history as stated by accused with the reports of investigating police officer. 55 % accused were between age group of 21-30 yrs. 67% of the accused were unmarried single, 32% were married. 78% accused were residing in urban and semi-urban areas and 22% from rural area. Out of the 62 accused who gave history of sexual relationship with victim, 48 accused 77.41% of them stated that it was consensual and the victim was known to them. 5.5% of the accused was examined within 24 hours of incidence, 15.59% were examined between 1-2 days of incidence. 78.89% of the accused were examined after 48 hours, leading to loss of important clinical evidence of recent sexual intercourse. Genital injury was found in one accused, while 7.34% accused had minor injuries over significant part of body, which can mostly be related with the incidence of sexual assault. Smegma was present in 22 accused (20.18%) of the accused, out of which 6 accused was examined within 24 hours of sexual incidence and these accused had history of not taken bath. Presence of smegma in accused examined within 24 hours of alleged sexual assault, is a finding which may be considered as favorable for defense of such accused. Absence of smegma in accused of sexual assault is not necessarily a conclusive proof of the fact that recent intercourse having been committed. [ABSTRACT FROM AUTHOR]

A father consulted his general practitioner with his 3-years-old son who had swelling on his penis for several months. He experienced no miction problems. The swelling appeared to be a retention of smegma. This is harmless and will disappear spontaneously as the process of separation of the preputium continues.

The article discusses a study on detection of protozoan parasite Leishmania infantum in infected dogs' smegma. It mentions that the study included purification of DNA from semen and smegma and compared percentages of positive polymerase chain reaction (PCR) reaction for smegma and semen samples. It mentions that the study concluded presence of Leishmania infantum in the smegma of contaminated dogs which can be a source of parasites for the female dog and the semen.

Background: The objective of this study is to document the common bacteria found in the smegma in the subpreputial space of asymptomatic boys in our environment, their antimicrobial susceptibility pattern, and to determine if they differ from those commonly isolated from children with established urinary tract infections in our sub-region. Materials and Methods: Between May 2009 and January 2010, smegma swabs were collected from asymptomatic boys who presented for circumcision in our institution. This was done using aseptic techniques in the theatre, following retraction of the prepuce. The swabs were immediately sent to our microbiology laboratory for microscopy, culture, and sensitivity tests. Bacteria were isolated, identified, and confirmed by standard bacteriological techniques, and antimicrobial sensitivity pattern was determined using the disc diffusion method. A total of 52 boys, with an age range of 7 d to 11 y (median 138.7d), were recruited into the study. Results: A total of 50 bacterial isolates were made. There were 29 gram-positive bacteria (58%) and 21 gram-negative ones (42%). A single isolate was found in 34 boys (65.4%), eight had a mixed isolate (15.4%), while no bacteria was isolated in 10 boys (19.2%). The most commonly isolated gram-negative bacteria was Escherichia coli (90.5%), while the commonly isolated gram-positive bacteria were Staphylococcus epidermidis (44.8%) and Staphylococcus aureus (41.4%). Most of the bacterial isolates were multi-drug-resistant. Conclusion: Smegma in the preputial space of children may be colonized by drug-resistant organisms, the antimicrobial sensitivity pattern of which must be determined for an effective treatment of any infection arising in the region. [Copyright &y& Elsevier]

Background Smegma is widely believed to cause penile, cervical and prostate cancer. This nearly ubiquitous myth continues to permeate the medical literature despite a lack of valid supportive evidence. Methods A historical perspective of medical ideas pertaining to smegma is provided, and the original studies in both animals and humans are reanalysed using the appropriate statistical methods. Results Evidence supporting the role of smegma as a carcinogen is found wanting. Conclusions Assertions that smegma is carcinogenic cannot be justified on scientific grounds. [ABSTRACT FROM AUTHOR]

We describe a Mycobacterium smegmatis mutant with impaired biofilm and smegma formation. A gene homologous to Escherichia coli bacA, which has been proposed to play a role as undecaprenyl phosphokinase (Upk) was unmarked in-frame deleted from M. smegmatis. Though Upk is involved in cell wall synthesis, the surface of the mutant strain appeared virtually comparable to that of the wild type by electron microscopy. The absence of Upk influenced colony morphology and bacitracin resistance. The M. smegmatis Δupk mutant developed a biofilm characterized by scattered islands of bacteria distinct from the completely covered biofilm surface observed for wild-type bacteria. We further demonstrate biological consequences of upk deletion for smegma development in an in vivo model. These results suggest the upk gene to be essential in biofilm and smegma development. [Copyright &y& Elsevier]

We present observations on an unusual tetratrichomonad species isolated from preputial smegma of virgin bulls. Ultrastructural studies were performed using scanning and electron microscopy techniques. This protozoan presents four anterior flagella of unequal length and a recurrent one forming the undulating membrane. It shows one anterior nucleus, a Golgi complex, an axostyle, and a costa. The hydrogenosomes are rather elongated, seen in groups, and presenting different electron densities. Vacuoles of different sizes containing bacteria and material in process of digestion were frequently found. PCR was also used in order to compare the species herein described with other trichomonad species. The amplification products were seen only with primers TFR1 and TFR2 (specific to trichomonads), but not with TFR3 and TFR4 (specific to Tritrichomonas foetus), suggesting that although collected from the genital tract of the bull, this protist was not T. foetus. We propose that the appearance of these tetratrichomonads were probably due to the sodomy practiced among bulls. Concomitant contamination of preputial cavity with feces could explain the presence of the opportunistic organism. The observations presented here show the importance of the correct diagnostic when investigating samples obtained from the urogenital tract of cattle. We also suggest that this flagellate belongs to the species Tetratrichomonas buttreyi. [Copyright &y& Elsevier]

Incidence of cancer in India is lower than in the West and the commonly affected sites are very different. Cancers of the upper alimentary and respiratory tracts (oral cavity, pharynx, larynx, oesophagus, and lung) contribute more than half of the cancers in men and about a quarter in women. In this category, cancers of the oral cavity are very common in some parts of the country and cancers of the pharynx, larynx and lung in others. Indigenous habits of chewing and smoking seem to be primarily responsible for the high incidence of these cancers. Cancer of the cervix uteri is a major problem in women and cancer of the penis in men is relatively common in some parts of the country. Practical measures are discussed for the prevention of these cancers common in India. [ABSTRACT FROM AUTHOR]

A 4-year-old boy presented with a subcutaneous, yellowish swelling of 0.8 by 1.5 cm on his penis. We made the diagnosis of a smegma retention cyst. This cyst is the result of a physiologic phenomenon that originates from the separation of the foreskin.

Pyogenic granulomas are benign vascular proliferations of the skin and mucous membranes. We present a case report of a 13-year-old uncircumcised boy with phimosis and a pyogenic granuloma of the glans penis. The relationship between these lesions, phimosis, smegma, and circumcision is discussed. When the lesion is found in conjunction with phimosis, consideration should be given for circumcision. Close follow-up to rule out recurrence is necessary.

A number of minor urological surgical procedures can be readily carried out in children in outpatient clinics with the availability of a good topical local anaesthetic. In boys, the separation of preputial adhesions, frenulotomy, meatoplasty, meatal dilatation following circumcision or meatal surgery, the removal of smegma and excision of penile skin lesions can be performed as outpatient treatment. In girls, hymenal abnormalities, meatal abnormalities and labial adhesions come into consideration for its use. Success is dependent on a good estimation of the mental capacity of the child to undergo a local surgical procedure and correct use of the anaesthetic.

The prepuce and glans was examined in 4521 healthy infants and young children with a birthweight over 2600 g. There were 3238 infants aged 1-12 months and 1283 children aged 3 years. There is no custom of circumcision in Japan. The term phimosis implies the adhesion of the prepuce and glans, which cannot be separated by manipulation. Phimosis was found in 88.5% of infants aged 1-3 months, and the corresponding figures at the ages of 4-6 months, 7-9 months, 10-12 months and 3 years were: 74.4, 63.9, 58.0 and 35.0%, respectively. However, cases where the prepuce could be retracted by gentle manipulation were found in 3.0% of infants aged 1-3 months, 19.9% of those aged 10-12 months and increased to 38.4% of children aged 3 years, which exceeded the rate of phimosis. The complete adhesion of prepuce and glans was found in many infants, and a small space between the prepuce and glans was observed in some cases of 3-year-old boys. The smegma was notable in only 16 cases (0.5%) of infants and in 5 cases (0.4%) of the 3-year-olds. Balanopothitis was found in only one case of the 3-year-olds. It is not recommended to separate the foreskin by manipulation, which sometimes leads to bleeding or paraphimosis. And it is not necessary to surgically correct phimosis in infancy and early childhood except in the case of accompanying urological disturbance.

Routine circumcision is gaining popularity in our community, as it is said to be a safe and painless operation in the neonate, and offers improved hygiene. That the circumcised foreskin is cleaner is undisputed, but whether the operation is safe is questioned. This article reviews the common problems encountered, and also reviews the physiology of the foreskin. The pros and cons of circumcision is discussed together with some complications of circumcision. The view is expressed that routine circumcision should not be encouraged.

World-wide incidences of penile cancer are reviewed and epidemiologic factors including ciecumcision, hygiene, phimosis, smegma, irritation, infection, veneral disease, viruses, environment, race, immune response, trauma, and age are discussed. The lowest rates appear in groups practicing infant circumcision and in areas where standards of sexual hygiene are high.