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  • Congenital malformations affecting the penis are abnormal location of urethral opening and phimosis. These abnormal locations may produce obstruction of urinary tract infection or infertility.
  • Phimosis occurs when the orifice of the prepuce (foreskin) is too small to permit normal retraction. It may be due to abnormal with cleanliness and favour the development of secondary infections and possibly carcinoma.
  • Paraphimosis is inability to roll back the prepuce after forcible retraction over glans penis. It is extremely painful and may cause obstruction of urinary tract (cause of acute urinary retention) or blood flow (may lead to necrosis of penis).
  • Balanoposthitis is a non-specific infection of glans and prepuce. It is mostly caused by Candida, anerobic bacteria and Gardernella.
Tumors of penis may be benign (condyloma acuminata) or malignant (carcinoma) in-situ and invasive carcinoma
Condyloma acuminatum is a bengin tumor caused by human papilloma virus (HPV), most commonly type 6 and sometimes type 11. Koilocytosis is a characteristic of infection with HPV. It is seen in condyloma as well as carcinoma.
  • Carcinoma in-situ refers to epithelia lesion in which cytological changes of malignancy are confined to epithelium, with no evidence of local invasion or metastasis. These are considered ass pre-cancerous lesion. In about 80% of cause, these lesion are associated with HPV-16. Bowen disease, Erythroplasia of Queyrat (a variant of Bowen’s disease) and Bowenoid papulosis are examples of carcinoma in-situ. Bowen disease may transform into invasive squamous cell carcinoma in 10% patients and is associates with occurrence of visceral cancers in about one thirds of patients. In contrast, bowenoid papulosis never develops into invasive carcinoma and many times, it spontaneously regresses.
  • Squamous cell carcinoma is associated with cigarette smoking and infection with HPV-16 (more commonly) and HPV-18. Mostly, squamous cell carcinoma invades tissue as finger like projections (papillary) of atypical squamous epithelial cells. These show varying degree of differentiation. A variant of squamous cell carcinoma is verrucous carcinoma (also know as Giant condyloma or Buschke-Lowenstein tumor) which invades the underlying tissue along a broad front (in contrast papillary carcinoma invades are finger like projections).

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