Shaheed Syed Nazrul Islam Medical College Journal
Volume 11, Issue 1
January, 2026
Histopathological Changes of the Preputial Mucosa Due to Retained Smegma
*Shimon MH,1 Amin MR,2 Sikdar K,3 Aktar M4
Abstract
Background: The smegma is cheese-like sebaceous matter which is a combination of shedded skin cells, skin oils and moistures. When the foreskin is not retractable, smegma can accumulate between the inner surface of the foreskin and the glans and looks like a yellowish-white, clearly defined, soft mass called smegma cyst which causes irritation. These chronic irritations may be injurious to cells and causes histological changes in preputial epithelium. This substance has been linked to penile cancer, although a clear etiology has not been established.
Purpose: To assess the histopathological changes of preputial mucosa due to presence of retained smegma in children.
Methods: This cross-sectional study was conducted at the Department of Paediatric Surgery, Bangladesh Medical University, Dhaka, Bangladesh, from March, 2021 to August, 2022. Samples were collected purposively. Proper clinical history, physical examination and initial investigation reports were recorded in a standard data sheet. Total 34 patients with smegmal cyst have been assessed by histopathological examination after circumcision. Histopathological reports were analyzed to asses the changes of preputial mucosa due to retained smegma. Data processing and analysis was performed by Statistical Package for the Social Sciences software.
Results: Out of 34 patients, 17 were in 5-8 years age group and mean age (±SD) was 5.27 ± 2.60 years. Highest 10 patients had retained smegma for 6 months, 8 patients for 5 months and 4 patients for 3 months with mean 4.73 ± 1.52 months. Overall histopathological change occurred in 25 patients and mean (±SD) was 5.40 ± 1.12. Among them cellular atrophy occurred in 22 patients and ulceration occurred in 3 patients. Duration of retained smegma in relation with histopathological changes had positive correlation. Overall changes occurred in 25 patients, mean was 5.40 ± 1.12. Cellular atrophy was present in 22 patients, mean of 5.50 ± 0.86. Ulceration was present in 3 patients, with a mean of 6.67 ± 0.58. Dysplasia was present in 1 patient, mean was 5.0. Koilocytic changes present in 2 patients, mean was 4.0 ± 2.83.
Conclusion: Retained smegma has an injurious effect at the cellular level. Majority of histopathological changes seen in cell cytoplasm. The changes are in the form of atrophy of cells, ulceration and koilocytic changes.
[Shaheed Syed Nazrul Islam Med Col J 2026, Jan; 11 (1):1-6]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.1.1
Keywords: Smegma, Preputial Mucosa, Histopathological Changes, Cell Injury, Cellular Atrophy, Ulceration.
- *Dr. Md. Samiul Huq Shimon, MS (Paediatric Surgery), Assistant Professor, Department of Surgery, Kushtia Medical College Hospital, Kushtia, Bangladesh.huq@gmail.com
- Professor Dr. Ruhul Amin, Department of Paediatric Surgery, Bangladesh Medical University, Dhaka, Bangladesh.
- Koushik Sikdar, Assistant Professor (Tropical Child Health), Bangladesh Institute of Tropical and Infectious Diseases, Foujderhat, Chattogram, Bangladesh.
- Mahfuza Aktar, Assistant Registrar, Department of Paediatrics, Kushtia Medical College Hospital, Kushtia, Bangladesh
*For correspondence