6,500 amputations in Brazil in a decade

[Pelican Press 0]

6,500 amputations in Brazil in a decade

7 minutes ago

By Luis Barrucho, BBC World Service

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In 2018, Brazilian pensioner João sought medical help after he found a wart on his ******.

“I started visiting medical clinics to find out what it was, but all the doctors told me it was due to excess skin and prescribed medication,” the 63-year-old recalls.

Despite the medication, the wart continued to grow. It started to take a toll on his marriage and João and his wife’s **** life declined. “We were like siblings,” he admits. He was determined to find out what was going on.

For five years João, not his real name, went back and forth to specialists who prescribed more medication and ordered new biopsies. “Nothing solved it,” he says.

Then, in 2023, he was given a diagnosis – João had ******* *******.

“For my family, it was a very unpleasant surprise, even more so because I had to have part of the ****** amputated. I feel like I was decapitated,” he says.

“It’s a type of ******* that you can’t talk about with people because it could turn into a joke.”

******* ******* is rare, but incidences and mortality rates are on the rise around the world.

According to the latest studies, Brazil, where João is from, has one of the highest incidence rates of 2.1 per 100,000 men.

‘Terrified of surgery’

Between 2012 and 2022, there were 21,000 reported cases, according to Brazil’s Ministry of Health. This resulted in more than 4,000 deaths and, over the past decade, there have been more than 6,500 amputations – averaging one every two days.

Maranhão, the poorest state in Brazil, was found to have the highest incidence rate globally at 6.1 per 100,000 men.

Symptoms of ******* ******* often start with a sore on the ****** that does not heal and a strong-smelling discharge. Some people get bleeding and colour changes of the ******, too.

When detected early, there is a high chance of recovery through treatments such as the surgical removal of the lesion, radiotherapy and chemotherapy.

But if left untreated, partial or total amputation of the ******, and possibly other nearby ******** organs such as the **********, may become necessary.

João underwent a partial amputation in January and says it was a difficult time.

“It’s something you never imagine will happen to you, and when it does, you can’t just go around telling people,” he says.

“I was terrified of surgery, but there was no other alternative. The feeling in the first weeks after the surgery was one of sadness, I can’t deny it. Not having part of your ****** is horrible.”

Some patients undergo a total amputation which is life-changing.

Thiago Camelo Mourão from the Department of Urology at AC Camargo ******* Center in São Paulo says: “In the case of partial amputation, ****** continues to exit through the ******.

“However, in total amputation, the urethral orifice can be relocated to the perineum, between the ******** and the *****, requiring the patient to ******** while sitting on the *******.”

SBU

Mauricio Dener Cordeiro of the Brazilian Society of Urology says personal hygiene is important

Mauricio Dener Cordeiro of the Brazilian Society of Urology says the persistent infection of human papillomavirus (HPV), a name given to a common group of viruses, is “one of the main risk factors”. HPV can be transmitted during **** and in some cases, it can lead to cancers including in the mouth and ******.

He says: “Mass vaccination against HPV is essential due to its high effectiveness in preventing related lesions,” but he adds that vaccination rates in Brazil are below the level needed to be truly effective.

“In Brazil, despite the availability of the vaccine, the HPV vaccination rate ******** low for ****** – reaching only 57% – and for boys, it doesn’t exceed 40%,” he says. “The ideal coverage to prevent the ******** is 90%.”

He believes misinformation about the vaccine, unfounded doubts about its effectiveness and a lack of vaccination campaigns have contributed to the low take-up.

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, smoking can increase the risk of getting ******* *******, too. It also says you might be more likely to get ******* ******* if you “have problems pulling back your ********* (the skin covering your ******) to keep your ****** clean (a condition called phimosis)”.

“When a man does not expose the glans and fails to clean the ********* properly, it produces a secretion that accumulates,” Dr Cordeiro says. “This creates a highly favourable environment for bacterial infections.

“If this occurs repeatedly, it becomes a risk factor for the appearance of the tumour.”

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Mass vaccination against HPV is essential to prevent ******* *******, experts say

But Brazil is not the only place where ******* ******* is on the rise. According to the latest research, the number of cases is increasing around the world.

In 2022, the journal JMIR Public Health and Surveillance published the results of a large-scale analysis involving the latest data from 43 countries.

It found the highest incidence of ******* ******* between 2008 and 2012 was in Uganda (2.2 per 100,000), followed by Brazil (2.1 per 100,000) and Thailand (1.4 per 100,000). The lowest was in Kuwait (0.1 per 100,000).

“Although developing countries still bear the higher incidence and mortality of ******* *******, the incidence is on the rise in most ********* countries,” the team of researchers led by Leiwen *** and Tian Tian from Sun Yat-Sen University in China found.

They reported that England had seen an increase in ******* *******, rising from 1.1 to 1.3 per 100,000 between 1979 and 2009 and in Germany cases increased by 50% from 1.2 to 1.8 per 100,000 between 1961 and 2012.

These figures are only set to get higher, according to the Global ******* Registries prediction tool. It estimates that by 2050, the global incidence of ******* ******* will rise by more than 77%.

This change can largely be attributed to the ageing population, according to the experts, who say the highest incidence occurred in men in their 60s.

Dr Cordeiro says: “******* ******* is a rare ******** but also highly preventable”.

He advised that using condoms during **** and undergoing surgery to remove the ********* in cases of phimosis could help reduce the risk of ******* *******.

Neil Barber, Clinical Lead for Urology at Frimley Health NHS Foundation Trust, adds: “******* ******* is almost unheard of in the circumcised population. Poor hygiene and infections beneath the *********, as well as conditions like phimosis that make it difficult to retract the ********* and maintain good hygiene, are risk factors. This is linked to higher overall infection risks”.

“Established risk factors also include unprotected ****, specifically not using condoms, with poor hygiene further increasing risks through this route.”

João is currently waiting for his latest test results, which he will receive later this year. “I’m confident that these exams will show that I’ll be cured,” he says.

“Now, following the amputation, the pain has gone away, and I’ve been feeling much better. But I’ll have to live with a partially amputated ****** for the rest of my days.”

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, more than 90% of men diagnosed with ******* ******* which has not spread to nearby lymph nodes survive for five years or more.

Additional reporting by Rone Carvalho, BBC Brasil

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#amputations #Brazil #decade

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