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To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis.
Urol Nurs. 2006 Jun; 26(3):181-94.UN

Abstract

Summary Although there continues to be considerable debate over the merits of circumcision, it is clear that preservation of the pediatric foreskin, even in the presence of phimosis, is a viable option. Steroid topical cream is a painless, less-complicated, and more economical alternative to circumcision for treating phimosis. Success rates are quite high, especially when patient selection is appropriate and parents are adequately instructed on application. In those children in whom topical steroid therapy has failed, there remains a variety of foreskin-preserving surgical options for treating phimosis. Compared to circumcision, these less-invasive techniques are associated with lower morbidities and cost. Furthermore, depending on the tissue-preserving technique used, satisfactory cosmesis is also achieved. Thus, those males who were not circumcised at birth now have medical and surgical options, which will decrease the likelihood of requiring circumcision at an older age. As health care providers in the United States see more and more uncircumcised male children, it is important for these children and their parents to understand the natural history of physiologic phimosis. Additionally, it is the responsibility of health care providers to present the management options available for the treatment of the persistent nonretractile foreskin and/or pathologic phimosis. These options are particularly important for those individuals whose religious, cultural, or personal preference is to retain the foreskin.

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Authors+Show Affiliations

Steadman B
UMass Memorial Medical Center, Worcester, MA, USA.
Ellsworth P
No affiliation info available

MeSH

AdolescentAge FactorsAttitude to HealthBalanitisChildChild, PreschoolCircumcision, MaleCultural CharacteristicsDecision MakingDissent and DisputesEvidence-Based MedicineHealth Knowledge, Attitudes, PracticeHumansIncidenceInfant, NewbornMaleParentsPatient SelectionPhimosisPractice Guidelines as TopicRisk FactorsSexually Transmitted DiseasesSkin CareTreatment OutcomeUrinary Tract Infections

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16800325

Citation

Steadman, Barbara, and Pamela Ellsworth. "To Circ or Not to Circ: Indications, Risks, and Alternatives to Circumcision in the Pediatric Population With Phimosis." Urologic Nursing, vol. 26, no. 3, 2006, pp. 181-94.
Steadman B, Ellsworth P. To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis. Urol Nurs. 2006;26(3):181-94.
Steadman, B., & Ellsworth, P. (2006). To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis. Urologic Nursing, 26(3), 181-94.
Steadman B, Ellsworth P. To Circ or Not to Circ: Indications, Risks, and Alternatives to Circumcision in the Pediatric Population With Phimosis. Urol Nurs. 2006;26(3):181-94. PubMed PMID: 16800325.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis. AU - Steadman,Barbara, AU - Ellsworth,Pamela, PY - 2006/6/28/pubmed PY - 2006/7/21/medline PY - 2006/6/28/entrez SP - 181 EP - 94 JF - Urologic nursing JO - Urol Nurs VL - 26 IS - 3 N2 - Summary Although there continues to be considerable debate over the merits of circumcision, it is clear that preservation of the pediatric foreskin, even in the presence of phimosis, is a viable option. Steroid topical cream is a painless, less-complicated, and more economical alternative to circumcision for treating phimosis. Success rates are quite high, especially when patient selection is appropriate and parents are adequately instructed on application. In those children in whom topical steroid therapy has failed, there remains a variety of foreskin-preserving surgical options for treating phimosis. Compared to circumcision, these less-invasive techniques are associated with lower morbidities and cost. Furthermore, depending on the tissue-preserving technique used, satisfactory cosmesis is also achieved. Thus, those males who were not circumcised at birth now have medical and surgical options, which will decrease the likelihood of requiring circumcision at an older age. As health care providers in the United States see more and more uncircumcised male children, it is important for these children and their parents to understand the natural history of physiologic phimosis. Additionally, it is the responsibility of health care providers to present the management options available for the treatment of the persistent nonretractile foreskin and/or pathologic phimosis. These options are particularly important for those individuals whose religious, cultural, or personal preference is to retain the foreskin. SN - 1053-816X UR - https://www.unboundmedicine.com/medline/citation/16800325/abstract/To_circ_or_not_to_circ:_indications_risks_and_alternatives_to_circumcision_in_the_pediatric_population_with_phimosis_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=16800325.ui DB - PRIME DP - Unbound Medicine ER -