To circ or not to circ: indications, risks, and alternatives to circumcision in the pediatric population with phimosis.
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.
Links
Authors+Show Affiliations
,UMass Memorial Medical Center, Worcester, MA, USA.
Source
MeSH
AdolescentAge Factors
Attitude to Health
Balanitis
Child
Child, Preschool
Circumcision, Male
Cultural Characteristics
Decision Making
Dissent and Disputes
Evidence-Based Medicine
Health Knowledge, Attitudes, Practice
Humans
Incidence
Infant, Newborn
Male
Parents
Patient Selection
Phimosis
Practice Guidelines as Topic
Risk Factors
Sexually Transmitted Diseases
Skin Care
Treatment Outcome
Urinary Tract Infections
Pub Type(s)
Journal ArticleReview
Language
eng
PubMed ID
16800325