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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.

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  • Aggregator Full Text
  • Authors+Show Affiliations

    ,

    UMass Memorial Medical Center, Worcester, MA, USA.

    Source

    Urologic nursing 26:3 2006 Jun pg 181-94

    MeSH

    Adolescent
    Age 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 Article
    Review

    Language

    eng

    PubMed ID

    16800325

    Citation

    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 ER -