As a part of external genitalia, the foreskin has a lot of functions. Despite its natural role many advocates routine circumcision due to problematic condition that can develop. Routine circumcision is not generally recommended. Improved education for physicians and parents with regard to the foreskin development and management is required.

Based on skeleton examination, cave-paintings and mummies the study of prehistoric medicine tells that the surgical experience dated with skull trepanning, male circumcision and warfare wound healing. In prehistoric tribes, medicine was a mixture of magic, herbal remedy, and superstitious beliefs practiced by witch doctors. The practice of surgery was first recorded in clay tablets discovered in ancient rests of Mesopotamia, translation of which has nowadays been published in Diagnoses in Assyrian and Babylonian Medicine. Some simple surgical procedures were performed like puncture and drainage, scraping and wound treatment. The liability of physicians who performed surgery was noted in a collection of legal decisions made by Hammurabi about the principles of relationship between doctors and patients. Other ancient cultures had also had surgical knowledge including India, China and countries in the Middle East. The part of ancient Indian ayurvedic system of medicine devoted to surgery Sushruta Samhita is a systematized experience of ancient surgical practice, recorded by Sushruta in 500 B.C.E. Ancient Indian surgeons were highly skilled and familiar with a lot of surgical procedures and had pioneered plastic surgery. In the ancient Egyptian Empire medicine and surgery developed mostly in temples: priests were also doctors or surgeons, well specialized and educated. The Edwin Smith Papyrus, the world’s oldest surviving surgical text, was written in the 17th century B.C.E., probably based on material from a thousand years earlier. This papyrus is actually a textbook on trauma surgery, and describes anatomical observation and examination, diagnosis, treatment, and prognosis of numerous injuries in detail. Excavated mummies reveal some of the surgical procedures performed in the ancient Egypt: excision of the tumors, puncture and drainage pus abscesses, dentistry, amputation and even skull trepanation, always followed by magic and spiritual procedures. Various types of instruments were innovated, in the beginning made of stone and bronze, later of iron. Under the Egyptian influence, surgery was developed in ancient Greece and in Roman Empire. Prosperity of surgery was mostly due to practice in treating numerous battlefield injuries. Records from the pre-Hippocrates period are poor, but after him, according to many writings, medicine and surgery became a science, medical schools were formed all over the Mediterranean, and surgeons were well-trained professionals. Ancient surgery closed a chapter when Roman Empire declined, standing-by up to the 18th century when restoration of the whole medicine began

Adrenal rests are usually unrecognized during operation, and the incidence of ectopic adrenal cortical tissue in pediatric patients during inguinal surgery procedures is unknown. We performed 3028 groin surgical explorations in 2680 patients aged 1 month to 17 years. Ectopic adrenal tissue was found in 69 inguinal operations (2.2%): 37 during 1.524 orchiopexy (2.4%), 23 during 1.115 herniectomy (2.0%), and 9 during 389 hydrocoela operation (2.3%). Statistically there were no significant differences among those three groups. No adrenal rests were detected in females. Although a few reported cases with hormonal activity of ectopic adrenocortical tissue (EACT), the recommendation is to remove them if found.

The timing of surgical treatment of undescended testis in the study period was far from the recommended optimal time. It is evidently necessary to plan and provide additional information for pediatricians and parents about the current view on cryptorchidism and consequences of the late treatment.

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