The records of 114 patients (51 adult, 63 paediatric) circumcised in a year were retrospectively reviewed. Indications for circumcision were phimosis, recurrent balanoposthitis and suspected squamous cell carcinoma (SCC). Data were collected on the following areas: patient age, indication, pre-operative and histological diagnosis. Pre-operative diagnosis was compared with histological diagnosis to determine whether histology differed from the clinical impression. Results: A total of 31 patients had histologically confirmed lichen sclerosus (22 adult, 9 paediatric). Of these patients, 26 (84%) were predicted pre-operatively. There were three adult patients diagnosed with squamous cell carcinoma and all of these cases were predicted pre-operatively. There were no cases of SCC or lichen sclerosus diagnosed in patients clinically thought to have normal foreskin.
Conclusions:The data indicate that routine histology is not necessary in adult and paediatric circumcision and should be reserved for patients with suspected lichen sclerosus or carcinoma.