Phimosis: Is circumcision necessary?

Abstract

Circumcision has been the traditional treatment for phimosis, but now is not the only management option, the best of which appears to be topical steroid application. Importantly, the literature suggests that phimosis probably is over-diagnosed, indicating that a prospective, randomized controlled study is needed to compare the non-circumcision options. Such a study would require consensus on the diagnostic criteria for phimosis; therefore, a more exacting definition would be needed and is suggested. Despite the non-controlled data on medical treatment of true phimosis, there seems little doubt that surgical intervention is not needed for all male infants with adherence of the foreskin to the glans, a non-retractable foreskin or, indeed, true phimosis.

Çocuklarda sünnetin idrar yolu enfeksiyonu sıklığı üzerine etkisi

“…Baz› toplumlarda kültürel ve dinsel inanç-lardan dolay› erkek çocuklar› binlerce y›ld›r sünnet edilmektedir (14). Yap›lan çal›flmalarda sünnetin ‹YE, cinsel yolla bulaflan hastal›klar, penis kanseri ve fimoz s›kl›¤›n› azaltt›¤› gösterilmifltir (15)(16)(17)(18)(19)(20)(21). Amerikan Çocuk Akademisi 1999 y›l› raporunda, bilimsel çal›flmalar›n yenido¤an döne-minde yap›lan sünnetin t›bbi olarak yarar sa¤lad›¤›n› gös-terdi¤ini bildirmifl ancak yenido¤an döneminde herkese sünnet önermek için yeterli veri olmad›¤›n› söylemifltir (15).…”

Libertarianism and circumcision

“…However, other surgical and non-surgical treatments exist with high success rates, with lower cost and lesser morbidities than circumcision, such as the use of steroid topical cream; nevertheless, most cases of phimosis are physiologic in nature, and understanding the distinction between these types of phimosis can prevent overdiagnosis and unnecessary circumcision, as gentle retraction and normal washing over time can serve to treat physiologic phimosis (55)(56)(57). Furthermore, penises that have not been forcibly retracted are statistically no more prone to UTIs than circumcised penises, and overall an uncircumcised male is less than 1% more likely to get a UTI than a circumcised male, with the highest prevalence seen at less than one year of age (27,54).…”

Fehler und Gefahren bei ambulanten Operationen: Zirkumzision

“…Bevor die Indikation zur Operation gestellt wird,sollten konservative Therapieversuche in die Überlegungen mit einbezogen werden, da einige Studien Erfolgsraten einer lokalen Behandlung mit Steroiden von über 80% beschreiben [4,11,12,13,16].…”