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[Should circumcision be performed in childhood?]
Julio César Morales Concepción1, Emilio Cordiés Jackson, Marlen Guerra Rodríguez
1Hospital Pediátrico de Centro Habana, Hospital Pediátrico del Cerro, Ciudad de La Habana, Cuba.
Archivos Espanoles De Urologia
|October 17, 2002
Summary
Prepuce retractability naturally improves with age, becoming fully retractable in most adolescent boys. Circumcision and forced dilation have limited indications in childhood due to common, normal adhesions.
Area of Science:
- Pediatric Urology
- Developmental Biology
Background:
- Incomplete separation of the prepuce and glans penis is a normal finding in newborns.
- Spontaneous separation typically occurs during childhood and adolescence.
Purpose of the Study:
- To assess prepuce development and retractability in boys aged 0-16 years.
- To evaluate the necessity of circumcision and forced prepuce dilation in childhood.
Main Methods:
- Evaluation of prepuce development and retractability in 400 boys aged 0-16 years.
- Assessment of retractability in younger boys without prior forced dilation.
Main Results:
- In boys under 1 year, 71.5% had non-retractile prepuces (Type I), compared to 5.5% with completely retractile prepuces (Type V).
- In adolescent boys, 82.3% had Type V retractile prepuces, with only 1.6% showing Type I.
- 106 boys who underwent forced dilation previously developed adhesions again; only 2.7% required circumcision for conditions like stenosis or recurrent balanitis.
Conclusions:
- Incomplete prepuce-glans separation is normal in newborns and resolves spontaneously by adolescence in most cases.
- Circumcision and forced prepuce dilation have limited indications in childhood based on study findings.
- Natural development leads to complete separation in the majority of boys by adolescence.