Foreskin Morbidity in Uncircumcised Males

Area of Science:

• Pediatric Surgery
• Urology
• Dermatology

Background:

• Discussions on male circumcision benefits versus risks are ongoing.
• Discrepancies in reported complication rates necessitate further investigation.
• Understanding the incidence of medically indicated foreskin surgery in boys is crucial.

Purpose of the Study:

• To evaluate the incidence and morbidity of foreskin surgery for medical reasons in boys.
• To assess the cumulative risk of foreskin operations and specific conditions like balanitis xerotica obliterans (BXO).
• To identify the primary indications for foreskin surgery in pediatric patients.

Main Methods:

• Retrospective review of medical records for boys undergoing foreskin surgery in the Capital Region of Denmark in 2014.
• Exclusion of patients with hypospadias, ritual circumcision, or redo-surgery due to complications from non-therapeutic circumcision.
• Analysis of surgical indications, pre-operative symptoms, and histological findings, including BXO.

Main Results:

• 181 boys underwent foreskin surgery, with a cumulative risk of 1.7% before age 18.
• Phimosis was the primary indication (95.0%), followed by frenulum breve (5.0%).
• Balanitis xerotica obliterans (BXO) was histologically verified in 37 out of 50 patients, with a total risk of 0.37%.

Conclusions:

• Childhood foreskin-related problems requiring surgical intervention are significant.
• Conditions such as phimosis and BXO necessitate medical attention in boys.
• The incidence of these conditions highlights the importance of addressing foreskin health in pediatric care.