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Circumcision Rates after the Release of Preputial Adhesions
O M Aworanti1, F Rasheed1, A Aldiab1
1Our Lady’s Children’s Hospital, Ireland
Irish Medical Journal
|September 26, 2019
Summary
Release of preputial adhesions (RPA) effectively manages physiological phimosis symptoms, often preventing the need for circumcision. This procedure offers a successful alternative when other treatments fail.
Area of Science:
- Pediatric Urology
- Dermatology
Background:
- Physiological phimosis is common in children.
- Circumcision is a common treatment, but alternatives are sought.
- Release of preputial adhesions (RPA) is a potential conservative management option.
Purpose of the Study:
- To evaluate the efficacy of RPA in managing physiological phimosis.
- To determine if RPA can prevent the need for circumcision.
Main Methods:
- Retrospective review of RPA procedures from January 2005 to December 2017.
- Analysis of patient data including age, follow-up duration, and subsequent surgical interventions.
- Histological examination of excised foreskins in cases requiring further surgery.
Main Results:
- 534 RPA procedures were performed with a median follow-up of 108 months.
- Only 8.4% of children required subsequent circumcision or preputioplasty.
- No significant difference in circumcision rates was observed between children under or over 5 years old at the time of RPA.
Conclusions:
- RPA is an effective alternative to circumcision for physiological phimosis.
- RPA successfully manages symptoms when reassurance or steroid treatment is insufficient.
- Histology revealed BXO and chronic inflammation in a subset of cases requiring further intervention.
