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Selective Histopathology Examination for Circumcision Specimens: A Retrospective Observational Study
Baidar Khalabazyane1, Rahel Rashid2, Laura Mclaren1
1Urology, Royal Bournemouth Hospital, Bournemouth, GBR.
Cureus
|September 5, 2024
Summary
Routine histological examination of adult circumcision specimens is often unnecessary. Malignancy is rare (0.9%) and only found in clinically suspicious cases, suggesting selective testing can optimize resources.
Area of Science:
- Urology
- Pathology
- Surgical Oncology
Background:
- Circumcision is a common global procedure for religious, cultural, or medical reasons.
- Routine histological examination of foreskin specimens is standard practice, despite low rates of premalignant/malignant lesions.
Purpose of the Study:
- To evaluate the necessity of routine histopathological examination of adult circumcision specimens.
- To determine malignancy frequency and compare rates between clinically suspicious and non-suspicious cases.
Main Methods:
- Retrospective observational study of 334 adult male circumcisions (2012-2016).
- Patients divided into clinically suspicious and non-suspicious preoperative groups.
- Electronic patient records used for follow-up and malignancy identification.
Main Results:
- Only 9 patients (2.7%) had suspicious preoperative clinical features; 3 (0.9% total) had malignancy.
- The remaining 6 suspicious cases had balanitis xerotica obliterans (BXO).
- No malignancies were found in the 325 patients without suspicious preoperative findings.
Conclusions:
- Low malignancy incidence (0.9%) suggests routine histopathological examination may not be essential for all circumcision specimens.
- Selective testing based on clinical suspicion can optimize resource allocation and reduce costs without compromising patient care.
