Variability in penile appearance and penile findings: a prospective study

Area of Science:

• Pediatric Urology
• Neonatal Care
• Genitourinary Health

Background:

• Penile morphology and clinical findings in children exhibit variations.
• Previous studies on post-circumcision findings have largely been retrospective.

Purpose of the Study:

• To prospectively document variations in penile morphology and clinical findings in children.
• To compare findings between circumcised and uncircumcised boys.

Main Methods:

• A consecutive sample of 468 boys underwent genital examinations in a primary-care pediatric practice.
• Data collection focused on penile morphology and clinical findings, including circumcision status.

Main Results:

• Circumcised boys under 3 years were more likely to have glans coverage, meatal redness, balanitis, and trapped debris than older circumcised boys.
• Among boys under 3 years, circumcised individuals had higher rates of coronal adhesions, trapped debris, meatal redness, preputial stenosis (phimosis), and balanitis compared to boys with foreskins.
• Specific findings in circumcised boys under 3 included partially covered glans (30.6%), adhesions (25.6%), completely covered glans (20.1%), entrapped debris (24.7%), reddened meatus (19.1%), and balanitis (15.5%).

Conclusions:

• Significant variations exist in circumcised boys, with clinical findings being more common than previously reported.
• The circumcised penis requires increased care during the first three years of life to prevent adhesions and debris accumulation.
• Penile inflammation (balanitis) may be more prevalent in circumcised boys; preputial stenosis (phimosis) occurs equally in circumcised and intact boys. Cosmetic circumcision revision is discouraged.