Purpose: Pathological phimosis in childhood typically results in
circumcision. Long-term follow-up data for men circumcised in childhood are
lacking. This study sought long-term data regarding satisfaction with
circumcision and voiding symptoms from men who had childhood circumcision between
1989 and 2010. Methods: Following ethical approval, a postal survey was
sent to males 17 years who underwent circumcision at an age 16 years for
pathological phimosis. Results: The survey was sent to 177 men, 23
completed surveys were returned [19 histology proven Lichen Sclerosus [LS, BXO],
4 chronic balanitis]. Mean age at circumcision was 9.7 years [range 3-15], at
survey 23.5 years [18-37]. Seven [all 9 years] remembered the decision for
circumcision. Four warranted urologist review as adults, three required surgery
for voiding symptoms and one still performs structure therapy; all had LS. When
asked which treatment option[s] they would have considered; ten of them chose
circumcision, nine of them chose preputioplasty, eight of them chose topical
creams [two of them chose all three options, one man chose both foreskin
preserving options]. Eight agreed with the statement “Having a circumcision in
childhood or adolescence had an impact on my adult life”; this was positive in
two men but negative in five men-they wouldn’t have chosen circumcision.
Conclusions: The response rate to the survey was low, making it
difficult to draw firm conclusions. However, even in this limited sample, not all
men would choose childhood circumcision for pathological phimosis, data
supporting the need for larger studies of alternative treatment options. In
addition, some men circumcised for childhood LS had significant voiding
difficulties in adulthood.