IMR Press / JOMH / Volume 17 / Issue 2 / DOI: 10.31083/jomh.2021.001
Open Access Original Research
A survey of adult men who underwent circumcision in childhood for pathological phimosis
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1 Department of Surgery, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK
2 University of Liverpool School of Medicine, Liverpool, UK
3 Founder & CEO at SKNDOCTOR, London, England
4 University of Northern British Columbia, Prince George, BC, Canada
*Correspondence: harriet.corbett@alderhey.nhs.uk (Harriet Jane Corbett)
J. Mens. Health 2021, 17(2), 43–48; https://doi.org/10.31083/jomh.2021.001
Submitted: 25 July 2020 | Accepted: 29 October 2020 | Published: 8 April 2021
Copyright: © 2021 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license (https://creativecommons.org/licenses/by/4.0/).
Abstract

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.

Keywords
Balanitis xerotica obliterans
Child
Circumcision
Lichen Sclerosus et atrophicus
Surgical decision making
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