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Acceptability and outcomes of foreskin preservation for phimosis: An Indian perspective - PubMed

  • ️Wed Jan 01 2020

Acceptability and outcomes of foreskin preservation for phimosis: An Indian perspective

B S Balaji et al. J Family Med Prim Care. 2020.

Abstract

Aim: Understanding the Indian perspective, effectiveness, and acceptability of prepuce conservation in children with phimosis. Circumcision is performed and recommended far too often for nonphysiological phimosis. Will a less radical approach be acceptable in the subcontinent?

Method: A two-arm study with the first arm as KAP (knowledge, attitude, and practice) study (n = 502). The second arm recruited deserving boys (n = 47) with symptomatic phimosis (see inclusion criteria). Betamethasone ointment was applied twice daily over the foreskin and gently massaged to stretch the phimotic band. Those who failed were offered lateral preputioplasty or circumcision. Religious beliefs influence attitude and practice and these were looked at with subgroup analysis.

Results: Most (85%) knew that circumcision was not the only treatment for phimosis. Though many parents (93%) knew the importance of foreskin cleanliness, few practiced it. The success of the steroid application was 81% (n = 38/47). Eight underwent preputioplasty. Minor discomfort as morbidity was noted. All parents were able to completely retract the foreskin of their children by the end of one month and were happy about the cosmetic result.

Conclusions: KAP data on foreskin health is not available in the subcontinent, and this is a landmark study. Religious belief and community identity play a strong role in decisions related to foreskin preservation. Prepuce hygiene and knowledge about the usefulness of the foreskin is poor. The combination of medical and surgical methods of conserving the prepuce was effective. A high rate of success and the non-mutilating cosmetic result of prepuce preservation were acceptable to these parents.

Keywords: Circumcision; foreskin; phimosis; religious beliefs.

Copyright: © 2020 Journal of Family Medicine and Primary Care.

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Conflict of interest statement

There are no conflicts of interest.

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References

    1. neonatal_child_MC_UNAIDS.pdf [Internet] [cited 2019 May 20]. Available from: https://www.who.int/hiv/pub/malecircumcision/neonatal_child_MC_UNAIDS.pdf .
    1. Ashfield JE, Nickel KR, Siemens DR, MacNeily AE, Nickel JC. Treatment of phimosis with topical steroids in 194 children. J Urol. 2003;169:1106–8. - PubMed
    1. Marques TC, Sampaio FJB, Favorito LA. Treatment of phimosis with topical steroids and foreskin anatomy. Int Braz J Urol. 2005;31:370–4. - PubMed
    1. Webster TM, Leonard MP. Topical steroid therapy for phimosis. Can J Urol. 2002;9:1492–5. - PubMed
    1. Esposito C, Centonze A, Alicchio F, Savanelli A, Settimi A. Topical steroid application versus circumcision in pediatric patients with phimosis: A prospective randomized placebo controlled clinical trial. World J Urol. 2008;26:187–90. - PubMed