H S Nagar1, A Chauhan2, V K Saxena3. 1. Classified Specialist (Surgery & Paediatric Surgery), INHS Kasturi, Lonawala, Maharashtra. 2. Post Graduate Resident, Department of Surgery, INHS Asvini, Mumbai. 3. Command Medical Officer, HQ, Southern Naval Command, Kochi 682 004.
Abstract
BACKGROUND: Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized, non-operative methods have been tried and operations preserving the skin of prepuce have been recommended. The presence of physiological phimosis, which is self-correcting by the age of 15 years in children, needs to be differentiated from the pathological variety. METHOD: The child population reporting to Surgery OPD was taken as sectional representative of the Indian communities and socioeconomic strata. A simple protocol was adapted to differentiate true phimosis from the physiological one and data collected. An observational study was done and data collected for last six years. RESULT: 566 children were referred to the hospital and only 212 were subjected to circumcision. Of these, 169 were cases of true phimosis, 7 had paraphimosis and the rest included 9 ritual circumcisions. CONCLUSION: The incidence in this study is much less as compared to the series from the west. Though rare, this simple surgery is often fraught with complications. A refined approach has been planned for referring cases and selection for surgery thereby reducing unnecessary referrals and circumcisions.
BACKGROUND: Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized, non-operative methods have been tried and operations preserving the skin of prepuce have been recommended. The presence of physiological phimosis, which is self-correcting by the age of 15 years in children, needs to be differentiated from the pathological variety. METHOD: The child population reporting to Surgery OPD was taken as sectional representative of the Indian communities and socioeconomic strata. A simple protocol was adapted to differentiate true phimosis from the physiological one and data collected. An observational study was done and data collected for last six years. RESULT: 566 children were referred to the hospital and only 212 were subjected to circumcision. Of these, 169 were cases of true phimosis, 7 had paraphimosis and the rest included 9 ritual circumcisions. CONCLUSION: The incidence in this study is much less as compared to the series from the west. Though rare, this simple surgery is often fraught with complications. A refined approach has been planned for referring cases and selection for surgery thereby reducing unnecessary referrals and circumcisions.