The management of penile zip entrapment in children.

Thirty boys, aged 2-12 years, presented with penile zip entrapment to one Paediatric Accident and Emergency Department over a 7 year period. The rate of presentation was one zip entrapment per 4068 new patient attendances. In contrast to previous reports, injuries occurred most commonly whilst the zip was being done up and whilst underpants were being worn. Two types of entrapment were seen, determining the way in which release was achieved. Contrary to previous suggestions, most children (26 out of 30) were easily managed in the Accident and Emergency Department without general anaesthetic. No patient required circumcision or suffered any sequelae. An algorithm for treatment based upon the experience of this study is presented.