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Circumcision Rates after the Release of Preputial Adhesions

Aim
We aim to determine if the release of preputial adhesions (RPA) successfully managed symptoms related to physiological
phimosis and prevented the need for circumcision.
Methods
We performed a retrospective review and analysed data on RPA procedures performed between January 2005 and
December 2017.
Results
534 RPA’s were performed. Median age at RPA was 52.7 months (range: 3-197 months). Mean follow-up was 108 months
(range: 4.7 to 152.4 months). 44 children and 1 child subsequently required a circumcision or preputioplasty respectively
(8.4% incidence). There was no statistical difference in the circumcision rates in children who had RPA over 5 years vs
those that had RPA under 5 years old (6.6% vs 9.8%; p = 0.21). The histology of the 44 excised foreskins showed BXO in 2
(4.5%) and chronic inflammation in 11 (25%).
Conclusion
RPA is an effective alternative to circumcision where either reassurance on the benign and self-limiting nature of
physiologic phimosis or steroid treatment are unsuccessful in managing symptoms.