Simple Procedure Relieves Tight Foreskin Problem

By Alison McCook

NEW YORK (Reuters Health) - A few small incisions may be all that are needed to fix a common foreskin problem in children, and avoid circumcision, according to Austrian researchers.

The new technique is used to treat phimosis, a condition in which the foreskin opening is too small for it to be pulled back over the head of the penis. Phimosis can affect 8 percent of boys between the ages of 6 and 7.

Although phimosis can resolve by itself, it is often treated by circumcision, in which the foreskin is surgically removed. However, circumcision carries a risk of complications, and is fraught with controversy; in recent years, vocal opponents have lobbied against the procedure, equating it with mutilation.

Consequently, a number of alternatives to circumcision have emerged to treat phimosis in young children. Results of the newest approach, known as triple incision plasty, are described in the medical journal BJU International.

During the procedure, doctors make three separate longitudinal incisions around the tight ring of the foreskin, then suture the incisions obliquely. This results in a looser, slightly shorter foreskin that can move easily up and down over the head of the penis.

"The foreskin will be preserved, only the tight ring of skin will be widened," study author Dr. Michael Rauchenwald of the General Hospital in St. Poelten told Reuters Health.

The report describes the results of triple incision plasties performed on 197 boys with phimosis.

Surveys of 128 parents and children showed that 84 percent were satisfied with how their child's penis functioned, and 80 percent were happy with how it looked after surgery. Ninety-three percent of parents said they would recommend the operation to other parents.

And in follow-up examinations of 91 children months after surgery, 77 percent had penises that looked and functioned normally.

At the time the article was published, only three children had eventually undergone circumcision, because they were not happy with the results of the triple incision plasty.

Rauchenwald told Reuters Health that most men are not circumcised in Europe, and many European parents prefer their children to remain uncircumcised so that they don't feel different.

While in many cases phimosis resolves on its own, Rauchenwald added that he believed all of the children included in the current study needed the operation, and he would recommend the surgery to many others.

SOURCE: BJU International, September 2003.