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J R Soc Med. 1992 June; 85(6): 324–325.
PMCID: PMC1293493

Inappropriate circumcision referrals by GPs.

Abstract

One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor in 15 patients. The implications of this survey are that a large proportion of general practitioners have difficulty in discriminating between a true phimosis and a developmentally non-retractile foreskin. This diagnostic inaccuracy was greatest when the referring doctor did not examine the patient.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Wiswell TE, Enzenauer RW, Holton ME, Cornish JD, Hankins CT. Declining frequency of circumcision: implications for changes in the absolute incidence and male to female sex ratio of urinary tract infections in early infancy. Pediatrics. 1987 Mar;79(3):338–342. [PubMed]
  • Type 2 diabetes or NIDDM: looking for a better name. Lancet. 1989 Mar 18;1(8638):589–591. [PubMed]
  • GAIRDNER D. The fate of the foreskin, a study of circumcision. Br Med J. 1949 Dec 24;2(4642):1433–illust. [PMC free article] [PubMed]
  • Oster J. Further fate of the foreskin. Incidence of preputial adhesions, phimosis, and smegma among Danish schoolboys. Arch Dis Child. 1968 Apr;43(228):200–203. [PMC free article] [PubMed]
  • Rickwood AM, Walker J. Is phimosis overdiagnosed in boys and are too many circumcisions performed in consequence? Ann R Coll Surg Engl. 1989 Sep;71(5):275–277. [PMC free article] [PubMed]
  • Schoen EJ. 'Ode to the circumcised male'. Am J Dis Child. 1987 Feb;141(2):128–128. [PubMed]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press