Search tips
Search criteria 


Logo of jrsocmedLink to Publisher's site
J R Soc Med. 1992 June; 85(6): 324–325.
PMCID: PMC1293493

Inappropriate circumcision referrals by GPs.


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.

Full text

Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (387K), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References.

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