Childhood circumcision

Circumcision is one the most frequently performed operations in males worldwide and is an integral part of several religions, including Judaism and lslam. Circumcision rates in the UK have reduced over the last few decades from 24% of males in the 1950s to an estimated 6% today. This reduction is largely as a result of better understanding of the physiology of the normal foreskin as well as rationalization of health care provision. The normal foreskin is non-retractable at birth and gradually separates spontaneously such that 90% of foreskins are retractable by three years of age. Medical indications for circumcision are few. Circumcision is contraindicated in a number of congenital penile disorders, including hypospadias, epispadias, chordee, buried penis, and micropenis. Various techniques are available for performing circumcision, including non-surgical techniques for use in neonates using devices such as the PlastibellTM, as well as surgical circumcision. Complications of circumcision include haemorrhage, infection, meatal stenosis, removal of incorrect amount of foreskin, penile injury, urethral injury, and painful scarring. However, many of these complications can be prevented using precise surgical techniques, including avoidance of monopolar diathermy and meticulous haemostasis. © 2008.