Conservative Management of Foreskin Conditions

Abstract

Circumcision is seen as a valid, and often necessary, medical treatment even in parts of the world where infant circumcision is rarely performed outside the religious arena. This paper looks at the justifications for circumcision “for medical reasons” in the context of British Medical Association advice that circumcision is unethical and inappropriate where non-invasive treatment is safe and effective. The common clinical indications given for circumcision are reviewed against the evidence for the availability of conservative or non-invasive treatment. This review concludes that the effective treatment preserving the foreskin is available in almost all cases commonly treated by circumcision. The only common condition that may justify circumcision is preputial lichen sclerosus which does not respond to potent topical steroids. New developments suggest that circumcision may perhaps be avoided even in these cases.