The frequency of foreskin problems in uncircumcised children

L. W. Herzog and S. R. Alvarez

Division of Ambulatory Pediatrics, Children's Hospital, Boston, Mass. 02115.

We performed a retrospective survey to determine the frequency of problems of the foreskin among uncircumcised children. Among 545 boys aged 4 months to 12 years, there were 272 uncircumcised boys and 273 control patients who were circumcised at birth. The total frequency of complications was significantly higher in the uncircumcised group (14% vs 6%). Both balanitis (6% vs 3%) and irritation (4% vs 1%) were more frequent among the uncircumcised children, but the difference was not statistically significant. Problems with adhesions were uncommon (1.5%) and equal in both groups. Symptomatic phimosis was seen in eight patients. The frequency of medical visits for penile problems was significantly higher in the uncircumcised group (10% vs 5%). Although the overall frequency of complications was higher among the uncircumcised children, most of the problems were minor.

[CIRP Comment: The control group for this study was composed of boys who had been circumcised. In other words, they did not have foreskins. One would expect the incidence of foreskin problems in such a group to be zero. However, some foreskin problems were noted. A group without foreskins seems an unsatisfactory control group with which to compare the incidence of foreskin problems. Retrospective studies are inherently limited in their ability to control for confounding factors, such as type of hygienic care.]