Care of Uncircumcised Penis

To the Editor.—

The controversy regarding circumcision and urinary tract infections following the article by Drs. Wiswell and Roscelli has not addressed one important factor—what kind of care is appropriate for an intact boy. After 40 years of pediatric practice, I am firmly convinced that the best hygiene is to keep hands off and leave the prepuce alone. I have had many infants with problems from inadequate and poorly done circumcisions; similarly, I have had many uncircumcised infants who got into trouble when a "helpful" nurse, doctor, or grandmother forcibly retracted and cleaned a tight prepuce. In an area where many infants are uncircumcised because of culture, I have never seen a problem when the mother just left it the way the Lord made it—no retractions, no vigorous cleansing, just left it alone. Admittedly, I may have missed some of the urinary infections they described. However, in comparing the circumcised with the uncircumcised, we need to know what kind of care or hygiene was given to the prepuce. Historically, many "scientific interventions" have proven to be more injurious than helpful. Perhaps vigorous cleaning of the prepuce and glans penis are in that category.

STAN J. WATSON, MD
159 E Aleho
Palm Springs, CA 92262