Circumcision is not mandatory in penile surgery

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Study Type – Therapy (case series)Level of Evidence 4OBJECTIVETo assess the outcome of not circumcising patients having surgery to correct a congenital or acquired curvature, through a subcoronal approach.PATIENTS AND METHODSIn a series of 251 consecutive patients (mean age 46 years, range 17–74) that had their penis straightened by either a Lue (86), or a Nesbit procedure (162) or a combination of both (three) between 2000 and 2008, a subcoronal circumferential incision was used for the degloving in 241. Among the 183 patients who had not been previously circumcised, 22 presented with a tight foreskin and were offered a circumcision; six of them refused to be circumcised. Of the remaining 161 patients, 115, including two who had previous penile surgery, opted not to be circumcised.RESULTSAfter a median (range) follow-up of 5.5 (1–50) months, secondary circumcision was performed in three of the six patients with a tight foreskin, in one of the 113 (0.8%) with a normal retractable foreskin and in one of the two who had had previous penile surgery and had a normal foreskin.CONCLUSIONSCircumcision should not be considered as a routine part of penile surgery unless a significant phimosis is present or revisional surgery is contemplated.

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