A study of clinical opinion and practice regarding circumcision

Aim-To establish clinical opinion regarding appropriate indications for cir cumcision and to examine actual clinical practice. Methods-A questionnaire was sent to all NHS hospital consultants in the Yor kshire region of the UK identified as having a role to play in the manageme nt of boys (under 16 years of age) requiring circumcision. Retrospective da ta on actual clinical practice during a three month study period were also collected via a simple proforma. Results-Of 153 questionnaires sent, 64 were returned. Responses revealed va rying opinions regarding appropriate indications for circumcision within ea ch consultant group, and between paediatricians and surgeons. Surgeons were generally more inclined to recommend circumcision for each of the indicati ons listed in the questionnaire. Analysis of clinical practice revealed tha t almost two thirds of procedures were carried out for phimosis, and nearly half of these children were under the age of 5 years. Conclusion-There are differences in the clinical opinions of surgeons and p aediatricians on what constitutes an appropriate indication for circumcisio n. Paediatricians' opinions are generally more in line with current evidenc e than those of surgeons, possibly resulting in many unnecessary circumcisi ons.