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.