Should prepuceplasty be offered to adults with phimosis?
BAUS ePoster online library. Roberts C. 06/21/21; 319069; p3-10
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Ms. Charlotte Roberts
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Abstract
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Introduction
Prepuceplasty is commonly utilised in the treatment of phimosis in children and is advocated in paediatric urology guidelines. However, its use is less established in the adult population. Circumcision is considered to be the mainstay of treatment in those with symptomatic phimosis resistant to conservative measures. Currently, in our centre, patients without evidence of BXO/lichen sclerosis are selectively offered a prepuceplasty whereby the narrowed preputial outlet is incised longitudinally and repaired transversely. Ideal patients are those who have a tight but retractable foreskin when flaccid.
Patients and Methods
Patients who underwent a prepuceplasty between 2012-2019 were identified by the coding department. Electronic records were searched to ascertain whether patients were re-referred seeking subsequent circumcision.
Results
54 patients underwent prepuceplasty over a 7 year period (2012 and 2019). 6 patients (were re-referred and went on to have a circumcision. All re-referrals were made within 6 months of initial surgery (range 2-5 months).
Conclusions
Prepuceplasty is a reasonable alternative to circumcision in carefully selected patients. The rate of subsequent re-referral and circumcision is lower than that quoted by colleagues currently. Patients should be counselled regarding the need for a circumcision. This work is limited for the following reasons; patients may have been referred on to other departments without our knowledge, lack of re-referral does not equate to patient satisfaction. There is certainly scope to extend this work in future. It may be possible to explore long term outcomes via use of a patient satisfaction survey.
Prepuceplasty is commonly utilised in the treatment of phimosis in children and is advocated in paediatric urology guidelines. However, its use is less established in the adult population. Circumcision is considered to be the mainstay of treatment in those with symptomatic phimosis resistant to conservative measures. Currently, in our centre, patients without evidence of BXO/lichen sclerosis are selectively offered a prepuceplasty whereby the narrowed preputial outlet is incised longitudinally and repaired transversely. Ideal patients are those who have a tight but retractable foreskin when flaccid.
Patients and Methods
Patients who underwent a prepuceplasty between 2012-2019 were identified by the coding department. Electronic records were searched to ascertain whether patients were re-referred seeking subsequent circumcision.
Results
54 patients underwent prepuceplasty over a 7 year period (2012 and 2019). 6 patients (were re-referred and went on to have a circumcision. All re-referrals were made within 6 months of initial surgery (range 2-5 months).
Conclusions
Prepuceplasty is a reasonable alternative to circumcision in carefully selected patients. The rate of subsequent re-referral and circumcision is lower than that quoted by colleagues currently. Patients should be counselled regarding the need for a circumcision. This work is limited for the following reasons; patients may have been referred on to other departments without our knowledge, lack of re-referral does not equate to patient satisfaction. There is certainly scope to extend this work in future. It may be possible to explore long term outcomes via use of a patient satisfaction survey.
Introduction
Prepuceplasty is commonly utilised in the treatment of phimosis in children and is advocated in paediatric urology guidelines. However, its use is less established in the adult population. Circumcision is considered to be the mainstay of treatment in those with symptomatic phimosis resistant to conservative measures. Currently, in our centre, patients without evidence of BXO/lichen sclerosis are selectively offered a prepuceplasty whereby the narrowed preputial outlet is incised longitudinally and repaired transversely. Ideal patients are those who have a tight but retractable foreskin when flaccid.
Patients and Methods
Patients who underwent a prepuceplasty between 2012-2019 were identified by the coding department. Electronic records were searched to ascertain whether patients were re-referred seeking subsequent circumcision.
Results
54 patients underwent prepuceplasty over a 7 year period (2012 and 2019). 6 patients (were re-referred and went on to have a circumcision. All re-referrals were made within 6 months of initial surgery (range 2-5 months).
Conclusions
Prepuceplasty is a reasonable alternative to circumcision in carefully selected patients. The rate of subsequent re-referral and circumcision is lower than that quoted by colleagues currently. Patients should be counselled regarding the need for a circumcision. This work is limited for the following reasons; patients may have been referred on to other departments without our knowledge, lack of re-referral does not equate to patient satisfaction. There is certainly scope to extend this work in future. It may be possible to explore long term outcomes via use of a patient satisfaction survey.
Prepuceplasty is commonly utilised in the treatment of phimosis in children and is advocated in paediatric urology guidelines. However, its use is less established in the adult population. Circumcision is considered to be the mainstay of treatment in those with symptomatic phimosis resistant to conservative measures. Currently, in our centre, patients without evidence of BXO/lichen sclerosis are selectively offered a prepuceplasty whereby the narrowed preputial outlet is incised longitudinally and repaired transversely. Ideal patients are those who have a tight but retractable foreskin when flaccid.
Patients and Methods
Patients who underwent a prepuceplasty between 2012-2019 were identified by the coding department. Electronic records were searched to ascertain whether patients were re-referred seeking subsequent circumcision.
Results
54 patients underwent prepuceplasty over a 7 year period (2012 and 2019). 6 patients (were re-referred and went on to have a circumcision. All re-referrals were made within 6 months of initial surgery (range 2-5 months).
Conclusions
Prepuceplasty is a reasonable alternative to circumcision in carefully selected patients. The rate of subsequent re-referral and circumcision is lower than that quoted by colleagues currently. Patients should be counselled regarding the need for a circumcision. This work is limited for the following reasons; patients may have been referred on to other departments without our knowledge, lack of re-referral does not equate to patient satisfaction. There is certainly scope to extend this work in future. It may be possible to explore long term outcomes via use of a patient satisfaction survey.
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