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J R Soc Med 2003;96:619
doi:10.1258/jrsm.96.12.619
© 2003 Royal Society of Medicine

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J R Soc Med 2003;96:619
© 2003 The Royal Society of Medicine

Letter

Preputioplasty

Tim Lane?   Marie South1

? Queen Mary Westfield School of Medicine, London
1 Maidstone Hospital, Maidstone, Kent, UK

Mr Barber and his colleagues describe parents' evaluations of preputioplasty (September 2003, JRSM1). We are concerned that in 40% of the children the main indication was asymptomatic phimosis without a history of either recurrent balanoposthitis or voiding dysfunction. In our opinion this group of patients do not require surgical intervention and can safely be reassured and discharged. Our own surgical preference in the management of symptomatic patients is lateral preputioplasty. This procedure involves two laterally placed vertical incisions over the stenotic preputial bands which are subsequently closed horizontally.2 It provides excellent symptom relief and avoids the unsightly cleft left by a single dorsal incision over a stenotic preputial band. Barber et al. had a rather poor success rate in preventing recurrent balanoposthitis. We think that a severely scarred foreskin is best managed by circumcision.3

REFERENCES

  1. Barber NJ, Chappell B, Carter PG, Britton JP. Is preputioplasty effective and acceptable? J R Soc Med2003; 96:452 -3[Abstract/Free Full Text]

  2. Lane TM, South LM. Lateral preputioplasty for phimosis. J R Coll Surg Edinb1999; 44:310 -12[Medline]

  3. Lane TM, South LM. Inappropriate applications of preputioplasty. J R Coll Surg Edinb2000; 45:139 -40[Medline]


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