Inappropriate circumcision referrals by GPs

J R Soc Med. 1992 Jun;85(6):324-5.


One hundred and twenty boys were referred by GPs over a 12-month period to a paediatric urologist for circumcision. The reasons for referral were: ballooning in 36, non-retraction in 28, balanoposthitis in 36 or a combination in 15. On examination 53% had a retractile, 21% a partially retractile and 21% a non-retractile foreskin. Six patients had obvious balanitis xerotica obliterans. Only one quarter of the patients required a circumcision. The penis was not examined by the referring doctor in 15 patients. The implications of this survey are that a large proportion of general practitioners have difficulty in discriminating between a true phimosis and a developmentally non-retractile foreskin. This diagnostic inaccuracy was greatest when the referring doctor did not examine the patient.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Circumcision, Male*
  • Diagnosis, Differential
  • Humans
  • Infant
  • Male
  • Phimosis / diagnosis
  • Phimosis / surgery*
  • Physicians, Family
  • Referral and Consultation*