As far as the foreskin retraction problems, I found this quote interesting (from the National Kidney and Urologic Diseases Clearinghouse):
"In some children, formation of a tight ring of scar (phimosis) due to repeat infection, irritation, or tearing prevents retraction; this causes spraying of the urine and traps urine beneath the foreskin, fostering infection in the urine or in the penis."
Sounds like a vicious cycle of infection causing more problems/infection. How do we prevent infection (and especially scarring from infection) before the foreskin can retract? I'm still not entirely sure, but found this interesting:
"Topical corticosteroid cream (0.05-0.1 percent betamethasone) applied to the penis can loosen the scarring in mild and moderate cases." (Although interestingly enough, they list two different surgeries, the first one being circumcision, as treatments for phimosis.)
Another quote from the same source:
"Furthermore, other factors are associated with penile cancer besides circumcision, and penile cancer incidence in societies with low circumcision rates and high levels of hygiene is comparable to that in societies with high circumcision rates. The UTI risk studies were nearly all retrospective and may have been skewed by other risk factors such as vesicoureteral reflux. Another factor that must be weighed in the balance is complications from circumcision; while the complication rate is very low, disastrous outcomes such as total loss of the penis are possible. Routine circumcision in the population would mean that thousands of children would be placed at risk to prevent just one case of cancer."
They basically sum up that more research needs to be done, i.e. better studies of UTI, how effective alternatives to circumcision are for treating phimosis, and study the effects of education of pediatricians and parents on proper care of an uncircumcised penis to see if it prevents pathological phimosis.
This information is from section 18, Phimosis and Circumcision Practice, of this paper.
"In some children, formation of a tight ring of scar (phimosis) due to repeat infection, irritation, or tearing prevents retraction; this causes spraying of the urine and traps urine beneath the foreskin, fostering infection in the urine or in the penis."
Sounds like a vicious cycle of infection causing more problems/infection. How do we prevent infection (and especially scarring from infection) before the foreskin can retract? I'm still not entirely sure, but found this interesting:
"Topical corticosteroid cream (0.05-0.1 percent betamethasone) applied to the penis can loosen the scarring in mild and moderate cases." (Although interestingly enough, they list two different surgeries, the first one being circumcision, as treatments for phimosis.)
Another quote from the same source:
"Furthermore, other factors are associated with penile cancer besides circumcision, and penile cancer incidence in societies with low circumcision rates and high levels of hygiene is comparable to that in societies with high circumcision rates. The UTI risk studies were nearly all retrospective and may have been skewed by other risk factors such as vesicoureteral reflux. Another factor that must be weighed in the balance is complications from circumcision; while the complication rate is very low, disastrous outcomes such as total loss of the penis are possible. Routine circumcision in the population would mean that thousands of children would be placed at risk to prevent just one case of cancer."
They basically sum up that more research needs to be done, i.e. better studies of UTI, how effective alternatives to circumcision are for treating phimosis, and study the effects of education of pediatricians and parents on proper care of an uncircumcised penis to see if it prevents pathological phimosis.
This information is from section 18, Phimosis and Circumcision Practice, of this paper.
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