Article
A study of clinical opinion and practice regarding circumcision
Z Farshi, K R Atkinson, R Squire
Department of
Clinical Effectiveness and Department of Paediatric Surgery, St
James's University Hospital, Leeds LS9 7TF, UK
Correspondence to: Mr Squire email: Roly.squire{at}gw.sjsuh.northy.nhs.uk
Accepted 1 June 2000
AIM
To establish clinical opinion
regarding appropriate indications for circumcision and to examine
actual clinical practice.
METHODSA questionnaire was sent to
all NHS hospital consultants in the Yorkshire region of the UK
identified as having a role to play in the management of boys (under 16 years of age) requiring circumcision. Retrospective data on actual
clinical practice during a three month study period were also collected
via a simple proforma.
RESULTSOf 153 questionnaires sent,
64 were returned. Responses revealed varying opinions regarding
appropriate indications for circumcision within each consultant group,
and between paediatricians and surgeons. Surgeons were generally more
inclined to recommend circumcision for each of the indications listed
in the questionnaire. Analysis of clinical practice revealed that
almost two thirds of procedures were carried out for phimosis, and
nearly half of these children were under the age of 5 years.
CONCLUSIONThere are differences in
the clinical opinions of surgeons and paediatricians on what
constitutes an appropriate indication for circumcision.
Paediatricians' opinions are generally more in line with current
evidence than those of surgeons, possibly resulting in many unnecessary circumcisions.
Keywords: circumcision; clinical opinion; clinical practice; regional audit
© 2000 by Archives of Disease in Childhood
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