title: Inappropriate circumcision referrals by GPs.
abstract: 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.
authors.affiliation: Bristol Royal Hospital for Sick Children, St Michael's Hill.
authors.forename: D
authors.initials: D
authors.lastname: Griffiths
authors.forename: J D
authors.initials: JD
authors.lastname: Frank
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male; D003937:Diagnosis, Differential; D006801:Humans; D007223:Infant; D008297:Male; D010688:Phimosis / Q000175:diagnosis / Q000601:surgery*; D010821:Physicians, Family; D012017:Referral and Consultation