[The need of circumcision or prepuce dilation. A study with 1200 boys].
OBJECTIVE
To demonstrate the increase of preputial retractability with age. To point out the small usefulness of circumcision and preputial forced dilation during childhood.


METHODS
The development of the prepuce and its retractability were evaluated in 1200 boys between 0 and 16 years. The prepuce was classified as type I to V depending on its lower or higher retractability in all cases having been dilated previously or not.


RESULTS
Prepuce retractability in boys under one year was type I (not retractile) in 63.4%, whereas it was type V (completely retractile) in only 3.7%. The contrary was observed in adolescents (11 to 16 years), in which type I was 0.9% and type V was observed in 80.9%. It was also observed that 309 boys (43. 1%) among the 717 with previous prepuce forced dilation, had types I to IV prepuces, so, they had acquired new balanopreputial adherences by the time of examination for our study. Seventeen boys (0.4%) required circumcision. No children suffered upper urinary tract infections.


CONCLUSIONS
All boys are born with the prepuce covering the glans penis, keeping adherences between both structures, which disappear with age, being the detachment complete at the time of puberty in most boys. So, we consider circumcision or forced dilation of the prepuce unnecessary in most boys.
Concepción
Julio C Morales
JC
Hospitales Pediátricos Centro Habana, Ciudad de La Habana, Cuba.
Fernández
Pedro González
PG
Aránegui
Aymée Morales
AM
Rodríguez
Marlen Guerra
MG
Casacó
Bárbara Mora
BM
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002944:Circumcision, Male / Q000706:statistics & numerical data*; D052816:Foreskin / Q000254:growth & development*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male