title: Circumcision : A Time to Rethink.
abstract: BACKGROUND
  Circumcision is one of the most routinely done surgery world over but has no scientific basis to enforce it on all patients. Of late, the operation has been criticized, non-operative methods have been tried and operations preserving the skin of prepuce have been recommended. The presence of physiological phimosis, which is self-correcting by the age of 15 years in children, needs to be differentiated from the pathological variety.
  
  
  METHODS
  The child population reporting to Surgery OPD was taken as sectional representative of the Indian communities and socioeconomic strata. A simple protocol was adapted to differentiate true phimosis from the physiological one and data collected. An observational study was done and data collected for last six years.
  
  
  RESULTS
  566 children were referred to the hospital and only 212 were subjected to circumcision. Of these, 169 were cases of true phimosis, 7 had paraphimosis and the rest included 9 ritual circumcisions.
  
  
  CONCLUSIONS
  The incidence in this study is much less as compared to the series from the west. Though rare, this simple surgery is often fraught with complications. A refined approach has been planned for referring cases and selection for surgery thereby reducing unnecessary referrals and circumcisions.
authors.affiliation: Classified Specialist (Surgery & Paediatric Surgery), INHS Kasturi, Lonawala, Maharashtra.
authors.forename: H S
authors.initials: HS
authors.lastname: Nagar
authors.affiliation: Post Graduate Resident, Department of Surgery, INHS Asvini, Mumbai.
authors.forename: A
authors.initials: A
authors.lastname: Chauhan
authors.affiliation: Command Medical Officer, HQ, Southern Naval Command, Kochi 682 004.
authors.forename: V K
authors.initials: VK
authors.lastname: Saxena
keywords: Circumcision; Phimosis