Foreskin Retraction and Circumcision: Possible Late Consequences

Abstract

This case report is about spontaneous foreskin retraction but it is relevant also to the status after circumcision. Non-therapeutic male circumcision remains controversial; there is evidence in support of its benefits; however, good hygiene may achieve some of the aims. Late consequences are understudied, in particular, those related to atrophy of the ageing genital skin and mucous membranes. A superficial scald burn of the genital area occurred to a 3-years-old boy in conditions of child neglect. Immediate medical help was not sought. In the following years, symptoms of balanoposthitis were repeatedly noticed. Along with the pubertal development, the foreskin became completely and permanently retracted. There has never been any strangulation or compression in terms of paraphimosis. The symptoms started appearing at the age of about 58 years: recurring superficial erosions in the frenular area, preputial rim and adjacent surfaces. The penis binding with a soft cloth and occasional topical treatment is necessary as atrophic skin is sensitive and vulnerable. Derangements of blood supply may contribute to atrophic changes; therefore, vascular diseases and diabetes mellitus must be included in the differential diagnosis. Potential adverse effects discussed in this report emphasize the fact that non-therapeutic neonatal circumcision is an invasive procedure performed without patients’ consent.