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Letter to editor regarding: Referrals from primary care with foreskin symptoms: Is there really room for improvement?

Published:December 27, 2022DOI:https://doi.org/10.1016/j.jpedsurg.2022.12.012
      In their article “Referrals from primary care with foreskin symptoms: Room for improvement” [
      • Sutton G.
      • Fryer S.
      • Rimmer G.
      • Melling C.V.
      • Corbett H.J.
      Referrals from primary care with foreskin symptoms: Room for improvement.
      ], Sutton et al. show an extraordinary disregard for the diagnostic abilities of general practitioners. We know of no other speciality in which 75% of referrals would be dismissed in such a cavalier fashion. Following the late AM Rickwood, a vehement opponent of circumcision [
      • Rickwood A.M.K.
      • Kenny S.E.
      • Donnell S.C.
      Towards evidence based circumcision of English boys: survey of trends in practice.
      ], they will only circumcise for recurrent attacks of balanitis, yet 110 years ago Sir William Whitla wrote that a single attack of balanitis necessitates circumcision [
      • Whitla W.
      A dictionary of treatment.
      ]. Why force a boy to suffer a painful condition multiple times before he gets the simple operation he needs? After all, each attack will require more antibiotics and thus more expense.
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      References

        • Sutton G.
        • Fryer S.
        • Rimmer G.
        • Melling C.V.
        • Corbett H.J.
        Referrals from primary care with foreskin symptoms: Room for improvement.
        J Pediatr Surg. 2022; (Online ahead of print, Oct 31)
        • Rickwood A.M.K.
        • Kenny S.E.
        • Donnell S.C.
        Towards evidence based circumcision of English boys: survey of trends in practice.
        BMJ. 2000; 321: 792-793
        • Whitla W.
        A dictionary of treatment.
        5th ed. Tindall & Cox, London, Baillière1912: 1204pp
        • Gairdner D.
        The fate of the foreskin.
        BMJ. 1949; 2: 1433-1437
        • Kacker S.
        • Frick K.D.
        • Gaydos C.A.
        • Tobian A.A.R.
        Costs and effectiveness of neonatal male circumcision.
        Arch Pediatr Adolesc Med. 2012; 166: 910-918
      1. IMC circumcision clinic. 2022