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Website tool launched to inform decisions about childhood circumcision

4-Skin Health website launch

A website to better educate boys, their parents and clinicians about foreskin conditions and the options for treatment has been launched, linking to the work of GIRFT’s national review of paediatric surgery.

As GIRFT’s clinical lead for paediatric general surgery and urology, Professor Simon Kenny carried out in-depth visits to all 22 specialist trusts in England and 67 of the highest-volume non-specialist trusts as part of his national review, speaking directly to frontline clinicians, nurses and managers.

A key finding from his discussions was a lack of awareness of, and training in, less-invasive alternatives to circumcision for young boys and teenagers with phimosis (restriction of the foreskin). His newly-published GIRFT national report, available to download by registering here, calls for a reduction in unnecessary circumcision operations, offering more choice for patients and saving money for the NHS.

Now, as a result of Professor Kenny’s work as a consultant paediatric surgeon at Alder Hey Children’s Hospital in Liverpool, one young patient’s parent has donated money to develop a website so that all boys, teenagers, young men, parents and doctors can better learn about foreskin issues, including phimosis, and make more informed decisions about their treatment.

With information tailored for all ages, the website offers details on what the range of treatments involve and what their side effects may be. It also features a treatment choice support tool to help GPs, paediatricians and surgeons identify possible treatment options for their patients and to support joint decision-making for foreskin conditions such as non-retractile foreskin, recurrent inflammation of the foreskin and clinical balanitis xerotica obliterans (BXO).

Professor Kenny, who is also NHS England’s National Clinical Director for Children and Young People, said: “In many cases circumcision is the best option for the patient, but we found that often the procedure is used to treat foreskin conditions that would have resolved over time or for which there are successful alternative treatments.

“Clinicians should prioritise minimally invasive treatments or those that can be administered at home to avoid burdening the NHS and over-treating cases where the child’s foreskin will retract naturally in time. This is particularly important in light of COVID-19 and the pressure the pandemic has put on elective procedures.

“We hope this website will be used by everyone involved in treating foreskin conditions – from the patients and their parents to the teams treating them – so that everyone has the information they need to make the best decision for the patient and achieve the best possible outcome.”

The Alder Hey 4-skin Health website can be found here.

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