# Inflammatory changes in the prepuce and clinical findings according to the stages of phimosis

## TL;DR

This study examines how phimosis stages relate to preputial inflammation and finds younger age is linked to more severe phimosis and inflammation.

## Contribution

The study provides new insights into the relationship between phimosis stages and preputial inflammation in children.

## Key findings

- Younger patients tend to have more advanced phimosis and higher inflammation.
- Stage 1 phimosis shows severe inflammation, possibly due to external contamination.
- Circumcision at younger ages may reduce urinary infections and antibiotic use.

## Abstract

Circumcision refers to the surgical removal of all or part of the prepuce. Circumcision is commonly performed on males in childhood to prevent urinary tract infections and for religious reasons. This study was designed to investigate the inflammatory processes in the prepuce according to the degree of phimosis in patients who underwent circumcision.

We conducted a prospective study on 173 male children under the age of 18 who underwent circumcision between June and September 2024. A comprehensive physical examination of the genitourinary system was performed. Foreskin retraction was assessed and recorded using the Kikiros grading score, and an elective surgical appointment was scheduled accordingly.

As the age of the patient decreases, phimosis appears to be more advanced. In Stage 2 phimosis, where the foreskin is more covered, mild to moderate inflammation is observed, whereas in Stage 1 phimosis, where the foreskin is moderately covered, severe inflammation is noted. This suggests that the partial constriction in Stage 1 phimosis may facilitate contamination from external sources.

It is known that circumcision in boys reduces urinary tract infections. This study investigated the inflammatory processes in the prepuce according to the degrees of phimosis. The results indicate that performing circumcision at younger ages is beneficial for preventing ascending urinary infections and reducing the need for antibiotic treatment.