Study published in MJA, Vol. 178, 155-58, February 2003. The study was to investigate the incidence rate of circumcision for phimosis and other medically indicated reasons in Western Australian boys. The authors found that as the national rate of routine circumcision decreased, the rate of medically indicated circumcisions increased for boys aged less than 15 years. More than half of the boys circumcised for phimosis were under the age of 5. Pathological phimosis is rare in that age group. The authors attributed the high rate of circumcision to physicians mistaking normal penile development for pathological phimosis.

Young boys with a confirmed diagnosis of phimosis do not necessarily need to be circumcised. Topical steroids have been shown to be a cost effective approach in reversing phimosis. Our findings suggest that improved education for physicians, and perhaps parents, with regard to foreskin development and management is required.

Conclusion: The rate of circumcision to treat phimosis in boys aged less than 15 years is seven times the expected incidence rate for phimosis. Many boys are circumcised before reaching five years of age, despite phimosis being rare in this age group.