A newborn boy has distal hypospadias with a normally positioned urethral meatus on the ventral shaft and a hooded prepuce. Why must routine neonatal circumcision be avoided in this child?

• A Circumcision increases the risk of meatal stenosis
• B Circumcision causes recurrent balanitis in hypospadiac boys
• C The foreskin is required as tissue for the future corrective repair ✓
• D The foreskin is needed to allow spontaneous straightening of the penis

Explanation

In hypospadias the preputial skin is deliberately preserved because it serves as a vascularised flap or graft material during urethroplasty, for example in tubularised preputial flap repairs. Circumcising the child destroys this valuable tissue and complicates later reconstruction. Repair is planned between roughly 6 and 18 months of age, using the inner preputial skin, so the parents should be told at birth never to consent to a ritual or routine circumcision.

Reference: Ashcraft's Pediatric Surgery, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.