Van Howe RS. Cost-effective treatment of phimosis Pediatrics 102: 4 October 1998, p. e43. A pediatrician and anti-circumcision activist reviews estimated costs and complications of 3 phimosis treatments (topical steroids, praeputioplasty, and surgical circumcision) and concludes that topical steroids should be tried first, and praeputioplasty has advantages over surgical circumcision. This article also provides a good discussion of the difficulty distinguishing pathological from physiological phimosis in young children and alleges inflation of phimosis statistics for purposes of securing insurance coverage for post-neonatal circumcision in the United States.
Lannon CM, Bailey AGD, Fleischman AR, Kaplan GW, Shoemaker CT, Swanson JT, Coustan D. Circumcision Policy Statement Pediatrics 103:686-693, 1999. Although not directly focusing on phimosis, this American Academy of Pediatrics report provides a synopsis of circumcision statistics and benefits, with noncommittal final recommendation. "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child."
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Dewan PA. Treating phimosis Med J Austral 178:148-150, 2003. Discussion of physiological and pathological phimosis in childhood and use of diagnosis to justify surgery for parents' sake. Pictures of infant penises with and without phimosis.
Multiple authors. "Matters arising" Med J Austral 178:587-90, 2003. Letters to the Med J Austral debating the phimosis statistics of Spilsbury and the treatment recommendations of Dewan from both proponents and opponents of circumcision.
Shankar KR, Rickwood AM. The incidence of phimosis in boys Brit J Urol Internat 84:101-102, 1999. This study gives a low incidence of pathological phimosis (0.6% of uncircumcised boys by age 15 years) by asserting that balanitis xerotica obliterans is the only indisputable type of pathological phimosis and anything else should be assumed "physiological". Restrictiveness of definition and circularity of reasoning have been criticized.
Imamura E. Phimosis of infants and young children in Japan Acta Paediatr Jpn 39:403-5, 1997. A study of phimosis prevalence in over 4,500 Japanese children reporting that over a third of uncircumcised had a nonretractile foreskin by age 3 years.
