This left him with further preputial adhesions and he later underwent circumcision. Cosmesis was good with high levels of patient satisfaction expressed. All had easily retractile foreskins at follow-up. Large numbers of patients might reasonably benefit from a lateral preputioplasty when presenting with a symptomatic phimosis in the absence of significant scarring of the prepuce. It avoids the needless loss of the fore-skin, the importance of which is only now beginning to emerge.
Medical treatment is an even more conservative treatment of narrow foreskin.
In those symptomatic patients in which surgical intervention is indicated, circumcision has traditionally been regarded as the treatment of choice. However, there are many who might benefit from a more conservative approach - that of preputial plasty. Those with a phimosis and secondary scarring resulting in a stiff foreskin were listed for circumcision. Those with a narrow foreskin and a history of recurrent balanitis, voiding problems or local symptoms such as fissuration or bleeding, and thought suitable for a more conservative procedure, were recommended for preputioplasty. Those with a phimosis but without a history of local symptoms were reassured and discharged.