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Medical Conditions Requiring Circumcision
The term "phimosis" denotes a congenital or acquired narrowing of the opening of the prepuce; it is often associated with a foreskin of unusual length which is sometimes adherent to the glans penis. The narrowed orifice of the prepuce sometimes causes retention of secretions, resulting in irritation and balanitis. It may interfere with forceful voiding. The relation between phimosis and venereal ulcers is well established, and the retention of local secretions may be a precursor to the development of epitheliomas and papillomas. Paraphimosis is a common complication of unrelieved phimosis.
By definition, paraphimosis obtains when the prepuce with its narrow orifice
has been fully retracted and cannot be drawn back over the glans. Swelliing
occurs rapidly in collar form, affecting the mucous membrane behind the
corona. When uncorrected, ulceration of the constricting band occurs.
Pain and anxiety increase, and difficulty in voiding may result. Gangrene
of the glans penis is rare, but it may occur.
Treatment consists of reduction by manipulation which should be accomplished as soon as possible; it is a painful procedure that often requires anesthesia. [procedure described] If manipulation as described proves unsuccessful, a dorsal slit must be performed. Unless circumcision is performed after the swelling and local inflammation disappear, recurrence may be expected.
Hospital admission statistics for U.S. Army active-duty personnel during World War II list paraphimosis and phimosis admissions at 110,562. That these conditions combined run numerically second to nonspecific urethritis as cause for hospital admission is not so startling when the degree of incapacity caused by phimosis and paraphimosis is recalled. These disturbances occur only in active-duty personnel who have not been circumcised, and in the the author's opinion, the enormous potential man-hour loss from diseases peculiar to the uncircumcised male would justify routine prophylactic circumcision."