Background: Primary phimosis can be resolved naturally by aging, however, it can cause a serious complication such as infection, emergency visit to hospital, and risk of developing penile cancer. Circumcision is a good option for treatment but there is no exact cut-off point of the age that the procedure should be performed. Conservative treatment such as manual foreskin retraction has benefit according to literature but timing and how to do it are still questionable.

Objective: To evaluate the prevalence of phimosis in kindergarten and primary school aged boys, the benefit of manual retraction by parents, and to explore the awareness of parents of the complications of phimosis.

Materials and Methods: The present study was a cross-sectional study initiated between June 2020 and August 2020 at Thammasat kindergarten and primary school, Pathumthani, Thailand. Data from 264 boys were collected by online questionnaire. The questionnaire consisted of the grading of phimosis and parental awareness of the complications of the phimosis.

Results: The prevalence of phimosis from the present study was 68% in 3- to 4-year-old boys, 54% in 5- to 6-year-old, 51% in 7- to 8-year-old, 44% in 9- to 10-year-old, and 39% in 11- to 12-year-old boys. For parental awareness, 61% of parents knew that phimosis can be a risk for urinary tract infection, 48% for acute event such as urinary retention or paraphimosis, and only 24% knew that phimosis can be a risk for developing penile cancer. The benefit of the manual retraction was not demonstrated in the present study.

Conclusion: In the present study, the prevalence of phimosis was almost 50%, even in children older than 6-year-old. The authors encourage the education of parents about the complications of phimosis, especially penile cancer.

Keywords: Phimosis; Manual retraction; Penile cancer; Parental awareness; Urinary tract infection; Penile cancer

DOI: 10.35755/jmedassocthai.2022.03.13275

Received 20 December 2021 | Revised 4 February 2022 | Accepted 7 February 2022