{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T21:47:04Z","timestamp":1792446424521,"version":"4.5.0"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World J Urol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate whether routine histopathological examination of the prepuce following adult circumcision without clinical suspicion of malignancy influences patient management and healthcare resource utilisation, and to report circumcision frequency and long-term oncological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was conducted of all adult circumcisions performed between January 2015 and December 2025. Patients aged\u2009\u2265\u200915 years undergoing circumcision for symptomatic phimosis, paraphimosis, or recurrent balanitis were included. Cases with suspected malignancy or known premalignant lesions were excluded. Demographic, operative, histopathological, and follow-up data were extracted from electronic records. Median follow-up was 85 months. Cost analysis was based on an estimated histopathology cost of \u00a3226 per specimen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 1,648 listed patients, 1,523 met the inclusion criteria (median age 44 years). Phimosis was the primary indication (98.2%). Lichen sclerosus was identified in 62% of specimens, while incidental penile intraepithelial neoplasia (PeIN) was detected in 0.5%. No invasive carcinomas were identified. All PeIN cases were managed with circumcision alone, and no progression or additional intervention was required at a median follow-up of 81 months. Eliminating routine histopathology would have saved 304.6 consultant hours and \u00a3344,198 over 11 years (\u00a331,291 annually).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In the absence of clinical suspicion, routine histopathological examination of the prepuce rarely detects clinically significant malignancy or alters management. A selective, risk-adapted approach may optimise resource utilisation while maintaining oncological safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06432-y","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:26:38Z","timestamp":1777577198000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Time to rethink routine histopathology after adult circumcision? Long-term oncological outcomes from an 11-year cohort"],"prefix":"10.1007","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4513-6994","authenticated-orcid":false,"given":"Ghulam Mustafa","family":"Nandwani","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mubeshar","family":"Hassan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2494-5119","authenticated-orcid":false,"given":"Devanand","family":"Lohana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasad","family":"Bollina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"6432_CR1","doi-asserted-by":"crossref","unstructured":"Alyami FA, Bateni ZH, Odeh R, Farhat WA, Koyle M (? 2018) Routine histopathological examination of the foreskin after circumcision for clinically suspected lichen sclerosis in children: Is it a waste of resources. 12(5):231\u2013233","DOI":"10.5489\/cuaj.4331"},{"key":"6432_CR2","doi-asserted-by":"publisher","unstructured":"Morris BJ, Wamai RG, Henebeng EB, Tobian AAR, Klausner JD, Banerjee J et al (2016) Estimation of country-specific and global prevalence of male circumcision. 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Available from: https:\/\/www.google.com\/search?q=how+many+adult+circumcision+performed+nhs+scotland&sca_esv=fcba3e255d597c32&ei=tLlZaarkGO3WhbIPsJy2iAI&sclient=gws-wiz-serp&udm=50&fbs=AIIjpHxU7SXXniUZfeShr2fp4giZ1Y6MJ25_tmWITc7uy4KIeiAkWG4OlBE2zyCTMjPbGmMU8EWskMk2JSE__efdUJ3x-dd8PyEzi5Y9BtPQcYyUv-qqGBKcZRAt6t3qPZ3-iSYj4NFTLo_PkVeRaPNr8Tt4VoiX2M8mh9n-sT5J21n9U2PyFXKatPNXBOlz7UuuHiqhCxVYFODW2lnaf74YkzQdFBoLbg&ved=2ahUKEwjxxcm01vCRAxU69QIHHbolOh4Q0NsOegQIAxAB&aep=10&ntc=1&mstk=AUtExfDQ4bqExPy03q9bNyvr7m9K9fhpQntq06ATgYeOqzXnX6HITj-wJZVZGx7k3EG1hS4H99oHTUreXSnyHteS2ZQGdk_VAMffTjD1q3Em3CCxL6-cDXqmOmD93JMf0GMCmOgHBJDmRTvgKf3nW-sfwaYFPU_Lu8661b4&csuir=1"},{"key":"6432_CR18","unstructured":"Hospital N (2021) Response to correspondence dated 24 October 2021 Request: Male Circumcision. ;(December):2019\u201321"},{"key":"6432_CR19","doi-asserted-by":"crossref","unstructured":"Neill SM, Lewis FM, Tatnall FM, Cox NH, Neill S (2010) British Association of Dermatologists \u2019 guidelines for the management of lichen sclerosus 2010. ;(May):672\u201382","DOI":"10.1111\/j.1365-2133.2010.09997.x"}],"container-title":["World Journal of Urology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06432-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00345-026-06432-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00345-026-06432-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T19:26:40Z","timestamp":1777577200000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00345-026-06432-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,30]]},"references-count":19,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6432"],"URL":"https:\/\/doi.org\/10.1007\/s00345-026-06432-y","relation":{},"ISSN":["1433-8726"],"issn-type":[{"value":"1433-8726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,30]]},"assertion":[{"value":"22 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 April 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Non-declared.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Information Governance & Cyber Assurance, McKenzie Building (Ninewells Campus), Ninewells Hospital and Medical School, Kirsty Semple Way, Dundee, DD2 4BF Tel: 01382 740074.\n                      \n                      .","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"This was an audit and that the need for consent was not required.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate"}}],"article-number":"334"}}