Routine Histopathological Analysis of Non-suspicious Looking Foreskin for Adult Patients: Is It Necessary?

Objective: To evaluate the routine histopathological analysis of foreskin in adult patients and determine whether histological processing is necessary in patients with non-suspicious foreskin.

Materials and Methods: All adult foreskin sent for histopathological analysis between September 2014 and February 2016 at a single institution (Leighton hospital) was included in this study. Histology was compared to macroscopic appearances. A cost analysis was performed.

Results: There were 262 specimens of foreskin sent for histopathological analysis between September 2014 and February 2016. The average age for patients was 48.5 years. Most cases showed chronic inflammation, (n=110, 42%). No cancer was identified in macroscopically non- suspicious looking foreskin. Clinically diagnosed balanitis, xerotica obliterans and suspicious looking foreskin was predictive of histological abnormality.

Conclusion: Sinister pathology was not identified in non-suspicious specimens. We recommend that foreskin of patients with a high risk for penile malignancy, and macroscopically abnormal looking foreskin should always be sent for histological analysis.