THE ENCYCLOPEDIA OF PHIMOSIS STATISTICS

My interpretation of Øster compared to all the other source statistics has now been presented simultaneously by two studies in 2003 in Australian medical magazines - both referring to Schöberlein, Øster and the other studies collected here ...

see : Medical Journal in 2003 by Guy Cox - His point is simpler than mine: you cant just rely on one set of statistics and ignore all the others.

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Herr Papke, the medical librarian responsible for DIMDI searches performed a search in November 1997 (Key word: phimo*). I researched the CUMULATIVE INDEX MEDICUS between 1920 and 1967 and checked MEDLINE in Feb 2001 and Jan 2006.

I am interested to collect any record of representative statistics - there must be recorded frequencies among army conscripts, boarding schools etc. which have never been published . - (records of hospital admissions only represent the number of referals for phimosis or the amount of circumcision operations in relation to other operations, all of which do not reflect general frequencies).

Øster's Routine Checks this file contains all the essential basic information with further links to other files:

Jacob Øster reported on a group of almost two thousand boys aged between 6 and 10 yrs. old. He studied them for a period of 7 to 8 years till they were between 13 and 17 years old. He wrote "phimosis was found in 4% of all observations, but with a diminishing incidence throughout the years, from 8% in 6-7 year-olds, to 1% in 16-17 year-olds." In addition his calculations show an incidence of 1.4% for tight foreskin among the 16-17 year-olds.

Schöberlein - (Schöberlein`s original German) measured a 8.8% incidence of phimosis among 3,000 young men, all over 17 years of age, mostly between 18 and 22 years old.

Saitmacher (30) studied 229 boys (aged between 14 and 19). He reported 8.7% where "the foreskin could be retracted only with difficulty or with pain,". Saitmacher noted: "It was completely unknown to some of the examined boys that the foreskin could be retracted."

Osmond (86) reports 14% of 718 uncircumcised British soldiers had foreskins which could not be retracted. He writes "The ignorance of these young soldiers is remarkable; many of them expressed surprise at the condition revealed when they retracted their foreskins : some of them had apparently never done so in their lives."

Parkash S, et.al.: "Human subpreputial collection: its nature and formation." J Urol 110(2), 211-212 (1973) (88) Gives an indication of frequencies among Indian men: " ... 1,000 male subjects seen as out patients and of 98 patients treated surgically for phimosis ...", "The high incidence of phimosis - 21 per cent in those treated for carcimona and 12 per cent in the over-all outpatient population - can definitely be ascribed to a lack of personal hygiene", "Since most patients were unaware that the prepuce was retractable, the history of phimosis often appeared to be from birth."

Bokström, Ludvigsson offer the only traceable or otherwise referred to statistics among adolescents in the medical literature. Bokström measured an incidence of 4.1% among 20,361 army conscripts. (Please - help is needed - translating Finnish or Swedish). From what I can read; Ludvigsson "examined 405 19 yr. olds" and Tabel 1 says "Normala 94,3% Fimosis 5,0%" - it appears that 2% already treated 2% healthy phimosis, 1% had phimosis.

Gairdner (1949) (4) reports "Of 200 uncircumcised boys aged 5-13 years from three different schools, 6% had a non-retractable prepuce; in a further 14% the prepuce could be only partially retracted."

6 studies on boys (when added together these studies cover a sample of at most 167 boys over the age of 11 yrs).

4 reports from general school checks

A Criticism of Shankar and Rickwood (incidence of BXO)
Estimations (Encyclopedia Judaica, Boon)

at least 13 Modern studies using quotes only from Øster

A personal appraisal of Realistic Statistics
The frequency of these conditions are generally underestimated. The statistics for frenulum breve have never been collected (except among animals). - The frequency of phimosis is inevitably too low due to the fact that medical checks are conducted in the flaccid state: phimosis is by nature less elastic, and expands relatively less than the rest of the foreskin, therefore any difficulty with retraction when flaccid, is magnified when erect. See Realistic Statistics.