TITLE:  Important Aspects: Caring for the Uncircumcised Male Patient

OBJECTIVES: 

Attendees will identify male foreskin complications, treatment, and preventive measures.

PROBLEM STATEMENT AND RATIONALE

In 1970, the majority of American parents opted to have their newborn male offspring circumcised. Today, less than 60% of newborn males will undergo the procedure (Steadman & Ellsworth, 2006). In 2004, Medicaid stopped funding for circumcision in 13 states (2006). Advances in medicine and technology bring new health care challenges to the clinical arena. Male patients recovering from traumatic events often require long-term acute care. The foreskin of an uncircumcised male patient is frequently neglected becoming immflamed and ulcerated. If the penile foreskin is left untreated serious conditions might occur such as Paraphymosis.  A long-term acute care (LTAC) hospital provides high acuity care to patients for over 25 days (RML). Due to their co morbidities and dependence on mechanical ventilation, the majority of the patients require an indwelling urinary catheter. The presence of the urinary catheter invites added risk to the uncircumcised male patient.

STUDY AIMS

The specific aims of this study were to describe complications uncircumcised male patients experienced in a LTAC hospital. The variables studied were: incidence of complications uncircumcised male patients experienced, foreskin ulceration, the development of paraphymosis, effectiveness of urinary catheter stabilization to prevent complications, and treatment of foreskin ulceration.

METHODOLOGY

This was a descriptive, retrospective study, using medical records and WOC Nurse treatment records. Data will be summarized in charts.

RESULTS AND CONCLUSIONS

            The male foreskin is often neglected receiving minimal attention. However, the consequences of penile ulceration and an untreated Paraphymosis result in permanent damage. Daily cleansing, assessment, and urinary catheter stabilization prevents serious consequences such as ulceration, Paraphymosis, and penile gangrene.

References

RML Statistics (2007).

Steadman, B. & Ellsworth, P. (2006). To Circumcise or Not Circumcise, Risks, and Alternatives to Circumcision in the Pediatric Population with Phimosis. Urologic Nursing, V26 (3).