Although these considerations are more or less accepted by most pediatric surgeons in central Europe, the surgical method of choice remains controversial. The classical technique of circumcision, with or without aids such as the plastic bell, etc., is preferred by more urologically oriented pediatric surgeons and adult-urologists who also operate on children. The remaining pediatric surgeons resect only as much of the foreskin as is necessary to prevent recurrence of the phimosis. In this method, which is also favored in my clinic, the inner preputial membrane along with any scar tissue is resected at its junction with the outer membrane, and the latter is then fixed to the corona glandis. There is usually sufficient foreskin remaining to cover three-fourths to all of the glans postoperatively, but good retractability must always be achieved..
Although we are aware that the philosophy of this method is just as open to criticism as the reasoning behind total circumcision, we feel more at ease with a glans penis that is surgically “protected” rather than “stark naked” postoperatively..
Interestingly enough, mothers tend to request total circumcision only when the child’s father is totally circumcised; otherwise they feel it is important that as little skin as possible be removed. Occasionally parents whose son had total circumcision have sought cosmetic surgery to reconstruct the original condition, which is unfortunately impossible..