English summary: CIRCUMCISION OF BOYS IN FINLAND - A QUESTIONNAIRE TO FINNISH PAEDIATRIC SURGEONS

We sent a questionare to surgeons treating children's phimosis and performing circumcision in Finland. We received responses from 90% of the hospitals, including 39 surgeons. 74% of the responders were paediatric surgeons and 18% were resident paediatric surgeons. They came from all parts of Finland so that the whole country was well covered.

The incidence of operative treatment of phimosis has declined during the last ten years in Finland. The most common operation for adolescent balanitis xerotica obliterans is still circumcision. Preputial plasty is the most widely used method for prepubertal boys. Physiological phimosis is seldom an indication for operative treatment in patients under age of 5 years. Topical steroids are widely used in first line treatment of phimosis. The operation is selected on the basis of discussions with patients and parents. All operations are performed under general anesthesia.

Non-medical circumcision is not performed in Finland except in a few hospitals. The most important reason for not performing cultural circumcision is that the total usefulness of the operation is questionable and that it does not benefit the boy's health. Circumcision does not belong to Finnish culture. The condition for performing a cultural circumcision is the informed consent of the boy himself. Over one third of the responders accept cultural circumcision only if it is performed by medical professionals, under general anaesthesia, and the costs are paid by the boy's parents. One third of the respondents, however, demanded criminalization of cultural circumcision of boys.