Background: It has been suggested that the number of pediatric circumcisions is rising in Belgium. This report has a two-fold character. Firstly, it describes how the circumcision rates, the mean age during circumcision and the indication to circumcise have changed in the Brussels University Hospital between 1994 and 2012. Secondly, the pediatric circumcision rate and the rate in the indications to circumcise are studied in Belgium from the year 2002 to 2011.
Materials and methods: To analyze the trends in pediatric circumcisions in the Brussels University Hospital, data were extracted from the Electronic Medical Dossier of the Hospital. A total of 3,937 patients, all boys from 0 to 15 years old who underwent a circumcision between 1994 and 2012 in the Brussels University Hospital, were included in the study. To analyze the trends in pediatric circumcisions in Belgium, data were obtained from the National Institute for Health and Disability Insurance (NIHDI or RIZIV). A total of 162,833 boys below 16 years of age were included in the study. Data regarding the Belgian male population over the study interval were excerpted from the Belgian National Institute for Statistics and the Research Department of the Flemish Government.
Results: The pediatric circumcision rate is increasing. From 1994 to 2012, the number of circumcisions performed in the Brussels University Hospital increased by 59.75%, from 187.79 in 1994 to 300.00 in 2012. From 2002 to 2011 the national pediatric circumcision rate increased by 49.81%, from 13.23 per 1000 boys per year in 2002 to 19.82 per 1000 boys per year in 2011. If the 2011 circumcision rate remains stable, 31.71% of boys will be circumcised by their 16th birthday. The number of circumcisions performed for parental request is increasing and the number of medically indicated circumcisions declined.
Conclusion: The increase of the pediatric circumcision rate is probably due to a rise in the number of circumcisions performed for parental request. Although the number of circumcisions performed for phimosis declined, it is estimated that, if the 2011 circumcision rate remains stable, 5.88% of boys will undergo a circumcision by their 16th birthday to treat phimosis in Belgium. This number is about 9 times higher than the reported incidence of phimosis at that age, which indicates that phimosis is currently still overdiagnosed.