Rosh Pediatrics Practice Exam

In the case of a 6-year-old boy with persistent penile sensitivity and retracted foreskin, what is the best intervention?

1. ADorsal penile slit incision

2. BEmergency circumcision

3. CGentle retraction of the foreskin

4. DPain control and manual reduction of the foreskin

The correct answer is: DPain control and manual reduction of the foreskin

For a 6-year-old boy experiencing persistent penile sensitivity with a retracted foreskin, the best intervention is pain control and manual reduction of the foreskin. This approach addresses both the discomfort and the condition itself without resorting to more invasive surgical methods. When a foreskin is retracted, it can become stuck and can lead to discomfort or pain, and in some cases, can progress to a medical emergency called paraphimosis. By providing adequate pain control, the child can be more comfortable during the procedure. Manual reduction involves gently pushing the retracted foreskin back to its normal position over the glans. This technique is non-invasive and can effectively restore the foreskin’s proper function while alleviating the associated pain and sensitivity. Other options such as dorsal penile slit incision or emergency circumcision may be considered in more severe or acute cases, but they are more aggressive interventions and not ideal for a situation that can be managed conservatively with careful handling. Gentle retraction of the foreskin without pain management might not be sufficient to address the child’s symptoms effectively. Therefore, pain control combined with manual reduction serves as a targeted and effective approach for the child’s condition.