Self-care promotion of the intact (non-circumcised) patient: A review of available recommendations.

Abstract

With routine infant circumcision ratesdeclining in the United States, nurses are likely to encounter more intact (non-circumcised) male patients requiring genital hygiene, nursing interventions, and education accessing the health system. To date, a little emphasis has been placed on the care of the intact male patient in the nursing literature, resulting in ambiguity in care recommendations. The vagueness is problematic, as improper intact care, particularly in the pediatric patient, can result in forced retraction injuries, bleeding, scarring, and unnecessary intervention. In addition, with nurses conducting many of the tasks of hygiene and education for self-care, there is potential for impaired patient self-care and harm if nurses are not knowledgeable in intact care. Utilizing Orem's self-care theory as a framework, the aim of this effort is to perform a review of current recommendations on intact care to inform nursing practice with this population. As no evidence was found in the scientific literature, readily available consumer website resources were reviewed. Themes of hygiene and age of retraction emerged. While recommendations for hygiene practices were variable, all review sources (n = 12) were clear in advising against the premature retraction of the intact foreskin and identified this as a route for injury. With no current literature available to summarize current nursing clinical or educational practices, dissemination of these recommendations is necessary to prevent patient injury and promote appropriate patient self-care.