The appearance and development of the foreskin vary among children, and, in most cases, non-retractile foreskin in younger boys is entirely normal. It is important for clinicians to understand what is within the range of normal development and what changes may indicate underlying pathology requiring referral to specialist services. While circumcision is performed in some parts of the world for cultural or religious reasons, in the UK, it is only recommended for specific medical conditions such as balanitis xerotica obliterans (BXO) or recurrent balanoposthitis. Awareness of typical foreskin development and appearance, appropriate hygiene practices and red flags for pathology are essential to guide families accurately, provide appropriate care and avoid any unnecessary referrals or interventions. This article summarises current UK guidance to support primary care physicians in recognising when medical or surgical management of foreskin conditions may be indicated.
Triage has become a defining feature of modern UK general practice, enabling practices to manage rising demand and prioritise clinical risk. However, triage is a complex clinical process that introduces challenges around diagnostic uncertainty, continuity of care and clinician workload. This article explores the rationale, models and risks of triage in primary care, with a focus on safe decision-making. Practical strategies are provided to support GPs and registrars in delivering effective, defensible triage.
