dorsal slit

Dorsal slit is now rare in Western countries as a treatment for phimosis.

The device is placed (this sometimes requires a dorsal slit) and remains there until blood flow has stopped.

Photo of baby with dorsal slit.

If this fails, the tight edematous band of tissue can be relieved surgically with a dorsal slit or circumcision.

Formerly, this treatment, used with peroxide powder and arsphenamine and, in severe cases, a dorsal slit, was the extent of therapy.

Preputioplasty, in which a limited dorsal slit with transverse closure is made along the constricting band of skin can be an effective alternative to circumcision.

With the advent of penicillin and other systemic and local antibiotics, the treatment is specific and effective; however, even now a dorsal slit procedure is sometimes necessary.

Should reduction of the swelling by conservative methods be unsuccessful, a dorsal slit is a common intervention of choice since circumcision is almost always excluded in such cases.

Dorsal slit has a long history as a treatment for adult phimosis, since compared with circumcision it was relatively easy to perform, did not risk damage to the frenulum, and before the invention of antibiotics was less likely to become infected.

A variety of "dorsal slit" circumcision was once predominant amongst the Maasai tribe of Kenya and Tanzania, and is still practised and found in many of the more remote regions of the very large area known as "Maasailand" generally.

However, the Maasai operation is different in this: rather than a dorsal slit from the opening of the prepuce to the corona, a heart shaped "oval" is excised from the dorsum of the prepuce and the glans is pushed through this hole.

It used a randomized and controlled trial where the PrePex device was compared to the dorsal slit method of circumcision, focusing on adult males aged 21-54, finding that the mean time for a non-surgical PrePex procedure was about 1/5 shorter in duration (3.1 minutes compared to 15.4 minutes).