Seven hundred and sixty-three males were evaluated. Age at presentation ranged from 3 to 17 years and 59% of patients were 3–6 years at initial presentation. Three hundred and forty patients underwent circumcision. The total estimated cost of care for all patients was $1,345,533.90. This compares to an estimated cost of $171,675 if all individuals underwent NC at 2020 costs.

The total estimated cost associated with the evaluation and management of 763 patients ≥3 years for phimosis/circumcision was 7.8 times the estimated cost of NC for all these patients and likely is an underestimation of the true difference in cost as we did not account for additional visits outside of the initial consultation and follow-up, post-operative visits outside of the global period, emergency room visits, and returns to operating room.

Only 18.5% of the circumcisions were for medically acceptable reasons, as defined by Florida Medicaid

TST [Salbentherapie] success rates reported in the literature range from 53.8% to 95.5%; ours was 34.3%. Caretakers who want to perform a circumcision may be less compliant with TST use, which may explain why our response rate is lower than that reported in the literature.

The number of unnecessary office visits, healthcare expenses, and family burdens might be reduced if PCPs [Primary care physician] adopted TST and were educated on the current Medicaid/MCG recommendations for evaluating and managing phimosis.