In their letter, Cox and Morris advocate for childhood circumcision and imply that our article aims to prevent boys undergoing the procedure. [ [1]

] As UK based practitioners where a large proportion of males have a foreskin, we follow the guidance given in the ‘Foreskin Conditions Commissioning Guide’ published by the Royal College of Surgeons of England in 2013 (revised 2016) [ [2]
] and the Statement from the British Association of Paediatric Urologists on behalf of the British Association of Paediatric Surgeons and The Association of Paediatric Anaesthetists ‘Management of Foreskin Conditions’ [ [3]
]. The indications for circumcision in the guidance include penile malignancy, traumatic foreskin injury where it cannot be salvaged, Balanitis Xerotica Obliterans, severe recurrent attacks of balanoposthitis and recurrent febrile UTI’s with an abnormal urinary tract. [ [3]
] Therefore, like the population of Canada and much of Europe, many boys in the UK ‘are likely to live out their lives with an intact prepuce’ and understanding what is normal and when intervention has greater benefit than risk is vital.