Many studies of balanitis do not examine the subjects' genital washing habits; a 1993 study by Birley et al. did so and found that excessive genital washing with soap may be a strong contributing factor to balanitis. Escala and Rickwood, in a 1989 examination of 100 cases of balanitis, concluded: "[T]he risk in any individual, uncircumcised boy appears to be no greater than 4% ... A policy of routine neonatal circumcision to avoid these preputial complains of childhood would be difficult to justify. We found no evidence that balanitis causes phimosis." [1]
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