Late complications of newborn circumcision: a common and avoidable problem

Abstract

Purpose

The purpose of this paper is to study the types of operative and post-operative late complications resulting from newborn circumcisions and to make recommendations to prevent them.

Methods

After obtaining IRB approval, a retrospective review of the late complications resulting from newborn circumcisions treated at the MassGeneral Hospital for Children from January 2003 to December 2007 was undertaken. The source used was the consultation notes and operative reports of affected patients. Additionally, cases seen in the outpatient Pediatric Urology Clinic from April 2007 to April 2008 were reviewed.

Results

A total of 8,967 children were operated during the study period, of which 424 (4.7%) were for complications resulting from previous neonatal circumcision. Penile adhesions, skin bridges, meatal stenosis, redundant foreskin (incomplete circumcision with uncircumcised appearance), recurrent phimosis, buried penis and penile rotation were the most frequent complications. At the outpatient clinic of the Section of Pediatric Urology, 127 boys with concerns following newborn circumcision were evaluated, representing 7.4% of the total volume of cases seen in this clinic.

Conclusions

Our results indicate the need to undertake a collaborative study to define the incidence of complications following newborn circumcisions, which should be performed by practitioners with adequate training in the technique of their choice and its post-operative care.

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References

  1. 1.

    Moses S, Bailey RC, Ronald A (1998) Male circumcision: assessment of health benefits and risks. Sex Transm Infect 74(5):368–373

    Article  CAS  PubMed  Google Scholar 

  2. 2.

    American Academy of Pediatrics (1999) Circumcision policy statement. Pediatrics 103:686–693

    Article  Google Scholar 

  3. 3.

    National Health Center for Health Statistics (2007) Trends in circumcisions among newborns

  4. 4.

    Clair DL, Caldamone AA (1988) Pediatric office procedures. Urol Clin North Am 15:715–723

    CAS  PubMed  Google Scholar 

  5. 5.

    Brisson PA, Patel HI, Feins NR (2002) Revision of circumcision in children: report of 56 cases. J Pediatr Surg 37:1343–1346

    Article  PubMed  Google Scholar 

  6. 6.

    Wiswell TE, Geschek DW (1989) Risks from circumcision during the first month of life compared with those for uncircumcised boys. Pediatrics 83:1011–1015

    CAS  PubMed  Google Scholar 

  7. 7.

    Gee WF, Ansell JS (1976) Neonatal circumcision: a ten year review with comparison of the Gomco clamp and the Plastibell device. Pediatrics 58:824–827

    CAS  PubMed  Google Scholar 

  8. 8.

    Harkavy KL (1987) The circumcision debate. Pediatrics 79:649–650

    CAS  PubMed  Google Scholar 

  9. 9.

    Fetus and Newborn Committee. Canadian Pediatric Society (1996) Neonatal circumcision revisited. CMAJ 154:769–780

    Google Scholar 

  10. 10.

    Williams N, Kapila L (1993) Complications of circumcision. Br J Surg 80:1231–1236

    Article  CAS  PubMed  Google Scholar 

  11. 11.

    Leitch IOW (1970) Circumcision—a continuing enigma. Aust Paediatr J 6:59–65

    Google Scholar 

  12. 12.

    Kaplan GW (1983) Complications of circumcision. Urol Clin North Am 10:543–549

    CAS  PubMed  Google Scholar 

  13. 13.

    Ponsky LE, Ross JH, Knipper N, Kay R (2000) Penile adhesions after neonatal circumcision. J Urol 164:495–496

    Article  CAS  PubMed  Google Scholar 

  14. 14.

    Datta NS, Zinner NR (1977) Complication from Plastibell circumcision ring. Urology 9:57–58

    Article  CAS  PubMed  Google Scholar 

  15. 15.

    Gluckman GR, Stoller ML, Jacobs MM, Kogan BA (1995) Newborn penile glans amputation during circumcision and successful reattachment. J Urol 153:778–779

    Article  CAS  PubMed  Google Scholar 

  16. 16.

    Cetinkaya M, Saglam HS, Beyribey S (1993) Two serious complications of circumcision. Case report. Scand J Urol Nephrol 27:121–122

    Article  CAS  PubMed  Google Scholar 

  17. 17.

    Gearhart JP, Rock JA (1989) Total ablation of the penis after circumcision with electrocautery; a method of management and long-term follow up. J Urol 142:799–801

    CAS  PubMed  Google Scholar 

  18. 18.

    Levitt SB, Smith RB, Ship AG (1976) Iatrogenic microphallus secondary to circumcision. Urology 8:472–474

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Audry G, Buis J, Vasquez MP, Gruner M (1994) Amputation of penis after circumcision–penoplasty using expandable prosthesis. Eur J Pediatr Surg 4:44–45

    Article  CAS  PubMed  Google Scholar 

  20. 20.

    Strimling BS (1996) Partial amputation of glans penis during Mogen clamp circumcision. Pediatrics 97:906–907

    CAS  PubMed  Google Scholar 

  21. 21.

    Patel HI, Moriarty KP, Brisson PA, Feins NR (2001) Genitourinary injuries in the newborn. J Pediatr Surg 36(1):235–239

    Article  CAS  PubMed  Google Scholar 

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Correspondence to Rafael V. Pieretti.

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Pieretti, R.V., Goldstein, A.M. & Pieretti-Vanmarcke, R. Late complications of newborn circumcision: a common and avoidable problem. Pediatr Surg Int 26, 515–518 (2010). https://doi.org/10.1007/s00383-010-2566-9

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Keywords

  • Circumcision
  • Complications
  • Newborn