Complications of Circumcision And its Management in Pediatric Age Group

Abstract

Background: Circumcision is the most common & oldest surgical procedure inthe world, about one third of males in the world are circumcised.Objectives : to evaluate the predisposition of early & late complications of circumcision in different age group regarding the technique used & operator as well as management strategy for each complication. Methods: A prospective case series study conducted at the pediatric surgery centre at AL-Khansaa Teaching Hospital in Mosul city in Iraq from the first of June /2019 to the first of December/2020. The complications were categorized as early complication (< 1 week) such as, infection, bleeding, huge mucosal edema, penile amputation & glans injury. Late complications (>1week) such as phimosis/trapped penis, adhesions/skin bridges, excess foreskin, ventral curvature, retention cyst, meatal stenosis & penile torsion. Results: 105 cases were referred to our pediatric surgery center. 101 (96.19%) circumcised by paramedical staff (nurse, dresser), 3 (2.85 %) patients circumcised by paediatric surgeon & 1 (0.95%) circumcision done by general surgeon {P=0.001}. Early & late complications included : phimosis/trapped penis [n=47 (44&%)], meatal stenosis [n=9 (8.5 %)], torsion [n=1 ( 0.95 %)], bleeding [n=11 (10.4%)], mucosal edema [n=1 ( 0.95 %)], ventral curvature [n=3 ( 2.8 %)], glans injury [n=4 ( 3.8 %)], penile amputation [n=1 (0.95 %)], urethral fistula [n=1 (0.95 %)]. Conclusion: There circumcision complications may be high in the infantile age group. Many complications seen in those circumcised by untrained paramedical staff with unauthorized thermocautery machine.