Severe complications from circumcision

A study by Ceylan, et al from Turkey evaluated their experience in 48 cases of severe complications of circumcisions.

Their patient's ages ranged from 5 months to 24 years with the mean age of 14 years. These circumcisions were performed at various centers or during religious ceremonies in environments other than health facilities.

The group found that the most commonly observed complication was preputio-glandular fusion that was seen in 25 cases (52%.). The other complications were as follows: meatal stenosis in 11 (23%); urethral fistula in 5 (10.4%); partial glandular amputation in 4 (8%); and a distal urethral fistula in 3 (6%). Lysis of adhesions and revisions were performed in all cases of preputio-glandular fusion. The patients with meatal stenosis underwent meatotomies. The urethral fistula cases were repaired by simple closure and not a hypospadias type repair. Partial glans amputations were patched only with buccal mucosa. There was one patient with a completely open distal urethra that appeared to be more of a megameatus in my interpretation that was repaired by a Mathieu in a tabularized incised plate urethroplasty type technique.

The group concluded that circumcisions are routine but they may be associated with serious complications. The group felt that experience played a major role and that when circumcisions are performed, they should be done by educated experience personnel.

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