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Review
.2011:11:2458-68.
doi: 10.1100/2011/373829. Epub 2011 Dec 26.

Complications of circumcision

Affiliations
Review

Complications of circumcision

Aaron J Krill et al. ScientificWorldJournal.2011.

Abstract

In the United States, circumcision is a commonly performed procedure. It is a relatively safe procedure with a low overall complication rate. Most complications are minor and can be managed easily. Though uncommon, complications of circumcision do represent a significant percentage of cases seen by pediatric urologists. Often they require surgical correction that results in a significant cost to the health care system. Severe complications are quite rare, but death has been reported as a result in some cases. A thorough and complete preoperative evaluation, focusing on bleeding history and birth history, is imperative. Proper selection of patients based on age and anatomic considerations as well as proper sterile surgical technique are critical to prevent future circumcision-related adverse events.

Keywords: Penis; child; circumcision; complications; inconspicuous; micropenis.

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Figures

Figure 1
Figure 1
(a) The Gomco clamp consists of 4 pieces: the bell, platform, hooking arm, and screw. These are assembled after placing the bell completely over the glans (b) and the skin drawn through the hole in the platform. Hemostasis is obtained by tightening the screw (c) and the skin excised.
Figure 2
Figure 2
The Mogen clamp is used by drawing the skin to be removed into the V and then providing hemostasis followed by amputation.
Figure 3
Figure 3
The Plastibell is placed over the glans and a suture is secured over the skin. After several days, the skin will slough and the Plastibell falls off.
Figure 4
Figure 4
The “sleeve” technique involves incising the inner preputial skin (a) and then the overlying outer preputial skin (b). Sutures are most commonly used to approximate the skin edges (c).
Figure 5
Figure 5
(a) The dorsal-ventral slit technique of circumcision involves making these incisions and then (b) removal of the skin between them. Sutures are most commonly used to approximate the skin edges.
Figure 6
Figure 6
Examples of redundant skin following circumcision (a,b,c).
Figure 7
Figure 7
Penile adhesions (a) between the shaft skin and the glans can be manually separated while penile skin bridges (b) cannot be manually separated and need to be excised—skin bridge.
Figure 8
Figure 8
Meatal stenosis in a 3 year old circumcised male who presented with a narrow stream.
See this image and copyright information in PMC

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References

    1. Nelson CP, Dunn R, Wan J, Wei JT. The increasing incidence of newborn circumcision: data from the nationwide inpatient sample. Journal of Urology. 2005;173(3):978–981. - PubMed
    1. Hutcheson JC. Male neonatal circumcision: indications, controversies and complications. Urologic Clinics of North America. 2004;31(3):461–467. - PubMed
    1. US Dept of Health and Human Services.http://www.ahrq.gov/ - PubMed
    1. Lannon CM, Bailey AGD, Fleischman AR, et al. Circumcision policy statement. American Academy of Pediatrics. Task Force on Circumcision. Pediatrics. 1999;103(3):686–693. - PubMed
    1. Rushton HG, Majd M. Pyelonephritis in male infants: how important is the foreskin? Journal of Urology. 1992;148(2):733–736. - PubMed

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