Treatment of circumcision complications in a Tertiary Institution in Tanzania

Abstract

Background and objective: Male circumcision is a minor surgical procedure that can have both physical and psychological complications. The aim of this study was to review the pattern of presentation of circumcision complications and to highlight on treatment offered at our setting.
Patients And Methods: We retrospectively analyzed the records from files of circumcision complication patients who attended and were managed at Kilimanjaro Christian Medical Centre, a University teaching hospital for the period 2001 -2010.We looked at age at time of circumcision, place where circumcision was done, the circumciser, level of health facility where circumcision was done, type of complication and kind of treatment offered.
Results: 48 patients presented and were treated for circumcision complications during the study period. Mean age at presentation was 8 years and 1month (10.9 years standard deviation) with a range of 1month to 65years. Majority (35.4%) were aged 5 – 18 years at time of circumcision. Sixty six point seven percent of the circumcisions were done by medical circumcisers while the rest were done by traditional circumcisers. Sixty four point six percent of all the cases were circumcised in rural settings. Ninety three point eight percent of all complications after traditional circumcision occurred in rural settings. The commonest type of circumcision complication found was urethrocutaneous fistula (31.3%) followed by glans amputation 25%, and buried glans 14.6%. One patient died. The proportion of those who presented late (more than a year after developing a complication) was noted to be higher in those traditionally circumcised (37.5%) compared to those medically circumcised (21.9%; P=.475). Complications from medical circumcision occurred most in dispensaries (71.9%) and health centres(12.5%). Majority (91.7%) of complications were surgically managed.
Conclusion: Patients with circumcision complications in our setting present late to tertiary level hospitals and majority come with severe complications. Factors such as age at circumcision, place of circumcision and level of health facilities have an infl uence on outcome of circumcision. Surgery outcome study especially for challenging complications isneeded for our management evaluation.

Keywords: male circumcision, circumcision complications, health facilities, treatment.