Severity of malcircumcisions and circumcision-related complications in three tertiary health facilities in Southern Nigeria

Abstract

Background: Complications following circumcision are well recognized. In our environment, it is relatively common and frequently encountered in pediatric surgical practice. While some may be easily corrected others may be more tasking and even life threatening. There is need to identify the serious complications, and to proffer ways of preventing them or managing them when they occur. We aimed to evaluate the spectrum of malcircumcision and circumcision related complications in our region and to identify the major challenging ones.

Patients and methods: Data was prospectively obtained from all male children presenting with malcircumcisions or circumcision related complications in three tertiary health facilities in southern Nigeria between June 2006 and May 2013. Data included complication presented, age, circumcisionist, method of circumcision, treatment offered, outcome.

Results: A total of 126 male children with 143 malcircumcisions or complicated circumcisions were seen within the period. The spectrum ranged from minor glandular adhesions to penile amputation and life
threatening excessive bleeding. Procedures Included: manual removal of plastibell, suture ligation of bleeding vessel, adhesiolysis, preputial trimming, meatoplasty, urethroplasty, fistuloplasty, glanuloplasty and penile repair. Most tasking were urethral loss, fistula closure and glanular amputation. There were no deaths.

Conclusion: Circumcision related complications are common in our region. Penile amputation, urethral loss, and fistulae are the most challenging complications. There is need to educate the health workers and general public on the hazard of untrained circumcisionists.

Keywords: circumcision, complications, severity, management