Complications of male cultural circumcisions: A single site retrospective review in Eldoret, Kenya

Abstract

Background: Cultural male circumcision is a commonly performed procedure in Kenya as a rite of passage, often including cultural  initiation activities in addition to the surgical procedure. These procedures are often performed out of medical facilities due to cultural  requirements, and sometimes by untrained personnel in unsterile conditions resulting in serious complications. In recent years, there  have been increased reports of devastating post-cultural circumcision complications both in the media and in our hospital in Western  Kenya. This study describes our hospital’s experience with post-cultural circumcision related complications between 2014 and 2023. 

Methods: A retrospective chart review of male patients who presented to Moi Teaching and Referral Hospital in Eldoret, Kenya from 2014  to 2023 with cultural circumcision-related complications was performed.

Results: A total of 129 patients presented between 2014 and  2023, 81% of which presented between 2022 and 2023. Mean age of admission was 16 years (range 6 to 27), and most presented between  November and January each year. Complications included local and systemic infections, bleeding, and tetanus, as well as lower extremity wounds which were related to initiation activities after the circumcision. Mean hospital length of stay was 11.8 days and 14% of  patients required ICU-level care. There were 11 mortalities between 2022 and 2023.

Conclusion: While male circumcision is generally  considered a safe procedure, this study shows that male cultural circumcision in our region of Kenya can be associated with high  morbidity and mortality and further studies are needed to understand the true scope of this problem.