Circumcision mishaps: A continuing challenge in the developing countries

Abstract

Objective: Circumcision has been described as the most commonly performed surgical operation in the boys and is probably the oldest surgical procedure in man. This prospective study was aimed at establishing the pattern, treatment outcome and cost of major complications of neonatal circumcision seen in a tertiary center in Nigeria.

Methods: Consecutive cases of complications of circumcision presenting at the Paediatric Outpatient Department in a tertiary centre in Nigeria were prospectively studied over a period of 3 and half years from July 2003 to December 2006. Information regarding the age of the patient, time of circumcision, the surgeon, place of circumcision was recorded as well as the type of mishap; outcome and cost of management were noted.

Results: Forty five patients with major complications of circumcision representing 6.2% of the patients. Their age at presentation ranged between 2 weeks to 10 years (Median = 3months). All the patients were circumcised during the neonatal period. The commonest complication reported is urethro-cutaneous fistula in 25 (56%), Meatal Stenosis in 4(8.9%), Severe bleeding in 4(8.9%), Epidermoid cyst in 3 (6.7%), and 2 (4.4%) cases each of Buried penis, penile amputation, penile degloving with glans amputation, glanular adhesions and redundant prepuce respectively. The cost of treatment for the repairs varies from 4500 -35,000NGN (40-305 Dollars)

Conclusion: The prevalence of complications of circumcision is high in our environment.