Childhood Circumcision, Indications & Complications

Abstract

Circumcision is the most commonly performed operation in males worldwide & is an integral part of several religions like Islam & Judaism. Medical indications of circumcision are a few. Circumcision is contraindicated in a number of congenital penile disorders, including hypospadias, epispadias, chordee, buried penis & micropenis. Various techniques are available for performing circumcision. Complications include haemorrhage, infection, and meatal injury resulting in stenosis, removal of incorrect amount of skin, penile injury, urethral injury& painful scarring. However many of these complications can be prevented by using precise surgical techniques, meticulous asepsis & haemostasis. Objectives: To note indications, age of children & complications developing after circumcision. Patients & Methods: The study was conducted in the Surgical Department of Ch. Rahmat Ali Memorial Hospital, Township, Lahore, from Jan 2009 to Dec 2011. A total of 1000 cases were   included in the study. Results: 860 (86%) children had circumcision performed in the surgical department & 140(14%) were referred to our unit after circumcision performed by quacks, barbers & general practitioners, after developing some complications. Ritual (religious) circumcision was done in 936 (93.6%). 64 (6.4%) had medical indications. Out of 936, 815 (87%) were Muslims & 121 (13%) were non Muslims. 64 (6.4%) children were circumcised because of medical indications, mainly phimosis & paraphimosis. 140 (14%) children were referred to our unit because of complications, mainly bleeding in 34 (24%), infection in 20 (14.2%), under circumcision in 85 (60.7%) & excessive removal of skin in 1 (0.7%) child. The only complication which occurred in children operated in the hospital was infection in 6 (0.7%) children. Ages of the children were: Less than 1 month- 208 (20.8%), 1 to 12 months- 655 (65.5%), 1to 5 years- 110 (11%), More than 5 years- 27 (2.7%).