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Circumcision: perspective in a Nigerian teaching hospital
L O Abdur-Rahman1, A A Nasir, J O Adeniran
1Department of Surgery, Paediatric Surgery Unit, University of Ilorin; University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Insights
Hospital-based male circumcision is common in Nigerian infants, with most procedures occurring in the neonatal period. However, the low rate of anesthesia use during these circumcisions is a significant concern.
Area of Science:
- Paediatric Surgery
- Urology
Background:
- Male circumcision practices are influenced by cultural, religious, and socioeconomic factors.
- Hospital-based circumcision is increasingly accepted due to ongoing debates on its benefits and risks.
Purpose of the Study:
- To evaluate the demographics, indications, methods, anesthesia use, and outcomes of male circumcision.
- Focus on a tertiary health center in Nigeria.
Main Methods:
- Retrospective review of male circumcision cases from January 2002 to December 2007.
- Data analysis using SPSS software version 15.
Main Results:
- 438 boys studied; 46% were neonates (under 29 days), 72.6% circumcised by 3 months.
- Major indications: religion/tradition (87.7%), phimosis (8.7%). Plastibel™ (48.9%) and classical circumcision (44.2%) were common methods.
- Anesthesia administered in only 39.7%; complication rate was 6.7%.
Conclusions:
- Neonatal circumcision is prevalent in hospital settings, with appropriate device use observed.
- The low rate of anesthesia administration during male circumcision is unacceptable and requires attention.
Background:
The practice and pattern of male infants circumcised is influenced by culture, religion and socio-economic classification. The debate about the benefits and risks of circumcision has made a hospital-based practice the most acceptable.
Objective:
The objective of this study is to evaluate the ages, indications, co-morbidity, types and methods of circumcision, usage and mode of anaesthesia and outcome of male circumcision at a tertiary health centre in Nigeria.
Materials And Methods:
A retrospective review of male circumcision in a paediatric surgery unit was done from January 2002 to December 2007. The data was analysed using SPSS software version 15.
Results:
There were 438 boys with age ranged between 6 days and 10 years (median 28 days, mean 53.6 days standard deviation 74.2). Neonatal circumcision (<29 days) was 201 (46%) and 318 (72.6%) of the children were circumcised by the 3 rd month of live. Religion or tradition were the major indicators in 384 (87.7%) patients while phimosis 38 (8.7%), paraphimosis 4 (1%), redundant post circumcision skin 10 (2.3%) and defective prepuce in 2 (0.5%) were other indications. Plastibel™ (PD) was used in 214 (48.9%), classical circumcision 194 (44.2%), guillotine technique (GT) and Gomco™ 10 (2.3%) cases each while 10 (2.3%) had a refashioning/re-excision post previous circumcision. There was an increase in use of PD, drop in the use of GT; and increase in the number of circumcision done over the years. Only 39.7% had anaesthesia administered and complication rate was 6.7%.
Conclusion:
Neonatal circumcision was highest in the hospital-based circumcision practice, which allowed the expected ideals in the use of devices in a tertiary health centre. However, the low rate of anaesthetic use is unacceptable.
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