Discovery of hypospadias during newborn circumcision should not preclude completion of the procedure

To test the hypothesis that completion of newborn circumcision does not complicate hypospadias repair, and that circumcision will minimize future operations.

Children referred for distal hypospadias over a 5-year period were grouped by presentation. Children with an aborted circumcision owing to concerns for hypospadias were subdivided into patients who underwent hypospadias repair (group 1a) and those who underwent circumcision (group 1b). Group 2 consisted of patients with a completed circumcision who underwent hypospadias repair. Children with traditionally recognized distal hypospadias served as controls.

A total of 93 newborns had an aborted newborn circumcision. Of these, 28 underwent hypospadias repair (group 1a), and 47 underwent circumcision completion under general anesthesia (group 1b). The remaining 18 either deferred surgery or underwent in-office circumcision. Ten patients with hypospadias and an intact prepuce had a completed circumcision and subsequently underwent repair (group 2). The control group comprised 151 patients. No patients with a completed circumcision experienced complications after hypospadias repair, whereas the control group had a 5.3% rate of complications.

Performing circumcision in newborns with hypospadias and an intact prepuce did not affect repair or the risk of complications. These findings, along with previous results, demonstrate that newborn circumcision can be safely completed in children with an intact prepuce. Furthermore, aborting a newborn circumcision after dorsal slit will expose a substantial number of children to additional procedures under general anesthesia.