Related Experiment Video
Updated: Mar 29, 2026
Microscopic Replantation of Penile Glans Amputation Due to Circumcision
Published on: June 3, 2022
Readmission characteristics of elective pediatric circumcisions using large-scale administrative data
Joshua D Roth1, Alison C Keenan1, Aaron E Carroll2
1Department of Urology, Section of Pediatric Urology, Riley Hospital for Children at IU Health, 702 Barnhill Drive, Suite 4230, Indianapolis, IN 46202, USA.
Insights
Elective circumcision is generally safe, with low readmission (0.3%) and reoperation (0.1%) rates. However, 3.1% of patients have a follow-up visit within 7 days, often to the ER, which is important for family counseling.
Area of Science:
- Pediatric Surgery
- Public Health
Background:
- Elective circumcision is a common and generally safe pediatric procedure.
- Limited data exist on readmission and reoperation rates following elective circumcision.
Purpose of the Study:
- To determine the rates of readmission and reoperation within 7 days after elective circumcision.
- To provide accurate risk information for counseling families.
Main Methods:
- Analysis of the Pediatric Health Information System (PHIS) database from 2004 to 2013.
- Inclusion of 95,046 ambulatory, elective circumcisions (ICD-9 CM code 640).
- Logistic regression used to identify factors associated with readmission and reoperation.
Main Results:
- A total of 3.1% of patients had a subsequent encounter within 7 days; 0.3% were hospital admissions/observations, and 0.1% required reoperation.
- Black patients and those with Medicaid had higher rates of any follow-up encounter.
- Older age at circumcision (12-18 years) was linked to increased reoperation risk (OR 1.91).
Conclusions:
- Elective circumcision has low readmission (0.3%) and reoperation (0.1%) rates.
- A significant proportion (3.1%) seek further care within 7 days, primarily ER visits.
- These findings aid in counseling families about potential post-circumcision care needs.
Introduction And Background:
Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision.
Objective:
We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure.
Study Design:
The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status.
Results:
We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1%) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4%) of encounters were ER visits, and 253 (0.3%) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1%) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p < 0.001) and patients on Medicaid (OR 1.63, p < 0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children <1 year, with children 12-18 years old having an OR of 1.91 (p = 0.033).
Discussion:
We present a descriptive study of clinical events occurring at the same tertiary children's hospital within the first 7 days following more than 95,000 elective postneonatal circumcisions. Limitations include a cohort generated from a single set of ICD-9 codes, and a follow-up of 7 days.
Conclusion:
Elective circumcision remains a safe procedure with a readmission rate of 0.3%, and a reoperative rate of 0.1%. However, a relatively high percentage of patients (3.1%) will have a secondary encounter within the first 7 days following circumcision, most of them seeking care in an ER, although not necessarily for circumcision-related reasons. These may be useful data when counseling patients.
